启咽汤治疗缺血性脑卒中后吞咽障碍临床研究

Clinical Study of Qiyan Tang for Dysphagia after Ischemic Stroke

目的:观察启咽汤治疗缺血性脑卒中后吞咽障碍的临床疗效。方法:将120例缺血性脑卒中后并发吞咽障碍患者随机分为对照组和治疗组各60例。2组均予脑卒中内科常规治疗,同时采用通脑活络法针刺及吞咽训练进行治疗,治疗组在此基础上加用中药启咽汤口服或鼻饲治疗,治疗前后对患者进行洼田饮水试验评分、神经功能缺损评分(NIHSS)、Barthel(BI)指数及中医症状评分的评定,并评价临床疗效。结果:治疗组总有效率为95.0%,高于对照组的80.0%,差异有统计学意义(P<0.05)。治疗前,2组洼田饮水试验评分、NIHSS、BI指数、中医症状评分相比,差异均无统计学意义(P>0.05)。疗程结束后,2组洼田饮水试验评分、NIHSS及中医症状评分均较治疗前下调,BI指数则提高,差异均有统计学意义(P<0.05,P<0.01);与对照组相比,治疗组洼田饮水试验评分、NIHSS、BI指数及中医症状评分改善更加明显,差异均有统计学意义(P<0.05,P<0.01)。结论:启咽汤口服配合常规西药、通脑活络法针刺及吞咽训练治疗缺血性脑卒中后吞咽障碍,能明显缓解临床症状,恢复患者的吞咽功能,提高生存质量。

Objective：To observe the clinical effect of Qiyan tang for dysphagia after ischemic stroke. Methods：Divided120 cases of patients with dysphagia after ischemic stroke into the control group and the treatment group randomly,60 cases in each group. The stroke conventional therapy of medical department was given to both groups, at the same time use Tongnao Huoluo acupuncture and swallow train for treatment,the treatment group received therapy of Qiyan tang orally or nasogastrically. Sub- water test score, neurologic impairment score（NIHSS）, Barthel index（BI） and Chinese medicine symptom score before and after treatment were observed,and clinical effect was evaluated. Results：The total effective rate in the treatment group was 95.0%,which was higher than 80.0% of the control group obviously（P 〈0.05）. Comparing scores of sub- water test, NIHSS, BI, Chinese medicine symptom scores of both groups before treatment, there was no significant difference（P 〉0.05）. After treatment,scores of sub- water test,NIHSS,BI,and Chinese medicine symptom scores of both groups were all lower than those before treatment, scores of BI were higher than that before treatment,differences being significant（P 〈0.05,P 〈0.01）. The scores of sub- water test,NIHSS,BI,and traditional Chinese medicine symptom scores in the treatment group were improved more obviously than those in the control group（P 〈0.05,P 〈0.01）.Conclusion： The therapy of Qiyan tang combined with Tongnao Huoluo acupuncture and swallow train for dysphagia after ischemic stroke can relieve clinical symptom obviously,recover swallowing function of patients,and improve life quality.