电针联合祛风化痰通窍方治疗脑梗死后吞咽障碍临床观察

Clinical efficacy of electroacupuncture combined with Qufeng Huatan Tongqiao Formula for post-ischemic stroke dysphagia

目的观察电针联合祛风化痰通窍方治疗脑梗死后吞咽障碍的临床疗效。方法将56例脑梗死后吞咽障碍患者按照随机数字表法分为2组,均予基础治疗。对照组28例予电刺激及基础康复训练,治疗组28例在对照组治疗基础上加电针联合祛风化痰通窍方治疗。2组均5天为1个疗程,连续治疗2个疗程。比较2组临床疗效;比较2组治疗前后洼田饮水试验评分、标准吞咽功能障碍量表(SSA)评分、吞咽困难分级评分变化;比较2组治疗前后汉密尔顿焦虑量表(HAMA)评分变化;比较2组治疗前后前白蛋白值变化;观察2组不良反应发生情况。结果治疗组总有效率96.43%(27/28),对照组总有效率75.00%(21/28),治疗组疗效优于对照组(P<0.05)。2组治疗后洼田饮水试验评分、SSA评分均较本组治疗前降低(P<0.05),吞咽困难分级评分较本组治疗前升高(P<0.05);治疗后治疗组洼田饮水试验评分、SSA评分均低于对照组(P<0.05),吞咽困难分级评分高于对照组(P<0.05)。2组治疗后HAMA评分均较本组治疗前降低(P<0.05),且治疗组降低更明显(P<0.05)。2组治疗后前白蛋白值均较本组治疗前升高(P<0.05),且治疗组升高更明显(P<0.05)。治疗组吸入性肺炎、低营养状态、焦虑加重发生率均低于对照组(P<0.05)。结论电针联合祛风化痰通窍方可明显改善脑梗死后吞咽障碍患者吞咽功能和焦虑状态,安全性高。

Objective To observe the clinical efficacy of electroacupuncture(EA)combined with Qufeng Huatan Tongqiao Formula for post-ischemic stroke dysphagia.Methods A total of 56 patients with post-stroke dysphagia were randomly assigned into treatment group(n=28)and control group(n=28).All patients were managed by swallowing therapeutic apparatus and routine rehabilitation training,and those in treatment group were additionally given EA combined with Qufeng Huatan Tongqiao Formula.The treatment continued for 2 courses(1 course for 5 days),the aim was to compare the scores of water swallow test(WST),standardized swallowing assessment(SSA),Dysphagia Severity Scale(DSS),Hamilton Anxiety Scale(HAMA),and the level of prealbumin.The curative effect and adverse reactions were assessed.Results The overall effective rate in the treatment group was better than that in the control group(96.43%[27/28]vs 75.00%[21/28],P<0.05).After treatment,the scores of WST and SSA were significantly decreased in the two groups than those before treatment,but DSS scores were significantly increased(all P<0.05),and the treatment group was superior to the control group for the scores of WST,SSA,DSS(all P<0.05).After treatment,HAMA scores in the both groups were significantly decreased(P<0.05),which decreased notably in the treatment group compared with the control group(P<0.05).The levels of prealbumin in the both groups were significantly increased(P<0.05),the increase in the treatment group was more prevalent compared with the control group(P<0.05).The incidences of aspiration pneumonia,low nutritional status,anxiety worsens in the both groups were significantly decreased(P<0.05),the decreases in the treatment group were more common than the control group(P<0.05).Conclusion For patients with post-stroke dysphagia,EA combined with Qufeng Huatan Tongqiao Formula can significantly improve swallowing function and anxiety status,and with high safety.