针刺疗法联合康复训练治疗脑卒中后吞咽障碍临床研究

Clinical Study on Acupuncture Combined with Rehabilitation Training for Dysphagia After Stroke

目的:观察针刺疗法联合康复训练治疗脑卒中后吞咽障碍的临床疗效。方法:选择116例脑卒中后吞咽障碍患者,按随机数字表法分为观察组和对照组各58例。对照组给予常规康复训练治疗,观察组在对照组基础上给予针刺疗法。采用X线透视吞咽功能检查(VFSS)和藤岛一郎吞咽评分(FIRS)评价患者吞咽功能,采用吞咽障碍特异性生活质量量表(SWAL-QOL)评价患者生活质量,采用洼田饮水试验评价2组临床疗效。结果:观察组总有效率为91.38%,高于对照组74.14%,差异有统计学意义(P<0.05)。治疗后,2组VFSS评分、FIRS评分较治疗前升高(P<0.05),且观察组VFSS评分、FIRS评分均高于对照组(P<0.05)。治疗后,2组SWAL-QOL评分较治疗前升高(P<0.05),且观察组SWAL-QOL评分高于对照组(P<0.05)。对照组并发症发生率为10.34%,观察组为8.62%,2组比较,差异无统计学意义(P>0.05)。结论:针刺疗法联合康复训练治疗脑卒中后吞咽障碍,可明显提升临床疗效,并改善患者吞咽功能,提高生活质量,且安全可靠。

Objective:To observe the clinical effect of the therapy of acupuncture combined with rehabilitation training in the treatment of dysphagia after stroke. Methods:A total of 116 patients with dysphagia after stroke were randomly divided into the observation group and the control group,58 cases in each group. The control group received routine rehabilitation training,and the observation group was additionally treated with acupuncture based on the treatment of the control group.X-ray examination of Video Fluoroscopy Swallowing Study(VFSS) and Fujijima Ichiro Rating Scale(FIRS) were used to evaluate the swallowing function of the patients. Swallowing-related Quality Of Life(SWAL-QOL) was used to evaluate the life quality of the patients, and Water Swallow Test was used to observe the clinical effect. Results: The total effective rate was91.38% in the observation group,higher than that of 74.14% in the control group,the difference being significant(P<0.05).After treatment,the scores of VFSS and FIRS in the two groups were increased when compared with those before treatment(P<0.05),and two scores in the observation group were higher than those in the control group(P<0.05). After treatment,the SWAL-QOL scores in the two groups were increased when compared with those before treatment(P<0.05),and the SWAL-QOL score in the observation group was higher than that in the control group(P<0.05). The incidence of complications was 10.34% in the control group and 8.62% in the observation group,there being no significant therapeutic effect in the comparison(P>0.05). Conclusion: The therapy of acupuncture combined with rehabilitation training for dysphagia after stroke, can significantly improve the clinical effect, the swallowing function, and the quality of life, which is safe and reliable.