舌三针联合康复训练对脑梗死后假性延髓麻痹所致构音障碍的疗效观察

Curative Effects of Tongue Three Acupuncture Combined with Rehabilitation Training on Dysarthria Caused by Pseudobulbar Paralysis after Cerebral Infarction

目的:探讨舌三针联合康复训练对脑梗死后假性延髓麻痹所致构音障碍疗效,以期提高脑卒中后患者生命质量。方法:选取2016年12月至2019年1月海南省人民医院收治的脑梗死后假性延髓麻痹所致构音障碍患者78例进行回顾性分析,按照治疗方法不同分为对照组和观察组,每组39例。对照组常规西医+康复训练治疗,观察组在以上基础上加用舌三针治疗,均连续治疗6周。观察2组治疗前、完成治疗后血脂、Frenchay构音评分、血液流变学、言语空气动力学指标变化并比较。完成治疗后总结疗效情况。结果:1)2组治疗完成后反射、呼吸、唇、颌、软腭、喉、舌、言语评分和治疗前比较均显著上升(P<0.05),且观察组上升幅度显著高于对照组(P<0.05)。2)2组治疗完成后三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白(LDL-C)较治疗前均显著下降,高密度脂蛋白胆固醇(HDL-C)较治疗前比较均显著上升(P<0.05),且观察组上升幅度显著高于对照组(P<0.05)。3)2组治疗完成后全血高低切黏度、血浆黏度、红细胞压积较治疗前均显著下降(P<0.05),且观察组优于对照组(P<0.05)。4)对照组治疗前、完成治疗后各指标比较差异无统计学意义(P>0.05),观察组治疗完成后平均声压级(MSDV)、音调(P)、最长发声时间(MPT)、平均气流率(MFR)、声门下压(SGP)、声门阻力(GR)、发声效率(VE)较治疗前均显著升高(P<0.05),且观察组优于对照组(P<0.05)。5)观察组治愈率38.46%、总有效率89.74%,显著高于对照组治愈率23.08%、总有效率79.49%(P<0.05)。结论:舌三针联合康复训练能通过促进脑微循环,改善血脂,促进言语功能来改善脑梗死后假性延髓麻痹所致构音障碍症状,提高生命质量。

Objective:To explore the effect of tongue three acupuncture combined with rehabilitation training on dysarthria caused by pseudobulbar palsy after cerebral infarction,so as to improve the quality of life of patients after stroke.Methods:Retrospective analysis was conducted on 78 patients with dysarthria caused by pseudobulbar paralysis after cerebral infarction treated in Hainan People′s Hospital from December 2016 to January 2019 and the patients were divided into a control group and an observation group,with 39 cases in each group.The control group was treated with routine Western medicine and rehabilitation training,and the observation group was treated with tongue three needles on the basis of the control group.Both groups were treated for 6 weeks.The changes of blood lipid,French articulation score,hemorheology and speech aerodynamics indexes were observed and compared before and after treatment.The curative effect was summarized after the treatment.Results:1)The scores of reflex,breath,lip,jaw,soft palate,larynx,tongue and speech in the 2 groups were significantly higher than those in the control group(P<0.05).2)After the treatment of the 2 groups,triglycerides(TG),total cholesterol(TC),and low-density lipoprotein(LDL-C)were significantly lower than those before treatment,and high-density lipoprotein cholesterol(HDL-C)was significantly lower than that before treatment(P<0.05),and the increase in the observation group was significantly higher than that in the control group(P<0.05).3)The whole blood high and low shear viscosity,plasma viscosity and hematocrit of the 2 groups were significantly lower than those before treatment(P<0.05),and the observation group was better than the control group(P<0.05).4)There was no significant difference between the control group before and after treatment(P>0.05).After treatment,the average sound pressure level(MSDV),tone(P),maximum phonation time(MPT),average air flow rate(MFR),subglottic pressure(SGP),glottic resistance(GR)and phonation efficiency(VE)in the observation group were significantly higher than those in the control group(P<0.05)(P<0.05).The observation group was better than the control group(P<0.05)5)The curative rate of the observation group was 38.46%,the total effective rate was 89.74%,which was significantly higher than that of the control group(23.08%),the total effective rate was 79.49%(P<0.05).Conclusion:The combination of three tongue acupuncture and rehabilitation training can improve the symptoms of dysarthria caused by pseudobulbar palsy after cerebral infarction and improve the quality of life by promoting cerebral microcirculation,improving blood lipid and promoting speech function.