芒针透刺联合吞咽功能训练对中风恢复早期吞咽障碍的影响

Effect of Elongated Needle Combined with Swallowing Function Training on Dysphagia in the Early Stages of Motor Recovery after Stroke

目的观察芒针透刺联合吞咽功能训练治疗中风恢复早期患者吞咽障碍的临床疗效。方法将中风恢复早期且伴有吞咽障碍的患者90例按照随机原则分为芒针透刺组、普通针刺组以及吞咽训练组各30例。吞咽训练组仅给予单纯吞咽功能训练,普通针刺组在吞咽功能训练的基础上结合普通毫针常规针刺治疗,芒针透刺组给予芒针透刺联合吞咽功能训练进行治疗。治疗从周一持续到周六,周日休息,14 d为1个疗程,共治疗3个疗程。治疗前后,90例患者均选择用洼田饮水试验评分(简称WWST评分),吞咽透视检查评分(简称VFSS评分)和吞咽障碍评价指数评分(简称FIRS评分)来检验3组患者的吞咽状况进行疗效评定。结果90例患者在进行治疗后,吞咽功能得到了有效的改善(P<0.05);且芒针透刺组的临床疗效较好,优于普通针刺组(P<0.05)和吞咽训练组(P<0.01)。结论在吞咽功能训练同时联合芒针透刺及吞咽训练联合普通针刺都要比单纯吞咽功能训练治疗中风恢复早期吞咽障碍更有效,芒针透刺比普通针刺治疗吞咽障碍临床疗效更为显著。

Objective:To study the effect of elongated needle combined with swallowing function training in the early stages of motor recovery after stroke,and to provide new thoughts in treating this disease.Methods:A total of 90 dysphagia patients in early stages of motor recovery after stroke were selected and randomly divided into the elongated group,acupuncture group and swallowing function training group,30 cases in each group.Patients were treated with swallowing function training alone,swallowing function training combined with acupuncture or swallowing function training combined with elongated needle,respectively.Treatments startted from Monday to Saturday,with 1 day off on Sunday and 14 d as 1 course of treatment.A total of 3 courses of continuous hospitalization were performed.Watian water swallow test(WWST),the video fluoroscopic swallowing study(VFSS)and Fujishima Ichiro rating scale(FIRS)were applied to evaluate the clinical treatment effects.Results:After treatment,the swallowing function was remarkably improved in all 90 patients(P<0.05);the clinical efficacy in elongated group was significantly better than that of acupuncture group(P<0.05)and training group(P<0.01).Conclusion:Compared with swallowing function training combined with acupuncture or swallowing function training alone,the swallowing function training combined with elongated needle has better effects on dysphagic treatment of early stages of motor recovery after stroke,which can promote the swallowing function recovery and increase the clinical efficacy.