吞咽超声对吞咽障碍患者针刺风池穴即刻效应的临床研究

Application of Ultrasonographic Examination in Functional Assessment of Immediate Effect of Puncturing Fengchi on Dysphagia Patients

目的利用吞咽彩超(ultrasonographic examination)评价针刺项丛刺主穴风池穴对吞咽障碍患者的即刻变化。方法符合标准的60例脑血管病吞咽障碍患者,随机分为试验组30例、对照组30例,均接受吞咽功能训练。试验组在此基础上应用项丛刺疗法治疗,1个月后对比两组患者美国国立卫生研究院卒中量表(NIH stroke scale,NIHSS),首次利用吞咽超声探讨针刺项丛刺主穴风池穴对颏舌骨肌的即刻变化,同时联合"金标准"吞咽X线荧光透视检查(video fluoroscopic swallowing study,VFSS)评价针刺风池穴对患者吞咽时间的影响,初探风池穴针刺即刻影响及作用机制研究。结果两组患者NIHSS评分均较治疗前减低,且试验组优于对照组(P <0.05)。吞咽彩超示针刺风池穴即刻可增加颏舌骨肌位移,且减少颏舌骨肌的运动时间(均P <0.05),且减少患者口腔期及咽期的吞咽时间(均P <0.05)。结论项丛刺疗法结合吞咽功能训练疗效显著,针刺风池穴即刻可改善吞咽肌群位移并减少患者的吞咽时间。

Objective The application of ultrasonographic examination in functional assessment of immediate effect of puncturing the main acupoint Fengchi( GB20) of nape-aligned acupuncture on Dysphagia Patients. Methods A total of 60 patients of dysphagia were randomly assigned into an observation group and a control group,30 cases in each group. The swallowing function treatment was provided to both two groups. Additionally,nape-aligned acupuncture was used in the observation group. The scores of the NIH stroke scale( NIHSS) and the video fluoroscopic swallowing study( VFSS) were observed after 1 mouth,and for the first time to explore immediate effect to geniohyoid muscle after puncturing the main acupoint Fengchi( GB20) of nape-aligned acupuncture using ultrasonographic examination. Results NIHSS scores of both 2 groups were lower than those before treatment( P< 0. 05). The above scores of observation group were better control group( P < 0. 05). Ultrasonographic examination showed immediate effect of puncturing Fengchi( GB20) could increase motion amplitude of the geniohyoid muscles and shorten the time of both geniohyoid muscles and the time of oral phase and pharyngeal stage by VFSS( P < 0. 05). Conclusion Therapeutic effects of nape-aligned acupuncture combined with swallowing function training were more effective,and immediate effect of puncturing Fengchi( GB20) is to shorten time and increase motion amplitude of dysphagia patients.