艾灸联合舌三针治疗卒中后吞咽功能障碍临床研究及对患者中医症状、营养状态的影响

Clinical study of moxibustion combined with tongue three needles on post-stroke dysphagia and its influence on traditional Chinese medicine symptoms and nutritional status of patients

目的观察艾灸联合舌三针治疗卒中后吞咽功能障碍的临床疗效,以及对患者中医症状、营养状态的影响。方法选取2018年2月至2020年7月收治的138例卒中后吞咽功能障碍患者,按照随机数字表法分为2组,2组均予常规卒中后康复治疗,对照组69例予舌三针针刺治疗,治疗组69例在对照组基础上联合艾灸治疗。2组均4周后统计疗效,比较2组治疗前后中医症状(包括饮水呛咳、吞咽困难、舌强语謇及肢体偏瘫)评分及营养状况指标[包括血清总蛋白(TP)、白蛋白(ALB)、前白蛋白(PAB)及血红蛋白(Hb)]水平变化情况,观察2组患者治疗期间不良反应发生情况,包括烫伤、血肿及淤青。结果治疗组总有效率92.75%(64/69),对照组总有效率81.16%(56/69),治疗组总有效率高于对照组(P<0.05)。与本组治疗前比较,2组治疗后中医症状饮水呛咳、吞咽困难、舌强语謇及肢体偏瘫评分均降低(P<0.05),且治疗组治疗后中医症状饮水呛咳、吞咽困难、舌强语謇及肢体偏瘫评分均低于对照组(P<0.05)。与本组治疗前比较,2组治疗后营养指标血清TP、ALB、PAB以及Hb水平均升高(P<0.05),且治疗组治疗后营养指标血清TP、ALB、PAB以及Hb水平均高于对照组(P<0.05)。治疗组不良反应总发生率4.35%(3/69),对照组不良反应总发生率2.90%(2/69),2组不良反应总发生率比较差异无统计学意义(P>0.05)。结论艾灸联合舌三针治疗卒中后吞咽功能障碍疗效确切,两者联合应用可起到协同作用,从而明显改善患者中医症状表现,改善患者营养状况,治疗效果及安全性良好。

Objective To explore the moxibustion combined with tongue three needles on post-stroke dysphagia and its influence on traditional Chinese medicine(TCM)symptoms and nutritional status of patients.Methods A total of 138 cases of post-stroke dysphagia admitted to the hospital from February 2018 to July 2020 were randomly assigned into a control group(n=69)and a treatment group(n=69).All patients were managed by tongue three needles,and patients in the treatment group were additionally given moxibustion,the treatment was performed for 4 weeks for Statistical efficacy.The aiming was to compare TCM symptoms including drinking cough,dysphagia,strong tongue and hemiplegia,and nutritional statusindexes including serum total protein(TP),albumin(ALB),prealbumin(PAB)and hemoglobin(Hb)levels between the two groups before and after treatment.The incidence of treatment-emergent adverse events(TEAEs)including scald,hematoma and bruising was assessed.Results The total treatment response rate in the treatment group was significantly higher than that in control group(92.75%[64/69]vs 81.16%[56/69],P<0.05).After treatment,the scores of TCM syndromes were significantly reduced in the two groups(P<0.05),and which were more pronounced in the treatment group(P<0.05).The levels of serum TP,ALB,PAB and Hb were significantly increased in the two groups(P<0.05),and the levels of these nutritional indexes in treatment group were significantly higher than those in control group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the treatment group and the control group(4.35%[3/69]vs 2.90%[2/69],P>0.05).Conclusion For post-stroke dysphagia patients,moxibustion combined with tongue three needles can play a synergistic role,significantly improve the TCM symptoms and nutritional status of patients,and its therapeutic effect is safe and good.