不同时机的针灸介入对脑卒中后吞咽障碍患者的临床疗效

Clinical Effect of Acupuncture Intervention at Different Time on Post-Stroke Dysphagia

目的:探讨不同时机的针灸介入对脑卒中后吞咽障碍患者的临床疗效。方法:回顾性分析2013年5月—2020年5月于本院就诊收治的84例脑卒中后吞咽障碍患者的临床资料,根据针灸介入时机的不同分为A、B、C共3组,A组于入院后第3天针灸介入,B组于入院后第7天针灸介入,C组于入院后第10天针灸介入。采用洼田饮水实验、SSA评分以及MNA评分评判3组患者不同时机针灸介入的临床疗效。结果:A组临床治疗总有效率>B组>C组,差异有统计学意义(P<0.05);治疗后3组患者吞咽功能较治疗前均有所改善(P<0.05),且A组SSA评分显著<B组<C组(P<0.05);治疗后3组患者MNA评分较之前均提高,且A组MNA评分>B组>C组,差异有统计学意义(P<0.05);3组患者在治疗后饮水实验分级结果较治疗前均有所改善,且A组洼田饮水实验结果1级患者显著多于B、C组,B组多于C组,差异有统计学意义(P<0.05);治疗后3组患者各项生活质量评分均较治疗前提高,3组治疗后组间比较差异有统计学意义,且A组各项生活质量评分高于B组、C组,B组各项生活质量评分高于C组(P<0.05)。结论:早期针灸介入可显著改善脑卒中后吞咽障碍患者的营养状态和吞咽功能,并提高生活质量。

Objective:To explore the clinical effect of acupuncture intervention at different time in patients with post-stroke dysphagia.Methods:84 patients with post-stroke dysphagia were analyzed retrospectively.According to the different time of acupuncture intervention,they were divided into Group A,Group B and Group C,which were received acupuncture intervention on the third day,the seventh day and the tenth day after admission respectively.The clinical effect of acupuncture intervention at different time was evaluated by the scores of swallowing drinking test,SSA and MNA.Results:The clinical effective rate from high to low was group A,group B and group C(P<0.05).The swallowing function was improved in the three groups(P<0.05).The SSA score from low to high was group A,group B and group C(P<0.05).The MNA score was higher after the treatment than that before the treatment in the three group,which from high to low was group A,group B and group C(P<0.05).The grade of drinking tests improved most significantly in group A,followed by group B and group C after the treatment(P<0.05).The scores of the quality of life increased most significantly in group A,followed by group B and group C(P<0.05).Conclusion:Early acupuncture intervention can significantly improve the nutritional status and swallowing function of the patients with dysphagia after stroke,and improve their life quality.