针刺颈项部腧穴治疗儿童病毒性脑炎吞咽障碍的临床研究

A Clinical Study on Viral Encephalitis in Children With Dysphagia by Acupuncture on the Neck Acupoints

目的:通过观察针刺颈项部腧穴治疗儿童病毒性脑炎后合并吞咽障碍的临床疗效,以1周为时间窗,对干预时间进行疗效相关因素分析,为儿童病毒性脑炎后吞咽障碍的早期康复干预提供临床证据。方法:59例病毒性脑炎合并吞咽障碍的患儿按就诊顺序随机分为针刺组(30例)与吞咽训练组(29例),治疗时间为8周,分别采用Sheppard吞咽障碍调查问卷(DDS评分)、才藤荣一吞咽障碍7级评价法于治疗前、后进行疗效评价。干预时间评估以1周为时间窗,按干预时间(<1周及>1周)分为两组,疗效因素相关分析用DDS评分、才藤荣一吞咽障碍7级评价法的改善程度进行比较。结果:两组患儿治疗前评价,DDS评分、才藤荣一吞咽障碍7级评定差异均无统计学意义(P>0.05);治疗后评价,组内治疗前后DDS评分、才藤荣一吞咽障碍7级评定差异有统计学意义(P<0.05);组间比较,DDS评分差值及才藤荣一吞咽障碍7级评定差值差异有统计学意义(P<0.05)。两组患儿疗效比较,差异无统计学意义(P>0.05)。干预时间因素分析,<1周与>1周在DDS评分差值及才藤荣一吞咽障碍7级评定差值差异有统计学意义(P<0.05)。结论:针刺颈项部腧穴能改善病毒性脑炎合并吞咽障碍患儿的DDS评分与才藤荣一吞咽障碍评定分级,促进患儿吞咽功能的恢复。疗效评价与干预时机呈正相关,干预越早(<1周),疗效越好。

Objective： To observe the curative effects of acupuncture therapy on the neck acupoints in treating the children＇s viral encephalitis with dysphagia. Then we do the analysis of the correlated influence factors with intervention time. Method： The 59 cases with viral encephalitis （VE） in children with dysphagia were randomized into the treatment group （30 eases） and the control group （29 cases）. Both of the groups were treated for 8 weeks. The curative effects were evaluated before and after the treatment by the methods of dysphagia disorders survey （DDS） and the Saito 7 grades of swallowing disorder. The analysis of relevant factors of affecting curative effect was done by invention time, which determined 1 week as the invention time-window, using the evaluation of the improvement of the DDS and the Satio 7 grades of swallowing disorder. Result： There was no statistically significantly difference between the two groups on DDS scoring pre-treated and atio 7 grades of swallowing disorder （P〉0.05）. The DDS scoring and atio 7 grades of swallowing disorder of both groups were significantly improved （P〈0.05）, and the treatment group was superior to the control group （P〈0.05）. The difference between the two groups on curative effect not statistically significant （P〉0.05）. There was no significant difference by statistical analysis （P〉0.05）. There was statistically significantly difference on the improvement of the DDS and the Satio 7 grades of swallowing disorder at the invention time-window below and above, and the former is superior to the latter （P〈0.05）. Conclusion： Acupuncture therapy on the neck acupoints can effectively improve the swallowing function of the viral encephalitis children with dysphagia; the earlier intervention （〈1 week） can achieve a better curative effect,and can be applied to the clinical practice.