通督调神针法联合吞咽功能训练在中风后吞咽功能障碍患者中的应用效果

Application effects of Tongdu Tiaoshen acupuncture combined with swallowing function training in patients with swallowing dysfunction after stroke

目的:观察通督调神针法联合吞咽功能训练在中风后吞咽功能障碍患者中的应用效果。方法:选取94例中风后吞咽功能障碍患者为研究对象,按照随机数字表法分为观察组与对照组各47例,对照组予以吞咽功能训练治疗,观察组在对照组基础上联合通督调神针法治疗,比较两组脑血流动力学指标[双侧大脑动脉平均血流速度(Vm)、血管阻力指数(RI)及收缩期峰值流速(Vs)]水平、洼田饮水试验评分、标准吞咽功能评价量表(SSA)评分、美国国立卫生研究院卒中量表(NIHSS)评分和吞咽障碍患者生命质量量表(SWAL-QOL)评分。结果:治疗后,两组Vm、Vs水平高于治疗前,且观察组高于对照组,RI水平低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组SSA评分、洼田饮水试验评分和NIHSS评分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组SWAL-QOL评分高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:通督调神针法联合吞咽功能训练在中风后吞咽功能障碍患者中的应用效果优于单纯应用吞咽功能训练,可改善患者脑血流动力学指标水平、吞咽功能、神经功能和生命质量。

Objective: To observe application effects of Tongdu Tiaoshen acupuncture combined with swallowing function training in patients with swallowing dysfunction after stroke. Methods: 94 patients with swallowing dysfunction after stroke were selected as the research objects, and were divided into observation group and control group according to the random number table method, 47 cases in each group. The control group was treated with swallowing function training, while the observation group was treated with Tongdu Tiaoshen acupuncture on the basis of that of the control group. The levels of cerebral hemodynamic indexes [bilateral cerebral arterial average blood flow velocity(Vm), vascular resistance index(RI), peak flow velocity(Vs)], the Kubota’s water drinking test score, the standardized swallowing assessment(SSA) score, the national institutes of health stroke scale(NIHSS) score, and the swallowing-quality of life scale(SWAL-QOL) score were compared between the two groups.Results: After the treatment, the levels of Vm and Vs in the two groups were higher than before the treatment, and those of the observation group were higher than those of the control group;the RI levels were lower than those before the treatment, and that of the observation group was lower than that of the control group;and the differences were statistically significant(P<0.05). After the treatment, the SSA score, the Kubota’s water drinking test score and the NIHSS score in the two groups were lower than those before the treatment;those of the observation group were lower than those of the control group;and the differences were statistically significant(P<0.05). Further, after the treatment, the SWAL-QOL scores of the two groups were higher than those before the treatment;that of the observation group was higher than that of the control group;and the differences were statistically significant(P<0.05). Conclusions: The Tongdu Tiaoshen acupuncture combined with swallowing function training in the patients with swallowing dysfunction after stroke is better than single swallowing function training. It can improve the levels of cerebral hemodynamic indexes, the swallowing function, the neurological function and the quality of life of these patients.