朱氏手针联合体针治疗脑卒中后吞咽障碍的临床疗效观察

Clinical Observation Effect of ZHU's Hand Acupuncture Combined with Body Acupuncture in the Treatment of Post-stroke Dysphagia

【目的】观察朱氏手针联合体针治疗脑卒中后吞咽障碍的临床疗效。【方法】将80例脑卒中后吞咽障碍患者随机分为观察组和对照组,每组各40例。2组患者均给予常规药物治疗和吞咽训练,对照组给予体针治疗,观察组在对照组治疗的基础上联合朱氏手针治疗。共治疗4周。治疗4周后,评价2组临床疗效,观察2组患者治疗前后洼田饮水试验评级的变化情况,以及功能性经口摄食量表(FOIS)评分的变化情况,并比较2组患者治疗前后表面肌电图(sEMG)最大波幅及吞咽时程的变化情况。【结果】(1)治疗后,2组患者的洼田饮水试验评级均较治疗前明显改善(P<0.05),且观察组在改善洼田饮水试验评级方面明显优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的FOIS评分均较治疗前明显提高(P<0.05),且观察组在改善FOIS评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的sEMG最大波幅、吞咽时程均较治疗前明显改善(P<0.05),且观察组在改善sEMG最大波幅、吞咽时程方面均明显优于对照组,差异有统计学意义(P<0.05)。(4)观察组总有效率为87.50%(35/40),对照组为75.00%(30/40)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。【结论】朱氏手针联合体针治疗脑卒中后吞咽障碍,可促进患者吞咽功能恢复,提高患者舌骨上、下肌群的sEMG最大波幅值、缩短吞咽时程,临床疗效显著。

Objective To observe the clinical efficacy of ZHU's hand acupuncture combined with body acupuncture in the treatment of post-stroke dysphagia.Methods Eighty patients with post-stroke dysphagia were randomly divided into an observation group and a control group,40 patients in each group.Both groups of patients were given conventional medication and swallowing training,while the control group was given body acupuncture and the observation group was treated with ZHU's hand acupuncture on the basis of treatment in the control group.A total of 4 weeks of treatment was given.After 4 weeks of treatment,the clinical efficacy of the two groups was evaluated,and the changes in the Kubota Water Swallowing Test and the changes in the functional oral intake scale(FOIS)scores were observed before and after treatment,and the changes in the maximum wave amplitude of surface electromyography(sEMG)and swallowing time course were compared between the two groups before and after treatment.Results(1)After treatment,the Kubota Water Swallowing Test of patients in both groups were significantly improved(P<0.05),and the observation group was significantly superior to the control group in improving the Kubota Water Swallowing Test,and the difference was statistically significant(P<0.05).(2)After treatment,the FOIS scores of patients in both groups were significantly improved compared with those before treatment(P<0.05),and the observation group was significantly superior to the control group in improving the FOIS scores,and the difference was statistically significant(P<0.05).(3)After treatment,the maximum wave amplitude of s EMG and swallowing time in both groups were significantly improved compared with those before treatment(P<0.05),and the observation group was significantly superior to the control group in improving the maximum wave amplitude of sEMG and swallowing time,and the difference was statistically significant(P<0.05).(4)The total effective rate was 87.50%(35/40)in the observation group and 75.00%(30/40)in the control group.The efficacy of the observation group was superior to that of the control group,and the difference was statistically significant(P<0.05).Conclusion ZHU's hand acupuncture combined with body acupuncture for post-stroke dysphagia can promote the recovery of swallowing function,increase the maximum wave amplitude of sEMG in the supraspinatus and infraspinatus muscle groups of patients and shorten the swallowing time,with remarkable clinical efficacy.