传统针刺法与深刺法对老年中风后吞咽障碍的临床疗效评价

Evaluation on clinical effect of traditional acupuncture and acupuncture with long needle method on dysphagia after stroke in elderly patients

目的评价传统针刺法与深刺法对老年中风后吞咽障碍的临床疗效。方法选取2013年9月~2014年4月于广东省人民医院住院的60例脑卒中后吞咽障碍患者,将其随机分为两组,治疗组（深刺法结合康复训练）30例,对照组（传统针刺结合康复训练）30例。治疗后评价疗效,比较两组患者的X线吞咽造影检查（VFSS）评分以及洼田饮水试验评分,记录两组不良反应。结果治疗组总有效率为90.0%,高于对照组的80.0%,但两组总有效率比较差异无统计学意义（P〉0.05）;两组治疗后洼田饮水试验评级均较治疗前显著改善（P〈0.05）,且治疗组优于对照组,差异有统计学意义（P〈0.05）。两组治疗后VFSS评分优于治疗前（P〈0.05或P〈0.01）,且治疗组优于对照组（除误咽、点头吞咽外）,差异有统计学意义（P〈0.05或P〈0.01）。两组不良反应发生率比较,差异无统计学意义（P〉0.05）。结论深刺法结合康复训练治疗卒中后吞咽障碍效果优于传统针刺法,可有效改善患者的吞咽功能,针刺操作安全,适于进一步推广应用。

Objective To evaluate the clinical effect of traditional acupuncture and acupuncture with long needle method on dysphagia after stroke in elderly patients. Methods Sixty cases of dysphagia after stroke in Guangdong General Hospital from September 2013 to April 2014 were selected, and randomly divided into two groups： the treatment group（acupuncture with long needle combined with rehabilitation training） and control group（traditional acupuncture combined with rehabilitation training）, each group with 30 cases. After treatment, the therapeutic effect was evaluated, the videofluoroscopic swallowing study（VFSS） scores, drinking water test scores of the two groups were compared, and the adverse reactions of the two groups were recorded. Results The total effective rate of treatment group was 90.0%, which was higher than that of control group（80.0%）, while there was no significant difference in efficiency between the two groups（P〉 0.05）. The evaluation of drinking water test in two groups after treatment were significantly improved compared with before treatment（P 〈 0.05）, and the treatment group was better than the control group, the difference was statistically significant（P 〈 0.05）. After treatment, the VFSS scores of two groups were better than before treatment（P〈 0.05 or P 〈 0.01）, and the treatment group was better than the control group（except for the aspiration and nod swallowing）, the differences were statistically significant（P 〈 0.05 or P〈 0.01）. The differences of the incidence of adverse events between the two groups were not statistically significant（P〉 0.05）. Conclusion The effect of acupuncture with long needle combined with rehabilitation training in the treatment of dysphagia after stroke is superior to the traditional acupuncture method, which can effectively improve the swallowing function of patients, has safe acupuncture operation, and it is suitable for further popularization and application.