三部开窍利咽针刺法联合吞咽康复训练治疗假性延髓性麻痹(风痰瘀阻证)临床研究

Clinical Study on Sanbu Kaiqiao Liyan Acupuncture Combined with Swallowing Rehabilitation Training on Pseudobulbar Palsy(Wind Phlegm Stasis Syndrome)

目的观察三部开窍利咽针刺法联合吞咽康复训练治疗假性延髓性麻痹(风痰瘀阻证)临床疗效。方法假性延髓性麻痹患者80例按随机数字表法分为对照组与观察组各40例,两组均给予常规的内科药物和针刺治疗,在常规治疗的基础上对照组给予吞咽康复训练治疗;观察组在对照组的基础上联合三部开窍利咽针刺法治疗。采用洼田饮水试验对患者治疗前、治疗1周、治疗结束后的吞咽功能进行评分,神经功能缺损评分(NIHSS)及日常生活能力量表(ADL)分别评估神经功能及日常生活能力,并采取吞咽功能(SSA)和中医症状量表评估积分,观察其疗效及并发症情况。结果观察组治疗有效率为90.00%,显著高于对照组的72.50%(P <0.05),两组治疗1周后与治疗结束时洼田饮水试验评分较治疗前均显著提高,且观察组在治疗1周、治疗结束后洼田饮水试验评分均高于同一时间对照组(P <0.05);治疗后两组SSA、NIHSS评分较治疗前均明显降低,且治疗后观察组SSA、NIHSS评分均低于对照组(P <0.05);两组治疗后ADL积分明显升高、中医症状评分明显降低,且观察组ADL积分高于对照组、中医症状评分低于对照组(P <0.05);观察组治疗后并发症发生率为7.50%,低于对照组的25.00%(P <0.05)。结论采取三部开窍利咽针刺法联合吞咽康复训练治疗假性延髓性麻痹(风痰瘀阻证)患者的疗效显著,可提高患者吞咽功能及日常生活能力,促进其神经功能恢复,缓解症状,降低并发症的发生率。

Objective:To investigate the effect of Sanbu Kaiqiao Liyan acupuncture combined with swallowing rehabilitation training on pseudobulbar palsy(wind phlegm stasis syndrome).Methods:80 patients were randomly divided into the control group and the observation group,40 cases in each.Both groups were given routine medicine and acupuncture treatment,and the control group was given swallowing rehabilitation training on the basis of routine treatment;the observation group was treated with Sanbu Kaiqiao Liyan acupuncture on that basis.The swallowing function of the patients before,1 week during the treatment and after the treatment was evaluated by water swallow test.The nerve function and daily living ability were evaluated by NIHSS and ADL respectively.The swallowing function(SSA)and symptom scale of TCM were used to evaluate the scores,and the curative effect and complications were observed.Results:The effective rate of the observation group was significantly higher than that of the control group(90.00%vs 72.50%)(χ~2=4.021,P=0.045).There was no significant difference between the two groups in the score of water swallow test before treatment(P>0.05),and the score of water swallow test in the two group was significantly improved during 1 week and after the treatment,and the score in the observation group was higher than that in the control group at the same time(P<0.05).There was no significant difference in the scores of SSA and NIHSS between the two groups before treatment(P>0.05),and the scores in the two group was significantly improved after treatment,and the scores of SSA and NIHSS in the observation group were significantly lower than those in the control group(P<0.05).There was no significant difference in the scores of ADL and TCM symptoms before treatment between the two groups(P>0.05),and the scores of ADL in the two group were increased after treatment,and TCM symptoms decreased,and the scores of ADL in the observation group was significantly higher than that in the control group,and TCM symptoms was significantly lower than that in the control group(P<0.05).The incidence of complications in the observation group was lower than that in the control group(7.50%vs 25.00%)(χ~2=4.501,P=0.034).Conclusion:The therapeutic effect of Sanbu Kaiqiao Liyan acupuncture combined with swallowing rehabilitation training on patients with pseudobulbar palsy is better.It can effectively improve the swallowing function and the ability of daily life,promote the recovery of nerve function,relieve symptoms and reduce the incidence of complications.