中医“三联疗法”治疗中风后假性球麻痹吞咽功能障碍临床研究

Clinical Study on Treaing Dysphagia of Pseudobulbar Palsy After Stroke with "Triple Therapy" of TCM

目的:观察中医“三联疗法”治疗中风后假性球麻痹吞咽障碍的临床疗效。方法:将80例中风后假性球麻痹吞咽障碍患者按照随机数字表法分为观察组和对照组,每组各40例。两组患者均给予常规西药治疗,对照组给予康复功能训练,观察组在对照组治疗的基础上采用中医“三联疗法”,包括舌根透针法、穴位贴敷、冰片柠檬冰棒咽部冷刺激等。比较两组患者的临床疗效及治疗前后日常生活活动能力(activities of daily living,ADL)评分、标准吞咽功能评定量表(standardized swallowing assessment,SSA)评分、美国国立卫生研究院卒中量表(national institute of health stroke scale,NIHSS)评分、血清前白蛋白水平。结果:观察组有效率为95.0%,对照组有效率为75.0%,两组患者有效率比较,差异具有统计学意义(P<0.05)。两组患者治疗后SSA评分低于本组治疗前,且治疗后观察组低于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后ADL评分高于本组治疗前,且治疗后观察组高于对照组,差异具有统计学意义(P<0.05)。两组患者治疗后NIHSS评分低于本组治疗前,血清前白蛋白水平高于本组治疗前,治疗后观察组NIHSS评分低于对照组,血清前白蛋白水平高于对照组,差异均有统计学意义(P<0.05)。结论:中医“三联疗法”治疗中风后假性球麻痹吞咽障碍,可改善患者的临床症状及营养状况,提高其生活质量,促进神经功能的恢复。

Objective:To observe the clinical efficacy of "triple therapy" of TCM on dysphagia of pseudobulbar palsy after stroke.Methods:A total of 80 patients with dysphagia due to pseudobulbar palsy after stroke were randomly divided into the observation group and the control group,with 40 cases in each group.Both groups of patients were first treated with conventional Western medicine.Then the control group was additionally given rehabilitation function training.The observation group,based on the treatment of the control group,adopted the "triple therapy" of TCM,including penetration needling through the root of the tongue,acupoint application therapy,cold stimulation of pharynx with borneol and lemon popsicle,etc.The clinical efficacy,the changes of activities of daily living(ADL) score,standardized swallowing assessment(SSA) score,National Institute of Health stroke scale(NIHSS) score and serum prealbumin level of the two groups before and after treatment were compared.Results:The effective rate was 95.0% in the observation group and 75.0% in the control group.The difference between the two groups was statistically significant(P<0.05).The SSA score of the two groups after treatment was lower than that before treatment,and the SSA score of the observation group was lower than that of the control group,with a statistically significant difference(P<0.05).The ADL score of the two groups after treatment was higher than that of the same group before treatment,and the score of the observation group was higher than that of the control group,with a statistically significant difference(P<0.05).The NIHSS of the two groups was lower than that of the same group before treatment,while the serum prealbumin level was higher than that before treatment.The NIHSS score of the observation group was lower than that of the control group,while the serum prealbumin level was higher than that of the control group,with statistical significances(P<0.05).Conclusion:The "triple therapy" of TCM can improve the clinical symptoms and nutritional status of patients with dysphagia of pseudobulbar palsy after stroke,improve their quality of life,and promote the recovery of neural function.