开窍利咽四步针法对脑卒中后吞咽障碍患者吞咽功能、神经功能及生活质量的影响

Effect of Four-step Acupuncture for Opening Orifice and Improving Pharynx on Swallowing Function,Neurological Function and Quality of Life in Patients with Swallowing Dysfunction after Stroke

目的:探究开窍利咽四步针法对脑卒中后吞咽障碍患者吞咽功能、神经功能及生活质量的影响。方法:选取2020年1月—2022年12月张家港市第一人民医院收治的102例脑卒中后吞咽功能障碍患者作为研究对象,采用随机数表法将其分为观察组和对照组,各51例。对照组采用常规对症治疗,观察组在对照组基础上联合开窍利咽四步针法治疗,比较两组吞咽功能、神经功能、生活质量及临床疗效。结果:治疗前,两组吞咽功能、神经功能、生活质量比较,差异无统计学意义(P>0.05);治疗后,两组吞咽功能评价量表(SSA)评分、美国国立卫生研究院卒中量表(NIHSS)评分较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组吞咽-生活质量问卷(SWAL-QOL)评分较治疗前提高,且观察组SWAL-QOL评分、功能性口服摄入量表(FOIS)分级优于对照组,差异有统计学意义(P<0.05)。观察组总有效率高于对照组,差异有统计学意义(P<0.05)。结论:开窍利咽四步针法能有效改善脑卒中后吞咽障碍患者的吞咽功能及神经功能,提高生活质量及临床疗效。

Objective:To investigate the effect of four-step acupuncture for opening orifice and improving pharynx on swallowing function,neurological function and quality of life in patients with swallowing dysfunction after stroke.Method:A total of 102 patients with swallowing dysfunction after stroke who treated in Zhangjiagang First People's Hospital from January 2020 to December 2022 were selected as the study objects,they were divided into the observation group and the control group by random number table method,with 51 cases in each group.The control group was treated with conventional symptomatic treatment,and observation group was treated with four-step acupuncture for opening orifice and improving pharynx on the basis of control group,the swallowing function,neurological function,quality of life and clinical efficacy of two groups were compared.Result:Before treatment,there were no significant differences in the swallowing function,neurological function and quality of life between two groups(P>0.05);after treatment,the scores of swallowing function evaluation scale(SSA)and National Institutes of Health stroke scale(NIHSS)in two groups were lower than those before treatment,and those in the observation group were lower than those in the control group,the differences were statistically significant(P<0.05);after treatment,the scores of swallowing-quality of life questionnaire(SWAL-QOL)in two groups were better than those before treatment,and the SWAL-QOL score and functional oral intake scale(FOIS)grade in the observation group was higher than those in the control group,the differences were statistically significant(P<0.05).The total effective rate of the observation group were higher than that of the control group,the difference was statistically significant(P<0.05).Conclusion:Four-step acupuncture for opening orifice and improving pharynx can effectively improve the swallowing function and neurological function of patients with swallowing dysfunction after stroke,improve the quality of life and clinical efficacy.