针刺兴奋法治疗脑卒中假性延髓麻痹吞咽障碍临床观察

Clinical Observation of Acupuncture-activating Method for Deglutition Disorder Due to Pseudobulbar Palsy After Cerebral Stroke

目的观察朱琏针刺兴奋法治疗脑卒中导致假性延髓麻痹吞咽障碍临床疗效。方法将60例脑卒中急性期假性延髓麻痹致吞咽障碍患者随机分为观察组、对照组,每组30例。两组均给予神经科相应治疗。两组患者均取廉泉、会厌、百会,率谷、完骨、照海、列缺、阴陵泉(均双侧穴位)。观察组给予朱琏针刺兴奋法刺激;对照组给予常规针刺后,接通G6805治疗仪,选疏密波,留针20 min。各组治疗开始前和治疗10个疗程结束后,均给予荧光透视吞咽检查评分(VFSS)和洼田饮水试验评分进行吞咽功能的评定。结果经过10个疗程治疗后,观察组总有效率为96.7%,对照组为83.3%,观察组与对照组比较差异具有统计学意义(P<0.05);观察组治疗后VFSS评分与对照组比较差异有统计学意义(P<0.01);观察组治疗后洼田饮水试验评分与对照组比较差异有统计学意义(P<0.01)。结论朱琏针刺兴奋法治疗脑卒中急性期假性延髓麻痹吞咽障碍,较使用电针疏密波效果明显。

Objective To observe the clinical efficacy of ZHU Lian＇s acupuncture-activating method in treating deglutition disorder due to pseudobulbar palsy after cerebral stroke. Method Sixty patients with deglutition disorder due to pseudobulbar palsy after cerebral stroke in acute stage were randomized into an observation group and a control group, 30 cases in each group. The two groups both received symptomatic neurological treatment. In the two groups, acupoints including Lianquan （CV23）, Huiyan （Extra）, Baihui （GV20）, and bilateral Shuaigu （GBS）, Wangu （GBI2）, Zhaohai （KI6）, Lieque （LUT）, and Yinlingquan （SP9） were selected. The observation group was intervened by ZHU Lian＇s acupuncture-activating method; the control group was intervened by ordinary needling method plus G6805 therapeutic appliance with sparse-dense wave for 20 rain. Prior to the treatment and after 10 treatment courses, the two groups were evaluated by using Videofluoroscopic Swallowing Study （VFSS） and Kubota＇s water drinking test for swallowing function. Result After 10 treatment courses, the total effective rate was 96.7% in the observation group versus 83.3% in the control group, and the between-group difference was statistically significant （P〈0.05）; the VFSS score in the observation group was significantly different from that in the control group （P〈0.01）; the water drinking test score in the observation group was significantly different from that in the control group （P＇〈0.01）. The results indicated that the therapeutic efficacy was more significant in the observation group compared to that in the control group. Conclusion ZHU Lian＇s acupuncture-activating method can produce a more significant efficacy in treating deglutition disorder due to pseudobulbar palsy after cerebral stroke in acute stage compared with sparse-dense-wave electroacupuncture.