针刺治疗重症手足口病合并吞咽障碍12例临床观察

Clinical Observation of 12 cases of Acupuncture for Severe Hand-Foot-Mouth Disease Complicated with Dysphagia

目的:观察针刺治疗重症手足口病合并吞咽障碍临床疗效。方法:采用针刺治疗重症手足口病合并吞咽障碍患儿12例,选用风府、风池、哑门、颈夹肌穴、廉泉、夹廉泉、合谷、百会、足三里等穴,观察治疗前后Sheppard吞咽障碍调查问卷(DDS)、Kaup指数及临床疗效。结果:DDS评分治疗前平均(11.7±3.12)分,治疗后平均(3.07±2.87)分,差异有统计学意义(P<0.05),提示针刺能够明显改善患儿的吞咽功能。营养状况Kaup指数情况,治疗前营养正常率16.67%,治疗后正常率58.33%,营养状况治疗前后比较,差异有统计学意义(P<0.05),提示针刺能改善患儿吞咽功能,从而营养状况较前好转。临床疗效显效7例,显效率58.33%,有效4例,有效率33.33%,无效1例,无效率8.33%。总有效率91.67%。结论:针灸能改善患儿的吞咽功能,降低DDS评分,改善患儿的生活质量,提高临床治愈率。

Objective： To observe the clinical effect of acupuncture on treating severe hand-foot-mouth disease complicated with dysphagia. Methods：12 cases of children with severe hand-foot-mouth disease complicated with dysphagia were treated with acupuncture. Some acupoints were selected, such as Fengfu, Fengchi, Yamen, splenius cervicis point, Lianquan, Jialianquan, Hegu, Baihui, Zusanli and so on. Observed Dysphagia Disorders Survey（DDS）, Kaup indexes and the clinical effect before and after treatment. Results： DDS score was （11.7 ±3.12） before treatment, and was （3.07 ±2.87） after treatment, the difference being significant（P 〈 0.05）, which indicates that acupuncture can effectively improve the swallowing function of children. In terms of Kaup indexes, the normal nutritional rate was 16.67% before treatment, and was 58.33% after treatment, the difference being significant（P 〈 0.05）, which implies that acupuncture can improve the swallowing function of children so that the nutritional status becomes better than before. 7 cases had marked effect, the obvious effective rate being 58.33% ; 4 cases were effective, the effective rate being 33.33% ; 1 cases was ineffective, the effective rate being 8.33%. The total effective rate was 91.67%. Conclusion： The acupuncture therapy for severe hand-foot-mouth disease complicated with dysphagia can improve the swallowing function of children, reduce DDS scores, improve quality of life of children, and enhance the clinical cure rate.