针刺联合肌电生物反馈对中风后吞咽障碍的作用

Effect of Acupuncture Combined with EMG Biofeedback on Dysphagia After Apoplexy

目的:观察针刺联合肌电生物反馈对中风后吞咽障碍疗效。方法:选取2015年8月至2017年8月包头市中心医院收治的中风后吞咽障碍患者114例作为研究对象,按照就诊顺序编号,采用数字随机表法随机分为对照组和观察组,每组57例。2组均接受常规康复治疗,对照组加用肌电生物反馈治疗,观察组在对照组基础上加用针刺,均连续治疗4周,舌骨喉活动度(舌骨上移、舌骨前移、甲状软骨上移、甲状软骨前移)情况;营养状况包括肱三头肌皮褶厚度(TSF)、健侧上臂中部肌围(AMC)、血清白蛋白(ALB)水平变化;吞咽功能评定量表(SSA评分)、吞咽障碍特异性生命质量量表(SWAL-QOL)、空吞咽持续时间、吞咽5 mL水平持续时间水平变化。结果:治疗4周后观察组舌骨上移、舌骨前移评分、ALB、SWAL-QOL提高,SSA、空吞咽持续时间、吞咽5 mL水平持续时间下降(P<0.05),且优于对照组(P<0.05),观察组患者痊愈率、总有效率优于对照组(P<0.05)。结论:针刺联合肌电生物反馈能提高中风后吞咽障碍疗效,改善舌骨喉活动度,·缩短吞咽持续时间,提高机体营养状况。

Objective:To observe the effect of acupuncture combined with EMG biofeedback on dysphagia after stroke.Methods:A total of 114 patients with dysphagia after stroke visited Central Hospital of Baotou City were numbered according to registration order and were randomly divided into control group(n=57)and observation group(n=57)according to random number table method.On the basis of conventional rehabilitation treatment,the control group was treated with electromyography biofeedback,and the observation group was treated with acupuncture for 4 weeks.Hyoid and laryngeal activity(hyoid bone upward,hyoid bone forward,thyroid cartilage upward,thyroid cartilage forward);nutritional status including the changes of triceps skinfold thickness(TSF),middle arm muscle circumference(AMC),serum albumin(ALB)level,swallowing function rating scale(SSA score),dysphagia specific quality of life scale(SWAL-QOL),empty swallowing duration and swallowing 5 mL level duration were observed.Results:after 4 weeks treatment,the hyoid bone upward movement,hyoid bone forward displacement score,ALB and SWAL-QOL increased,SSA,the duration of empty swallowing and the duration of swallowing 5 mLdecreased in the observation group(P<0.05),which were superior to those in the control group(P<0.05).The cure rate and total effective rate in the observation group were better than those in the control group(P<0.05).Conclusion:acupuncture combined with EMG biofeedback can improve the curative effect of dysphagia after stroke,improve the activity of hyoid and larynx,shorten the duration of swallowing and improve the nutritional status of the body.