“项针”联合康复训练治疗脑卒中后假性球麻痹临床观察

Clinical Observation of Nape Acupuncture plus Rehabilitation Training in Treating Pseudobulbar Palsy After Cerebral Stroke

目的观察"项针"联合基础治疗和康复训练治疗脑卒中后假性球麻痹的临床疗效及其与发病年龄的关系。方法将100例患者随机分为观察组和对照组,每组50例,对照组给予基础治疗和吞咽康复训练,观察组在对照组基础上结合"项针"治疗,每日1次,每星期5次,治疗8星期。观察两组治疗前后的反复唾液吞咽测试(RSST)、洼田氏饮水试验(WST)、标准吞咽功能评分(SSA)变化;观察患者发病年龄与"项针"联合基础治疗和吞咽康复训练疗效的关系。结果两组治疗后RSST、SSA评分及WST分级均优于治疗前(P<0.01),且观察组治疗后各项评分及分级均优于对照组(P<0.01)。"项针"联合基础治疗和吞咽康复训练的疗效与患者的发病年龄有关(P<0.05)。结论 "项针"联合基础治疗和吞咽康复训练可有效改善脑卒中后假性球麻痹吞咽困难,且本法对51~60岁患者的疗效最佳,优于60岁以上的患者,且不劣于41~50岁患者。

Objective To observe the clinical efficacy of nape acupuncture plus basic treatment and rehabilitation in treating pseudobulbar palsy after cerebral stroke and the relation between the efficacy and age of onset. Method A hundred patients were randomized into an observation group and a control group, 50 cases each. The control group was intervened by basic treatment and swallowing rehabilitation training, and the observation group was intervened by nape acupuncture in addition to the treatment given to the control group, once a day, five sessions a week, for 8 weeks in total. The Repetitive Saliva Swallowing Test （RSST）, Water Swallowing Test （WST） and Standardized Swallowing Assessment （SSA） were observed in the two groups before and after the treatment; the relation between the age of onset and the efficacy of the integrated treatment method was also observed. Result The scores of RSST, SSA and WST were significantly improved after the treatment in both groups （P〈0.01）, and the improvements in the observation group were more significant than those in the control group （P〈0.01）. The therapeutic efficacy of nape acupuncture plus basic treatment and swallowing rehabilitation training was associated with the age of onset （P〈0.05）. Conclusion Nape acupuncture plus basic treatment and swallowing training can effectively improve dysphagia in pseudobulbar palsy after cerebral stroke. This method produces the most significant efficacy for patients aged 51-60, better than that for those aged over 60 and equivalent to the efficacy for patients aged 41-50.