舌三针联合中药冰棒咽部冷刺激治疗脑卒中后吞咽障碍疗效观察

Therapeutic effect of tongue three acupuncture combined with cold stimulation of the pharynx of Chinese medicine popsicle for dysphagia after stroke

目的 观察舌三针联合中药冰棒咽部冷刺激治疗脑卒中后吞咽障碍的疗效。方法 选择2018年6月至2021年6月南阳医学高等专科学校第二附属医院收治的106例脑卒中后吞咽障碍患者为研究对象,根据治疗方法将患者分为对照组(n=53)和观察组(n=53)。对照组患者给予常规药物配合吞咽功能训练治疗,观察组患者在对照组治疗基础上给予舌三针联合中药冰棒咽部冷刺激,2组患者均治疗1个月。比较2组患者治疗前后的中医症候积分、吞咽功能、舌骨喉复合体动度、生活质量及治疗后的临床疗效和并发症发生率。结果 治疗前2组患者的中医症候积分比较差异无统计学意义(P>0.05);2组患者治疗后的中医症候积分均显著低于治疗前(P<0.05);治疗后,观察组患者的中医症候积分显著低于对照组(P<0.05)。治疗前2组患者吞咽功能分级分布比较差异无统计学意义(Z=-0.824,P>0.05);2组患者治疗后吞咽功能分级分布情况较治疗前改善(Z=-5.165、-7.463,P<0.05);治疗后,观察组患者吞咽功能分级分布情况优于对照组(Z=-3.167,P<0.05)。治疗前2组患者舌骨喉复合体动度比较差异无统计学意义(P>0.05);2组患者治疗后舌骨喉复合体动度显著大于治疗前(P<0.05);治疗后,观察组患者舌骨喉复合体动度显著大于对照组(P<0.05)。治疗前2组患者的吞咽生活质量(SWAL-QOL)评分比较差异无统计学意义(P>0.05);2组患者治疗后SWAL-QOL评分显著高于治疗前(P<0.05);治疗后,观察组患者SWAL-QOL评分显著高于对照组(P<0.05)。对照组和观察组患者治疗总有效率分别为73.58%(39/53)、92.45%(49/53),观察组患者总有效率显著高于对照组(χ^(2)=6.692,P<0.05)。对照组与观察组患者并发症总发生率分别为20.75%(11/53)、5.66%(3/53),观察组患者并发症总发生率显著低于对照组(χ^(2)=5.267,P<0.05)。结论 舌三针联合中药冰棒咽部冷刺激治疗脑卒中后吞咽障碍可更有效地改善患者的临床症状,提高患者的临床疗效、吞咽功能和生活质量,加快舌骨喉复合体动度,降低并发症发生率。

Objective To observe the therapeutic effect of tongue three acupuncture combined with cold stimulation of the pharynx of Chinese medicine popsicle for dysphagia after stroke.Methods A total of 106 patients with dysphagia after stroke admitted to the Second Affiliated Hospital of Nanyang Medical College from June 2018 to June 2021 were selected as the study subjects, and the patients were divided into the control group(n=53) and the observation group(n=53) according to the treatment method.The patients in the control group were treated with conventional drugs combined with swallowing function training.On the basis of treatment of the control group, the patients in the observation group were treated with tongue three acupuncture combined with cold stimulation of the pharynx with Chinese medicine popsicle.All patients were treated for one month.The traditional Chinese medicine(TCM) symptom scores, swallowing function, mobility of hyoid laryngeal complex, quality of life of patients were compared between the two groups before and after treatment;the clinical efficacy after treatment and the incidence of complications were compared between the two groups.Results There was no significant difference in TCM symptom scores of patients between the two groups before treatment(P>0.05);the TCM symptom scores of patients after treatment were significantly lower than those before treatment in the two groups(P<0.05);the TCM symptom scores of patients in the observation group were significantly lower than those in the control group after treatment(P<0.05).There was no significant difference in the distribution of swallowing function grading of patients between the two groups before treatment(Z=-0.824,P>0.05);the distribution of swallowing function grading of patients after treatment was better than that before treatment in the two groups(Z=-5.165,-7.463;P<0.05);after treatment, the distribution of swallowing function grading of patients in the observation group was better than that in the control group(Z=-3.167,P<0.05).There was no significant difference in the mobility of the hyoid laryngeal complex of patients between the two groups before treatment(P>0.05);the mobility of the hyoid laryngeal complex of patients after treatment was significantly higher than that before treatment in the two groups(P<0.05);the mobility of the hyoid laryngeal complex of patients in the observation group was significantly higher than that in the control group after treatment(P<0.05).There was no significant difference in swallowing-quality of life(SWAL-QOL) scores of patients between the two groups before treatment(P>0.05);the SWAL-QOL score of patients after treatment was significantly higher than that before treatment in the two groups(P<0.05);the SWAL-QOL score of patients in the observation group was significantly higher than that in the control group after treatment(P<0.05).The total effective rates of patients in the control group and the observation group were 73.58%(39/53) and 92.45%(49/53),respectively;the total effective rate of patients in the observation group was significantly higher than that in the control group(χ^(2)=6.692,P<0.05).The total incidence of complications of patients in the control group and the observation group were 20.75%(11/53) and 5.66%(3/53),respectively;the total incidence of complications of patients in the observation group was significantly lower than that in the control group(χ^(2)=5.267,P<0.05).Conclusion Tongue three acupuncture combined with cold stimulation of popsicle pharynx in the treatment of dysphagia after stroke can effectively improve the clinical symptoms, the clinical efficacy, swallowing function and quality of life of patients, accelerate the mobility of hyoid laryngeal complex, and reduce the incidence of complications.