针刀分期调治卒中后咽期吞咽障碍临证探讨

Clinical study of acupotomy staging in the treatment of dysphagia in the posterior pharyngeal stage after stroke

卒中后咽期吞咽障碍系脑络受损后神机失用,神不御气,咽喉经筋继发气血不通、不荣而出现,病程不同阶段形神病变特点不一,治疗上也应有所区别。针刀治疗具有良好的改善循环、抗肌萎缩纤维化的作用,根据病程特点分期松解枕下肌群和舌骨上肌群形成急性期调神御气、恢复期形神共调、后遗症期全形通神的针对性治疗,符合临床实际需要,可为卒中后咽期吞咽障碍的治疗提供一些参考。

Dysphagia in the posterior pharyngeal phase after stroke is caused by the hypofunction of mental activity due to impairment of head collaterals,and the failure of spirit to restrain Qi.Obstructed and nonnutritive Qi and blood in the channels and tendons in the throat can make the disease appear.The conditions of body shape,spirit and disease nature at different stages of the course of the disease are different,and the treatment should also be different.Acupotomy treatment has a good effect on improving circulation and anti-muscular atrophy fibrosis.According to the characteristics of the course of the disease,the targeted treatments of regulating spirit to restrain Qi in acute stage,co-regulating of body and spirit in the recovery stage and recovering body shape and communicating spirit in the sequelae stage are formed by staging releasing the suboccipital muscle group and subohyoid muscle group.This meets the practical clinical needs,and can provide some references for the treatment of swallowing disorders in the posterior pharyngeal stage after stroke.