三子利咽汤冰刺激联合吞咽功能训练治疗卒中后吞咽障碍

Clinical study on ice stimulation of Sanzi Liyan decoction combined with swallowing function training in the treatment of patients with dysphagia after stroke

目的探讨三子利咽汤咽部冰刺激联合吞咽功能训练治疗卒中后吞咽功能障碍的临床疗效。方法选择卒中后吞咽障碍患者60例。随机分为观察组与对照组,各30例。2组均给予营养管理、心理疏导及常规吞咽功能训练,对照组餐前30 min予生理盐水进行咽部冰刺激,观察组以三子利咽汤浓煎代替生理盐水,每日刺激2次,每次15 min,每周治疗5 d。4周后比较2组治疗前后吞咽功能、生活质量及营养状况,疗程结束后评定治疗效果。结果治疗后,2组吞咽功能均明显改善,观察组改善更为显著(P<0.05);治疗后,2组的生活质量均明显提高,观察组提高更为显著(P<0.05);治疗后,2组营养状况指标均明显提高,观察组改善更为显著(P<0.05);观察组治疗总有效率(90.00%,27/30)显著高于对照组(73.33%,22/30)(P<0.05)。结论三子利咽汤冰刺激联合吞咽功能训练能更有效缓解卒中后吞咽障碍患者的临床症状,提高生活质量,改善营养状况,且操作简单易行,经济负担小,值得临床推广。

Objective To explore the clinical efficiency of Sanzi Liyan decoction combined with swallowing function training in the treatment of patients with dysphagia after stroke.Methods A total of 60 patients with dysphagia after stroke admitted to our department were included and divided into the observation group and the control group randomly.Both groups were given nutritional management,psychological counseling and routine swallowing function training.The control group was given normal saline for ice stimulation of the pharynx 30 minutes before meals.The observation group was given Sanzi Liyan decoction concentrated decoction instead of normal saline,stimulated twice a day,15 minutes each time,5d/week.After 4 weeks,the swallowing function,quality of life and nutritional status of the two groups of patients before and after treatment were compared,and the therapeutic effect was evaluated after the course of treatment.Results After treatment,the swallowing function,the quality of life,the nutritional status indicators in the two groups were signifi cantly improved,especially in the observation group(P<0.05).The total effective rate of the observation group(90.00%)was significantly higher than that of the control group(73.33%).Conclusion Ice stimulation of Sanzi Liyan decoction combined with swallowing function training can more effectively relieve the clinical symptoms of patients with dysphagia after stroke,improve their quality of life and the nutritional status.The operation of this combined therapy is simple and easy,its economic burden is small.Therefore it is worthy of clinical promotion.