穴位注射结合神经电刺激对脑卒中后吞咽障碍随机研究

Randomized Trial of Acupoint Injection plus Nerve Electrical Stimulation for Deglutition Disorders After Cerebral Stroke

目的观察穴位注射结合神经电刺激治疗脑卒中后吞咽障碍的临床疗效。方法将77例脑卒中后吞咽障碍患者随机分为电刺激组24例、水针组26例及综合组27例,分别予以Vitalstim电刺激治疗、甲钴胺穴位注射治疗及二者综合治疗,5 d为1个疗程,疗程间休息2 d,共治疗4个疗程。采用改良洼田饮水试验、标准吞咽功能评估表(SSA)分别于治疗前、治疗20 d后、治疗60 d后对各组进行疗效评价,比较各组疗效差异。结果经过20 d治疗,每组改良洼田饮水试验、SSA评分均较治疗前有显著性差异,其中综合组各评分均显著优于电刺激组及水针组。不过在治疗60 d后,3组各评分达到同一基线水平。结论 Vitalstim电刺激及甲钴胺穴位注射治疗对脑卒中后吞咽障碍均有治疗作用,且二者之间有协同作用,配合应用可以加快改善脑卒中吞咽障碍患者的吞咽功能。

Objective To observe the clinical efficacy of acupoint injection plus nerve electrical stimulation in treating deglutition disorders after cerebral stroke.Method Seventy-seven patients with deglutition disorders after cerebral stroke were randomized into an electrical stimulation group of 24 cases,a hydroacupuncture group of 26 cases,and a comprehensive group of 27 cases,to respectively receive Vitalstim electrical stimulation,acupoint injection of Mecobalamin,and both of the treatments,5 d as a treatment course,with 2-day interval between two courses,for 4 courses in total.The modified water-drinking test and Standardized Swallowing Assessment（SSA） were adopted to evaluate the therapeutic efficacy before the intervention,after 20-day treatment,and after 60-day treatment,and the therapeutic efficacies were compared.Result The modified water-drinking test and SSA scores were significantly changed in the three groups after 20-day treatment compared with that before the intervention,and the scores in the comprehensive group were superior to that of the electrical stimulation group and hydroacupuncture group.However,on the 60 th day,the scores were equivalent among the three groups.Conclusion The Vitalstim electrical stimulation and acupoint injection of Mecobalamin both can produce certain treatment effects for deglutition disorders after cerebral stroke;the two methods can work in a synergistic way and can boost the improvement of swallowing function.