吞咽训练联合穴位按摩对脑卒中患者吞咽障碍的效果观察

Efficacy of Swallowing Training Combined with Acupoint Massage on Stroke Patients with Dysphagia

目的观察吞咽训练联合穴位按摩对脑卒中吞咽障碍的效果。方法将200例脑卒中吞咽障碍患者随机分为观察组和对照组各100例,均采用常规药物治疗和系统护理,对照组进行吞咽训练1个月;观察组在对照组的基础上进行按摩廉泉、天突、承浆、颊车、完骨穴位,每日3次,每次15 min,连续1个月。观察2组患者治疗前1 d、治疗2周末和1个月末洼田饮水试验得分以及治疗1个月之后的临床疗效。结果观察组洼田饮水试验得分优于对照组（F=20.216,P〈0.001）,其中治疗2周末、1个月末2个时点差异有统计学意义（P=0.007,P〈0.001）;治疗1个月之后,观察组总有效率明显高于对照组,差异有统计学意义（χ^2=35.526,P〈0.001）。结论吞咽训练联合穴位按摩可明显改善脑卒中患者的吞咽障碍,促进吞咽功能恢复,疗效明显优于单纯吞咽训练。

Objective To observe the efficacy of swallowing training combined with acupoint massage on stroke patients with dysphagia. Methods Two hundred stroke patients with dysphagia were randomly divided into observation group（ n=100） and control group（n=100）, and both groups were given conventional medication therapy and systematic nursing. In addition, swallowing training for a month was adopted in control group while swallowing training combined with acupoint massage by massaging Lianquan（CV23）,Tiantu（CV22）, Chengjiang（CV24）, Jiache（ST6） and Wangu（GB12） acupoints 15 minutes per time and 3 times per day for a month in observation group. The score of water swallow test 1 day before, 2 weeks and 1 month after the treatment and treatment efficacy 1month later were compared. Results The score of water swallow test in observation group was higher than that of control group（F=20.216, P〈0.001）and the scores at the end of 2 weeks and 1 month after the treatment were statistically significant（P=0.007, P〈0.001）.One month after the treatment, the total effective rate in observation group was apparently higher than that in control and there was statistical significance（χ^2=35.526, P〈0.001）. Conclusion Swallowing training combined with acupoint massage could obviously promote swallowing function to recover for stroke patients with dysphagia. The efficacy was superior to the simple swallowing training.