双侧头针结合体针治疗脑卒中后假性延髓麻痹疗效观察

Therapeutic Observation of Acupuncture at Bilateral Scalp Acupoints plus Needling Trunk Acupoints for Post-stroke Pseudobulbar Palsy

目的观察双侧头针结合体针及康复训练治疗脑卒中后假性延髓麻痹的临床疗效。方法将80例假性延髓麻痹患者随机分为治疗组和对照组,每组40例。治疗组采用双侧头针结合体针配合康复训练,对照组仅采用体针及康复训练,治疗前后进行洼田氏饮水试验评分、VFSS评分、营养评分及疗效比较。结果与治疗前比较,两组患者洼田饮水积分均有明显改善(P<0.05);治疗组治疗后洼田饮水积分低于对照组(P<0.05)。两组患者治疗后VFSS评分均有明显改善(P<0.05);治疗组治疗后VFSS评分高于对照组(P<0.05)。治疗组总有效率(87.5%)明显优于对照组(60.0%)(P<0.05)。两组治疗后3个月营养评分明显升高(P<0.05);治疗组治疗后3个月营养评分高于对照组(P<0.05)。结论采用双侧头针联合体针及康复训练能明显改善脑卒中后假性延髓麻痹的吞咽功能。

Objective To observe the clinical efficacy of acupuncture at bilateral scalp acupoints plus needling trunk acupoints and rehabilitation training in treating post-stroke pseudobulbar palsy. Method Eighty patients with pseudobulbar palsy were randomized into a treatment group and a control group, with 40 cases in each group. The treatment group was intervened by acupuncture at bilateral scalp acupoints plus needling trunk acupoints and rehabilitation training, while the control group was only given acupuncture at trunk acupoints plus rehabilitation training. Kubota’s water drinking test, videofluoroscopic swallowing study （VFSS）, nutrition score and therapeutic efficacy were compared. Result The Kubota’s water drinking test scores improved significantly after the intervention in the two groups （P〈0.05）; the score in the treatment group was lower than that in the control group after the treatment （P〈0.05）. The VFSS scores improved significantly after the intervention in both groups （P〈0.05）; the score in the treatment group was higher than that in the control group after the treatment （P〈0.05）. The total effective rate of the treatment group （87.5%） was markedly higher than that of the control group （60.0%） （P〈0.05）. Three months after the intervention, the nutrition scores increased significantly in the two groups （P〈0.05）; the nutrition score in the treatment group was higher than that in the control group at this time point （P〈0.05）. Conclusion Acupuncture at bilateral scalp acupoints plus needling trunk acupoints and rehabilitation training can significantly improve the deglutition function in post-stroke pseudobulbar palsy.