舌三针联合舌下刺络放血治疗脑卒中后吞咽障碍的临床研究

Clinical Observation of Three Tongue Acupuncture Combined with Hypoglossal Blood Letting in the Treatment of Cerebral Apoplexy

目的:探讨舌三针联合舌下刺络放血治疗脑卒中后吞咽障碍的临床效果。方法:采取前瞻性随机对照的研究方法,将2018年1月至2021年1月60例脑卒中后吞咽障碍患者分为对照组(30例)与治疗组(30例)。对照组给予常规吞咽功能训练,在对照组基础上,治疗组给予"舌三针"针刺联合舌下刺络放血治疗。治疗前后采用洼田饮水试验评分系统和吞咽障碍特异性生活质量量表(SWAL-QOL)及对两组患者进行评估,评估临床疗效,并调查满意度。结果:治疗后,两组饮水试验评分均下降(P<0.05),而治疗组饮水试验评分较对照组低(P<0.05)。两组SWAL-QOL评分均明显提高(P<0.05),而治疗组SWAL-QOL评分明显高于对照组(P<0.05)。治疗组总有效率(80.00%)明显高于对照组(56.67%)(P<0.05)。治疗组总满意度(96.67%)明显高于对照组(60.00%)(P<0.05)。结论:舌三针联合舌下刺络放血治疗脑卒中后吞咽功能障碍的疗效肯定,配合吞咽功能训练具有增效作用,可有效提高患者生活质量,安全耐受,患者的满意度高,值得临床推广应用。

Objective: To observe the clinical effect of tongue three needle combined with sublingual collateral puncture and bloodletting in the treatment of swallowing dysfunction after stroke. Methods: A prospective randomized controlled study divided 60patients with poststroke swallowing disorders between January 2018 and January 2021 into matched group(30 patients) and therapy group(30 patients). The matched group were given swallowing function training, and the therapy group were given "tongue three needle" acupuncture combined with sublingual collateral puncture and bloodletting on the basis of the matched group. Before and Post-treatment, the scores of Wada drinking water test system and the swallowing disorder-specific quality of life scale(SWAL-QOL)were used to evaluate the two groups of patients. Their clinical efficacy were assessed and satisfaction were surveyed. Results:Post-treatment, the scores of Wada drinking waterin of both groups were significantly decreased(P<0.05), while the scores of Wada drinking water in the therapy group was significantly lower than that in the matched group(P<0.05). The SWAL-QOL scores of both groups were significantly improved(P<0.05), while the SWAL-QOL scores in the therapy group was significantly higher than that in the matched group(P<0.05). The total effective rate in the therapy group(80.00 %) was significantly higher than that in the matched group(56.67 %)(P<0.05). The overall satisfaction of the research group(96.67 %) was significantly higher than that of the matched group(60.00 %)(P<0.05). Conclusion: Tongue three-needle combined with sublingual pricking and bloodletting has a positive effect on the treatment of post-stroke dysphagia. It has a synergistic effect with swallowing function training, and can effectively improve the quality of life of patients. It is safe, tolerated, and has high patient satisfaction,which were worth of clinical application.