通督益脑化痰汤对卒中假性球麻痹吞咽困难患者疗效、SSA评分及对TCD血流动力学改变的影响

Effect of Tongdu Yinao Huatan Decoction on Dysphagia, SSA Score and TCD Hemodynamic Changes in Stroke Patients with Pseudobulbar Palsy

目的:探讨通督益脑化痰汤对卒中假性球麻痹吞咽困难患者疗效、标准吞咽功能评估量表评分(SSA)及对TCD血流动力学改变的影响。方法:选取2020年1月—2021年10月诊治的102例卒中假性球麻痹吞咽困难患者作为研究对象,按照随机数字表法分为对照组(予以常规治疗)与观察组(予以通督益脑化痰汤治疗),各51例,对比总有效率、SSA评分、功能性经口摄食量表评分(FOIS);观察大脑前动脉(ACA),大脑中动脉(MCA),大脑后动脉(PCA)的平均血流速度(V_(m))及基底动脉(BV)、椎动脉(VA)的动脉搏动指数(PI)。结果:观察组的总有效率高于对照组(P<0.05)。治疗前,两组的SSA评分、FOIS评分、V_(m)(ACA、MCA、PCA)、PI(BV、VA)比较,差异无统计学意义(P>0.05);治疗4周、治疗后4周,观察组的SSA评分低于对照组,而FOIS评分、V_(m)(ACA、MCA、PCA)、PI(BV、VA)高于对照组(P<0.05)。结论:通督益脑化痰汤治疗卒中假性球麻痹吞咽困难具有较为理想效果,有利于降低SSA评分和改善大脑动脉血流动力学。

Objective:To investigate the effect of Tongdu Yinao Huatan Decoction on dysphagia,SSA score and TCD hemodynamic changes in stroke patients with pseudobulbar palsy.Methods:A total of 102 stroke patients with pseudobulbar dysphagia were randomly divided into the control group and the observation group,with 51 cases in each group.The control group was treated with conventional treatment,and the observation group was treated with Tongdu Yinao Huatan Decoction.The total effective rate,the score of Standard Swallowing Assessment Scale(SSA)and the score of Functional Oral Food Intake Scale(FOIS)were compared between the two groups.The mean blood flow velocity(V _(m))of anterior cerebral artery(ACA),middle cerebral artery(MCA)and posterior cerebral artery(PCA),as well as the arterial pulsatility index(PI)of basilar artery(BV)and vertebral artery(VA)were observed in the two groups.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).There were no statistical differences in SSA score,FOIS score,V _(m) of ACA,MCA and PCA,as well as PI of BV and VA between the two groups before the treatment(P>0.05).SSA score was lower,whereas FOIS score,V _(m) of ACA,MCA and PCA,as well as PI of BV and VA were higher in the observation group than those in the control group after 4 weeks of the treatment and 4 weeks after the treatment(P<0.05).Conclusion:Tongdu Yinao Huatan Decoction has an ideal effect on dysphagia in the treatment of stroke pseudobulbar palsy,which is beneficial to reduce SSA score and improve cerebral artery hemodynamics.