以电针颈夹脊穴为主治疗脑卒中后吞咽障碍疗效观察

Therapeutic Observation of Electroacupuncture at Cervical Jiaji Points (EX-B2) as the Main Treatment for Deglutition Disorders After Cerebral Stroke

目的观察电针颈夹脊穴为主配合吞咽康复训练与单纯吞咽康复训练在脑卒中后吞咽障碍康复中临床疗效的差异。方法将70例患者随机分为观察组(35例)、对照组(35例),观察组脱落1例。两组患者均在病情稳定后行吞咽康复训练,观察组吞咽康复训练前接受针刺治疗,选穴以颈_(2-6)夹脊穴为主,配风池、廉泉,电针选断续波,频率5 Hz,留针30 min,每日1次,连续治疗5 d后休息2 d,2周为1个疗程,共治疗2个疗程。于治疗前及治疗1周、2周、4周后分别根据洼田吞咽能力评定记录吞咽能力分级,比较两组临床疗效。结果治疗1周、2周后,两组总有效率比较差异无统计学意义(P>0.05)。治疗4周后总有效率比较差异有统计学意义(P<0.05),观察组优于对照组。结论以电针颈夹脊穴为主配合吞咽康复训练治疗脑卒中后吞咽障碍安全、有效,且疗效优于单纯吞咽康复训练。

Objective To observe the difference in the therapeutic efficacy between electroacupuncture at cervical Jiaji points（EX-B2） plus swallowing rehabilitation training and swallowing rehabilitation training alone in treating deglutition disorders after cerebral stroke. Method Seventy patients were randomized into an observation group（35 cases） and a control group（35 cases）, with one case dropped out in the observation group. The two groups of patients all began to receive swallowing training based on a stable disease condition. The observation group was intervened by acupuncture prior to swallowing training by selecting Jiaji points of C（2-6） plus Fengchi（GB20） and Lianquan（CV23）, with intermittent wave and 5 Hz chosen as the electroacupuncture parameters. The needles were retained for 30 min, and the treatment was given once a day with a 2-day interval after successive 5-day treatment, for 2 courses in total. Before the treatment, and respectively after 1-week, 2-week and 4-week treatment, the deglutition ability was recorded based on Kubota＇s water swallowing test, and the clinical efficacies were compared between the two groups. Result There were no significant differences in the total effective rate between the two groups after 1-week and 2-week treatment（P0.05）. There was a significant difference in the total effective rate between the two groups after 4-week treatment（P0.05）, and the observation group was superior to the control group. Conclusion Electroacupuncture at cervical Jiaji points plus swallowing rehabilitation training is safe and effective in treating deglutition disorders after cerebral stroke, and it can produce a more significant efficacy than swallowing rehabilitation training alone.