针刺配合康复训练治疗中风后吞咽障碍临床观察

Clinical Observation of Acupuncture plus Rehabilitation Training for Post-stroke Deglutition Disorder

目的研究针刺阿呛组穴配合康复训练治疗中风后吞咽障碍的临床疗效。方法将90例中风后吞咽障碍患者随机分为治疗组和对照组,每组45例。在常规治疗基础上,对照组给予吞咽康复训练,治疗组在对照组治疗基础上采用针刺阿呛组穴(阿呛穴、治呛穴、吞咽穴、提咽穴和发音穴)为主进行治疗,均连续治疗3个疗程。比较两组治疗前后美国国立卫生院脑卒中神经功能缺损评分量表(NIHSS)、荧光透视吞咽检查(VFSS)和中风后吞咽障碍的中医评分量表(以下简称中医评分)的评分及相关并发症发生率。结果治疗组总有效率为97.8%,显著高于对照组的84.4%(P<0.05);治疗组治疗后NIHSS、VFSS和中医评分优于对照组(P<0.05);对照组患者发生并发症24例,治疗组8例,治疗组明显少于对照组(P<0.05)。结论针刺阿呛组穴为主配合康复训练可以有效改善中风后吞咽障碍,减低并发症的发生,具有良好的安全性和稳定性。

Objective To observe the clinical efficacy of needling a group of acupoints for choke plus rehabilitation training in treating post-stroke deglutition disorder. Method Ninety patients with post-stroke deglutition disorder were randomized into a treatment group and a control group, 45 cases in each group. In addition to the conventional treatment, the control group also received swallowing rehabilitation training, and the treatment group received acupuncture at a group of acupoints for choke as the major intervention （Aqiang point, Zhiqiang point, Tunyan point, Tiyan point and Fayin point, all extra） besides the intervention given to the control group, both for 3 successive treatment courses. Before and after the intervention, the National Institute of Health Stroke Scale （NIHSS）, Videofluoroscopic Study （VFSS）, post-stroke swallowing scale of traditional Chinese medicine （TCM） （TCM scale for short）, and the occurrence rate of relevant complications were compared between the two groups. Result The total effective rate was 97.8% in the treatment group, significantly higher than 84.4% in the control group （P〈0,05）; the scores of NIHSS, VFSS and TCM scale in the treatment group were superior to those in the control group （P〈0.05）; the NIHSS, VFSS and TCM scale scores in the treatment group were superior to those in the control group after the intervention （P〈0.05）; 24 cases in the control group presented complications versus 8 cases in the treatment group （P〈0.05）. Conclusion Acupuncture at the points group for choke predominantly plus rehabilitation training can effectively improve post-stroke deglutition disorder and reduce the occurrence of complications, with satisfactory safety and consistency.