醒脑启咽汤联合舌三针对脑卒中恢复期吞咽功能障碍的干预作用研究

Intervention Effect of Xingnao Qiyan Decoction Combined with Tongue Three-needle Acupuncture on Dysphagia in Convalescent Stroke Patients

目的研究醒脑启咽汤结合舌三针对脑卒中恢复期患者吞咽功能障碍的干预作用。方法选择2017年7月—2019年6月医院住院的脑卒中后吞咽障碍患者200例,根据Excel随机表格法分为对照组和观察组,每100例;对照组患者采用单纯吞咽康复训练。观察组在对照组的基础上加用醒脑启咽汤结合舌三针进行治疗。7 d为1个疗程,两组均治疗2个疗程。对比两组治疗疗效;对比两组治疗前后洼田氏饮水试验、NIHSS及BI指数评分;对比两组治疗前后神经营养指标的变化;对比两组治疗前后中医证候积分;对比两组并发症发生情况。结果观察组总有效率92.00%(92/100)显著优于对照组74.00%(74/100)有统计学意义(P<0.05)。观察组洼田氏饮水试验、BI指数显著高于对照组,NIHSS指数评分显著低于对照组(P<0.05)。观察组神经营养指标IGF-1、BDNF、VEGF含量高于对照组,Nogo-A低于对照组(P<0.05)。观察组患者饮水呛咳、吞咽困难、舌强语謇和肢体偏瘫积分显著低于对照组(P<0.05)。观察组并发症总发生率达到5.00%(5/100),对照组并发症总发生率达到17.00%(17/100),观察组总发生率显著低于对照组(P<0.05)。结论醒脑启咽汤结合舌三针对脑卒中恢复期患者吞咽功能障碍进行治疗,通过多角度、多层次及多靶点进行干预,改善了患者吞咽功能,提高了治疗疗效,减轻了临床症状,值得临床进一步研究推广。

Objective To study the intervention effect of Xingnao Qiyan Decoction combined with tongue three-needleacupuncture on dysphagia in convalescent stroke patients.Methods A total of 200 patients with dysphagia after stroke hospitalized in our hospital from July 2017 to June 2019 were selected.They were divided into control group and observation group according to excel random table method,100 patients in group.The patients in control group were given simple swallowing rehabilitation training.The observation group was treated with Xingnao Qiyan Decoction combined with tongue three-needle acupuncture on the basis of the control group.Seven days was a course of treatment,and both groups were treated for two courses.The curative effect of the two groups was compared.Watian drinking water test,NIHSS and BI index scores before and after treatment were compared between the two groups.The changes of neurotrophic indexes and the scores of TCM syndromes before and after treatment were compared between the two groups.The occurrence of complications between the two groups were compared.Results The results showed that the total effective rate of the observation group was 92.00%(92/100),and that of the control group was 74.00%(74/100).The total effective rate of the observation group was significantly better than that of the control group(P<0.05).Watian's drinking water test and BI index in the observation group were significantly higher than those in the control group,and NIHSS index score was significantly lower than that in the control group(P<0.05).The contents of IGF-1,BDNF and VEGF in the observation group were higher than those in the control group,and Nogo-A was lower than those in the control group(P<0.05).The scores of drinking cough,dysphagia,tongue stoppage and limb hemiplegia in the observation group were significantly lower than those in the control group(P<0.05).The total incidence of complications was 5.00%(5/100)in the observation group and 17.00%(17/100)in the control group.The total incidence of complications in the observation group was significantly lower than that in the control group(P<0.05).Conclusion To sum up,Xingnao Qiyan Decoction combined with tongue three-needleacupuncture for the treatment of dysphagia in convalescent stroke patientswere conducted from multiple perspectives,multiplelevels and multipletargets.It improves the swallowing function of patients and the therapeutic effect and alleviates the clinical symptoms,which is worthy of further clinical research and promotion.