深刺廉泉为主配合吞咽康复训练治疗脑卒中后吞咽功能障碍临床研究

The clinical efficacy of deep acupuncture atLianquan （CV23） combined with swallowing rehabilitation training on dysphagia after stroke

目的 评价深刺廉泉为主配合吞咽康复训练治疗脑卒中后吞咽功能障碍的疗效.方法 将符合入选标准的84例脑卒中后吞咽功能障碍患者,采用随机数字表法分为2组,每组42例.对照组接受吞咽康复训练,观察组在对照组基础上配合深刺廉泉为主的治疗.2组均连续治疗3周.采用吞咽困难评价量表（videofluoroscopy swallowing study,VFSS）评估患者的吞咽功能,评价临床疗效.结果 观察组痊愈率为69.1%（29/42）、总有效率为85.7%（36/42）,对照组分别为42.9%（18/42）、66.7%（28/42）,2组痊愈率、总有效率比较,差异均有统计学意义（χ2值分别为5.845、4.200,P值分别为0.016、0.040）.治疗后,观察组VFSS评分[（7.43±2.27）分比（4.31±1.53）分,t=5.433]高于对照组（P〈0.05）.观察组29例痊愈患者治疗时间为（12.0±3.0）d、对照组18例痊愈患者治疗时间为（17.8±2.2）d,2组比较差异有统计学意义（t=7.094,P=0.001）.结论 深刺廉泉为主配合吞咽康复训练可改善脑卒中后吞咽功能障碍患者的吞咽功能,缩短吞咽功能障碍的恢复时间,提高临床疗效.

Objective To evaluate the clinical effect of deep acupuncture at Lianquan （CV23） combined with swallowing rehabilitation training in the treatment of dysphagia after stroke.Methods A total of 84 patients with dysphagia after stroke who met the inclusion criteria were divided into 2 groups, 42 in each. The control group received swallowing rehabilitation training, and the observation group was treated with acupuncture therapy based on deep acupuncture atLianquan （CV23） combined with swallowing rehabilitation training. The VFSS score and clinical efficacy were compared between the 2 groups before and after treatment.Results The cure rate of observation group was 69.1% （29/42）, the total effective rate 85.7% （36/42）, while the control group were 42.86% （18/42） and 66.67% （28/42）. The comparison of cure rate and total efficiency rate between the two group had statistically significant differences （χ2=5.845, 4.200,P=0.016, 0.040）. After treatment, the VFSS score of the observation group was significantly higher than that of the control group （7.43 ± 2.27vs.4.31 ± 1.53;t=5.433, P〈0.05）. The recovery time of the 29 cured patients in the observation group was （12.0 ± 3.0） d, while the recovery time of the 18 cured patients in the control group was （17.8 ± 2.2） d. There was statistically significant difference between the 2 groups （t=7.094,P=0.001）.Conclusions Deep acupuncture at Lianquan （CV23） combined with swallowing rehabilitation training can improve the swallowing function of patients with dysphagia after stroke, shorten the recovery time of swallowing function and improve the clinical efficacy.