针灸结合神经肌肉电刺激治疗脑卒中后吞咽功能障碍的疗效及预后

Therapeutic effect and prognosis of acupuncture combined with neuromuscular electrical stimulation on dysphagia after stroke

目的:探讨针灸结合神经肌肉电刺激治疗脑卒中后吞咽功能障碍的临床疗效及预后,为患者的诊疗提供指导。方法:选取北京北大医疗康复医院2017年1月~2018年12月收治的82例脑卒中后吞咽功能障碍患者进行研究。按照随机数表法,分两组,各41例。对照组采用神经肌肉电刺激治疗,观察组采用针灸结合神经肌肉电刺激治疗。治疗15d后,观察比较两组患者的临床疗效及治疗前后吞咽功能量表评分、洼田饮水试验分级和生活质量评分情况。结果:观察组治疗的总有效率(92.68%)明显高于对照组的73.17%,差异有统计学意义。观察组治疗后吞咽功能量表评分[(21.52±2.43)分]、洼田饮水试验分级[(1.32±0.31)级]均明显低于对照组[(24.73±3.87)分、(2.67±0.54)级],差异有统计学意义。观察组治疗后活力、社会功能、情感功能、疼痛、健康方面、生理方面评分[(76.52±10.42)分、(73.35±10.37)分、(61.42±9.83)分、(72.58±9.45)分、(73.74±10.38)分、(64.53±8.39)分]均明显高于对照组[(64.71±6.37)分、(65.62±7.28)分、(46.81±6.27)分、(64.26±6.62)分、(59.63±7.35)分、(51.28±6.18)分],差异有统计学意义。结论:针灸结合神经电刺激治疗脑卒中后吞咽功能障碍临床疗效显著,可明显提高患者生活质量,改善临床症状,值得临床推广应用。

Objective To explore the clinical effect and prognosis of acupuncture combined with neuromuscular electrical stimulation in the treatment of dysphagia after stroke,so as to provide guidance for the diagnosis and treatment of patients.Methods 82 patients with dysphagiaafter stroke admitted toour hospital from January 2017 to December 2018were studied.According to the random number table method,the patients were divided into observation group and control group,41 cases each.The control group was treated with neuromuscular electrical stimulation,and then the observation group was treated with acupuncture and neuromuscular electrical stimulation.After 15 days of treatment,the clinical efficacy,scores of swallowing function scale,Watian drinking water test grade,and quality of life score were compared between the two groups.Results The total effective rate oftreatment in the observation group (92.68%) were significantly higher than 73.17% in the control group,and the difference was statistically significant.The score of the swallowing function scale [(21.52±2.43) points]and the wada drinking water rest [(1.32±0.31)] grade]in the observation group were significantly lower than those in the control group [(24.73±3.87) points,(2.67±0.54)]grade],the difference was statistically significant.The scores of vitality,social function,emotional function,pain,health,and physiology in the observation group [(76.52±10.42) points,(73.35±10.37) points,(61.42±9.83) points,(72.58±9.45) points,(73.74±10.38) points and (64.53±8.39) points]were significantly higher than the control group [(64.71±6.37) points,(65.62±7.28) points,(46.81±6.27) points,(64.26±6.62) points,(59.63±7.35) points,(51.28±6.18) points],the difference was statistically significant.Conclusion Acupuncture combined with electrical nerve stimulation in the treatment of swallowing dysfunction after stroke has a significant clinical effect,which can significantly improve the quality of life of patients,improve clinical symptoms,and is worthy of clinical promotion and application.