头针配合吞咽言语诊治仪治疗卒中后吞咽障碍的临床观察

Clinical Observation of Scalp Acupuncture Combined with Swallowing and Speech Therapeutic Instrument for Treatment of Post-stroke Dysphagia

【目的】观察头针结合吞咽言语诊治仪对脑卒中后患者吞咽功能障碍的临床疗效。【方法】将68例患者随机分为治疗组和对照组,每组各34例。2组患者均接受降脂稳斑、营养神经等内科常规基础治疗和康复训练,在此基础上,治疗组给予头针联合吞咽言语诊治仪治疗,对照组单纯给予吞咽言语诊治仪治疗。2组均以2周为1个疗程,共治疗2个疗程。依据标准吞咽功能评分(SSA)、吞咽障碍特异性生活质量量表(SWAL-QOL)分别于治疗前后对2组患者进行评分及比较,并根据才藤氏吞咽障碍7级评价法进行疗效估算。【结果】(1)完成试验情况:至观察结束时,68例患者中有7例因转科、失访等原因予以剔除。其中,治疗组剔除3例,对照组剔除4例。(2)临床疗效情况:治疗组总有效率为90.32%,对照组为66.67%,治疗组疗效优于对照组,差异有统计学意义(P<0.05)。(3)量表评分情况:治疗后,2组患者的SSA评分均下降(P<0.01),SWAL-QOL评分均升高(P<0.01),且治疗组对SSA评分的下降作用和对SWAL-QOL评分的升高作用均优于对照组,差异均有统计学意义(P<0.01)。【结论】2组均能改善吞咽障碍、提高患者生活质量,但头针结合吞咽言语诊疗仪对脑卒中后吞咽功能障碍的治疗效果更优。

Objective To observe the clinical effect of scalp acupuncture combined with swallowing and speech therapeutic instrument for the treatment of post-stroke dysphagia. Methods Sixty-eight patients with post-stroke dysphagia were randomly divided into treatment group（N = 34） and control group（N = 34）. Both groups were given the internal medicine treatment for lowering blood lipids,stabilizing plaque,and nourishing nerves,and took rehabilitation training. And additionally,the treatment group was given scalp acupuncture therapy and the treatment with swallowing and speech therapeutic instrument,and the control group was given the treatment with s wallowing speech therapeutic instrument alone. Two weeks constituted one treatment course,and the two groups were treated for 4 weeks. The scores of Standardized Swallowing Assessment（SSA） and Swallowing Quality of Life Instrument（SWAL-QOL） of the two groups were observed before and after treatment, and then the curative effects were evaluated by Saito 7-grade dysphagia assessment method. Results（1） Till the end of the trial,7 cases of the 68 patients were excluded for transferring to other departments or loss to follow-up. Of the 7 excluded cases, 3 cases were from the treatment group and 4 were from the control group.（2） The total effective rate of the treatment group was 90.32% and that of the control group was 66.67%,the difference being significant（P〈0.05）.（3） After treatment,SSA scores of the 2 groups were decreased（P〈0.01） and SWALQOL scores were increased（P〈0.01）,and the effect on improving SSA scores and SWAL-QOL scores in the treatment group was superior to that in the control group（P〈0.01）. Conclusion Both groups can relieve dysphagia and improve the quality of life of post-stroke dysphagia patients,and the scalp acupuncture combined with swallowing and speech therapeutic instrument is more effective for the treatment of post-stroke dysphagia.