针刺联合舌压抗阻反馈训练治疗中风后吞咽障碍:一项随机对照试验

Acupuncture plus tongue pressure resistance feedback training for post-stroke deglutition disorders:a randomized controlled trial

目的:观察通关利窍针刺法联合舌压抗阻反馈训练治疗中风后吞咽障碍患者的疗效。方法:采用前瞻性随机对照研究,将120例中风后吞咽障碍患者采用随机数字表法分为对照组与观察组,每组60例。两组均采用常规治疗,对照组加用舌压抗阻反馈训练治疗;观察组在对照组干预基础上加用通关利窍针刺法。两组治疗4周后进行临床疗效评价并总结治疗期间并发症发生情况。治疗前及治疗4周后进行藤岛一郎吞咽困难分级量表(FILS)评分和吞咽障碍特异性生活质量问卷(SWAL-QOL)评分。结果:观察组总有效率高于对照组(P<0.05)。治疗4周后,两组FILS及SWAL-QOL评分均高于治疗前,且观察组高于对照组(P<0.05)。两组治疗期间并发症发生情况差异无统计学意义(P>0.05)。结论:在常规治疗基础上,通关利窍针刺法联合舌压抗阻反馈训练治疗中风后吞咽障碍的疗效较好,可有效改善患者吞咽功能,提高生活质量,且安全性较好。

Objective:To observe the effect of Tongguan Liqiao(opening orifices)needling plus tongue pressure resistance feedback training in treating post-stroke deglutition disorders.Methods:A prospective randomized controlled trial was conducted.A total of 120 patients with post-stroke deglutition disorders were divided into a control group and an observation group using the random number table method,with 60 cases in each group.Both groups were treated with routine treatments.The control group was treated with additional tongue pressure resistance feedback training,and the observation group was treated with additional Tongguan Liqiao needling based on the same intervention in the control group.After 4 weeks of treatment,the clinical efficacy was evaluated,and the complications that occurred during treatment were summarized.The FUJISHIMA Ichiro food intake level scale(FILS)and the swallowing quality of life questionnaire(SWAL-QOL)were scored before treatment and after 4 weeks of treatment.Results:The total effective rate of the observation group was higher than that of the control group(P<0.05).After 4 weeks of treatment,the FILS and SWAL-QOL scores in both groups were higher than those before treatment,and the scores in the observation group were higher than those in the control group(P<0.05).There was no statistical difference in the complication occurrence between the two groups(P>0.05).Conclusion:On the basis of routine treatments,Tongguan Liqiao needling plus tongue pressure resistance feedback training has a better effect in the treatment of post-stroke deglutition disorders.This method can effectively improve the swallowing function of patients,improve the quality of life,and is safe.