三部开窍利咽针刺法联合辨证取穴对中风后假性延髓性麻痹吞咽困难患者吞咽功能及血清前白蛋白水平的影响

Effect of Sanbu Kaiqiao Liyan Acupuncture Combined with Acupoints Differentiation on Swallowing Function and Serum Prealbumin Level in Patients with Dysphagia due to Pseudobulbar Paralysis after Stroke

目的观察三部开窍利咽针刺法联合辨证取穴对中风后假性延髓性麻痹吞咽困难患者吞咽功能以及血清前白蛋白水平的影响。方法选择80例中风后假性延髓性麻痹吞咽困难患者,随机分为治疗组与对照组各40例。两组患者均给予常规药物治疗与基础针刺治疗,其中治疗组运用三部开窍利咽针刺法配合辨证取穴法进行治疗,每日施针1次,7 d为1疗程,共观察2个疗程。比较两组患者临床疗效以及治疗前后吞咽功能评分、洼田氏饮水试验分级、血清前白蛋白水平、不良反应情况。结果治疗组临床总有效率明显高于对照组(P <0.05)。治疗后,治疗组与对照组吞咽功能评分明显降低,且治疗组降低明显优于对照组(P <0.05);治疗组与对照组洼田氏饮水试验分级与治疗前比较明显改善,且治疗组分级明显优于对照组(P <0.05);治疗组与对照组血清前白蛋白水平明显升高,且治疗组升高明显优于对照组(P <0.05)。治疗组与对照组未出现明显的不良反应。结论对中风后假性延髓性麻痹吞咽困难患者应用三部开窍利咽针刺法联合辨证取穴治疗能够明显提高临床疗效,有效改善患者吞咽功能障碍,提高血清前白蛋白水平。

Objective:To investigate the effect of Sanbu Kaiqiao Liyan Acupuncture combined with acupoint differentiation on swallowing function and serum prealbumin level in patients with dysphagia due to pseudobulbar paralysis after stroke.Methods:80 patients were randomly divided into the treatment group and the control group,40 cases in each group.Two groups were given conventional drug treatment and basic acupuncture treatment.With the basic treatment,the treatment group were given Sanbu Kaiqiao Liyan Acupuncture combined with syndrome differentiation and acupoint selection,once a day,7 days as a treatment course,a total of 2 courses of observation.The clinical effect,swallowing function score,grade of water provocative test,serum prealbumin level and adverse reactions were compared before and after treatment.Results:The clinical effect of the treatment group was significantly higher than that of the control group(P<0.05).After treatment,the water provocative test socres were significantly decreased,and the reduction of the treatment group was significantly better than that of the control group(P<0.05).After treatment,it was significantly improved,and that in the treatment group was significantly better than that in the control group(P<0.05).Meanwhile,the serum prealbumin level in 2 groups was significantly increased,and the increase in the treatment group was significantly better than that in the control group(P<0.05).There was no significant adverse reaction in the treatment group and the control group.Conclusion:Sanbu Kaiqiao Liyan Acupuncture combined with dialectical acupoint selection can significantly improve the clinical efficacy of patients with dysphagia after apoplexy pseudobulbar palsy,and effectively improve the dysphagia of patients and the level of serum prealbumin.It is worthy of clinical application.