项五针疗法治疗脑卒中吞咽障碍的临床研究

Clinical Research of Five-Needle-in-Nape Acupuncture in the Treatment of Stroke Dysphagia

目的观察项五针疗法治疗脑卒中吞咽障碍的临床疗效。方法选取100例脑卒中后吞咽障碍病人,随机分为对照组和观察组,每组50例。所有病人均采用抗凝、抗血小板聚集、改善脑循环、控制血压、调节血糖等脑卒中常规基础治疗及对症治疗。对照组采用单纯康复吞咽训练,观察组在常规治疗和康复吞咽训练的基础上给予项五针(廉泉、人迎、供血三穴五针)治疗,8周为1个疗程。治疗后采用电视荧光吞咽检查(VFSS)吞咽困难评价量表、洼田饮水试验、藤岛一郎吞咽障碍评分和改良的曼恩吞咽能力评估量表(MMASA)评价病人治疗前后吞咽障碍和吞咽能力的改善程度,并按照VFSS评分对两组病人的临床疗效进行评价。结果治疗前,两组VFSS量表评分、吞咽能力、藤岛一郎吞咽障碍评分、MMASA量表评分差异均无统计学意义(P>0.05)。治疗后,观察组VFSS评分明显优于对照组(P<0.05);洼田饮水试验吞咽能力级别显著低于对照组(P<0.05);藤岛一郎吞咽障碍评分明显高于对照组(P<0.05);MMASA量表吞咽能力评分明显高于对照组(P<0.05);观察组吞咽能力临床疗效明显优于对照组(P<0.05)。结论项五针疗法治疗脑卒中吞咽障碍,能够明显改善脑卒中病人吞咽障碍,恢复病人的吞咽能力,优于单用吞咽训练。

Objective To investigate the clinical efficacy of five-needle-in-nape acupuncture in the treatment of stroke dysphagia.Methods One hundred patients with dysphagia after stroke were randomly divided into control group and observation group,fifty cases in each group.The patients of the control group received routine swallowing training.The patients of the observation group were given five-needle-in-nape acupuncture on the basis of the control group.Eight weeks for a course of treatment.After treatment,the improvement degree of dysphagia and swallowing ability was assessed by video fluoroscopic swallowing study(VFSS)dysphagia rating scale,water swallow test,Fujishima Ichiro dysphagia score,and Mann improved swallowing ability assessment scale(MMASA).Results Before treatment,There was no significant difference in the scores of VFSS scale,water swallow test,Fujishima Ichiro dysphagia score,and MMASA between the two groups(P>0.05).After treatment,the VFSS score in the observation group was significantly better than that in the control group(P<0.05);the water swallow test capability level was significantly lower than that in the control group(P<0.05);Fujishima Ichiro dysphagia score was significantly higher than that in the control group(P<0.05);MMASA scale swallowing score was significantly higher than that in the control group(P<0.05);the improvement of swallowing ability in the observation group was significantly better than that in the control group(P<0.05).Conclusion Five-needle-in-nape acupuncture can significantly improved dysphagia of patients with stroke and restoring the patient's ability to swallow,which is better than routine swallowing training.