头针、舌针联合康复训练治疗脑卒中后吞咽障碍疗效研究

Efficacy of scalp acupuncture and tongue acupuncture combined with rehabilitation training on dysphagia after cerebral stroke

目的:分析头针、舌针联合康复训练对脑卒中后吞咽障碍的疗效。方法:将60例脑卒中后吞咽障碍患者依密封信封法等比例分为观察组与对照组,各30例,对照组予以康复训练治疗,观察组予以头针、舌针联合康复训练治疗,比较两组治疗效果,中医症状(进食呛咳、饮水呛咳、口角流涎、食物滞留、声嘶舌謇)积分,洼田氏饮水试验评分,藤岛一郎吞咽疗效评分,吞咽困难,生活质量(SWAL-QOL)评分的变化情况。结果:治疗后,观察组治疗效果较对照组显著提升(P<0.05),两组进食呛咳、饮水呛咳、口角流涎、食物滞留、声嘶舌謇积分均明显降低(P<0.05),且观察组降低幅度更大(P<0.05)。两组洼田氏饮水试验评分在治疗后3周、6周依次显著降低(P<0.05),且观察组变化幅度大于对照组(P<0.05),两组藤岛一郎吞咽疗效评分在治疗后3周、6周依次显著升高(P<0.05),且观察组变化幅度大于对照组(P<0.05)。两组SWAL-QOL评分得到明显改善(P<0.05),且观察组变化幅度更大(P<0.05)。结论:头针、舌针联合康复训练治疗脑卒中后吞咽障碍,能够明显提高临床治疗效果,改善患者吞咽障碍,提升生活质量。

Objective:To analyze and observe the efficacy of scalp acupuncture and tongue acupuncture combined rehabilitation training on dysphagia after cerebral stroke.Methods:60 patients with dysphagia after cerebral stroke were divided into observation group and control group according to the sealed envelope method,with 30 cases in each group.Control group was given rehabilitation training,and observation group was given scalp acupuncture and tongue acupuncture combined with rehabilitation training.The treatment effects,TCM symptoms(feeding bucking,drinking bucking,slobbering,food retention,hoarseness and tongue retraction) scores,Watian drinking water test score,Fujishima Ichiro swallowing response evaluation criteria and dysphagia quality of life(SWAL-QOL) score were compared between the two groups.Results:After treatment,the treatment effects in observation group were significantly improved compared with those in control group(P<0.05).The scores of feeding bucking,drinking bucking,slobbering,food retention and hoarseness and tongue retraction in the two groups were significantly decreased(P<0.05),and the decreases were greater in observation group(P<0.05).The score of Watian drinking water test in the two groups was decreased significantly at 3 w and 6 w after treatment in turn(P<0.05),and the change in observation group was greater than that in control group(P<0.05).The score of Fujishima Ichiro swallowing response evaluation criteria in the two groups was increased significantly at 3 w and 6 w after treatment in turn(P<0.05),and the change in observation group was greater than that in control group(P<0.05).The SWAL-QOL score in the two groups was significantly improved(P<0.05),and the change in observation group was greater(P<0.05).Conclusion:Scalp acupuncture and tongue acupuncture combined with rehabilitation training for dysphagia after cerebral stroke can significantly enhance the clinical treatment effects,improve the dysphagia and promote the quality of life.