舌针配合康复训练对脑卒中恢复期患者吞咽功能及肢体功能影响研究

Effect of Tongue Acupuncture Combined with Rehabilitation Training on Swallowing Function and Limb Function during Stroke Convalescence

目的:探讨舌针配合康复训练对脑卒中恢复期患者吞咽及肢体功能的影响。方法:将我院78例脑卒中恢复期患者随机分为对照组与联合组,各39例。急性期后对照组予系统康复训练治疗,联合组加用舌针治疗,每日1次,7天为1个疗程,休息1天,均连续治疗12个疗程。评估治疗前后吞咽功能、肢体运动功能、日常生活活动能力、可塑性相关蛋白,并比较临床疗效。结果:与治疗前比较,治疗后两组蛙田饮水试验分级降低(P<0.05),中文版吞咽功能评估量表(CUSS)评分升高(P<0.05),简式Fugl-Meyer量表(FMA)评分升高(P<0.05),Barthel指数(BI)评分升高(P<0.05),NGF、BDNF水平升高(P<0.01);与同时间对照组比较,治疗后1、2、3个月联合组蛙田饮水试验分级较低(P<0.01),CUSS评分较高(P<0.01),FMA评分较高(P<0.01),BI评分较高(P<0.01),NGF、BDNF水平较高(P<0.01),总有效率较高(P<0.01)。结论:早期应用舌针配合康复训练能最大程度恢复脑卒中恢复期患者吞咽功能及肢体运动功能,对预后具有积极意义。

Objective: To investigate the effect of tongue acupuncture combined with rehabilitation training on swallowing function and limb function during stroke convalescence. Methods: 78 patients met the inclusion criteria were randomly divided into the control group and the combination group, with 39 patients in each group. The control group was treated with rehabilitation training;on which basis, the combination group was also treated with tongue acupuncture. The treatment of tongue acupuncture was once per day for 12 courses with one day interval between each course, 7 days was taken as one course of treatment. The function of swallowing, limb movement and daily living were evaluated before and after the treatment, as well as the levels of plasticity- related proteins and the clinical efficacy were compared between the two groups. Results: The scores of Kubato water drinking test were lowered( P <0.05), the scores of Chinese evaluation version of swallowing function scale(CUSS), the scores of Fugl-Meyer(FMA) and Barthel index(BI) were increased( P <0.05), as well as the levels of NGF and BDNF were increased( P <0.01) after the treatment in the two groups. Compared to the control group, the scores of Kubato water drinking test were lowered( P <0.01), CUSS scores, FMA score, BI scores, levels of NGF and BDNF and the total efficiency was higher( P <0.01) in the combination group after one month, two months and three months of treatment. Conclusion: Tongue acupuncture combined with rehabilitation training can restore swallowing function and limb motor function in patients with stroke, and it has important positive significance for prognosis.