合谷、颊车针灸联合电针治疗卒中后吞咽困难的疗效及对吞咽功能的影响

Effect of Buccal Motor Acupuncture Combined with Electroacupuncture on Dysphagia after Apoplexy and Its Influence on Swallowing Function

目的探究合谷、颊车针灸联合电针治疗卒中后吞咽困难的疗效及对吞咽功能的影响。方法选取2020年1月—2022年6月该院诊治的卒中后吞咽困难患者82例。根据随机数字表法分为观察组(40例)和对照组(42例),两组均进行常规治疗。对照组采用电针治疗,观察组在对照组基础上采用针灸合谷、颊车治疗,两组均治疗1个月。观察两组治疗前后吞咽障碍、吞咽功能、生活质量、中医证候积分、临床疗效、血流变指标、不良反应。结果观察组治疗后洼田饮水试验评分低于对照组(P<0.05)。观察组标准吞咽功能评定量表评分低于对照组,吞咽障碍特异性生活质量量表高于对照组(P<0.05)。观察组中医证候积分得分低于对照组(P<0.05)。观察组总有效率高于对照组[95.00%(38/40)vs 78.57%(33/42)](P<0.05)。治疗后,两组全血黏度、血浆比黏度、纤维蛋白原、红细胞压积水平均降低,观察组下降幅度大于对照组(P<0.05)。两组患者治疗期间均未发生吸入性肺炎、体温升高、血白细胞数增高等并发症。结论合谷、颊车针灸联合电针治疗卒中后吞咽困难可明显减轻患者吞咽障碍,改善吞咽功能及临床症状,提高生活质量,进而治疗效果较好,且安全性较高。

Objective To explore the effect of Hegu(LI4)and Jiache(ST6)acupuncture combined with electroacupuncture on dysphagia after stroke and its influence on swallowing function.Methods A total of 82 patients with dysphagia after stroke diagnosed and treated in the hospital from January 2020 to June 2022 were selected.According to random number table method,they were divided into observation group(40 cases)and control group(42 cases),and both groups received routine treatment.The control group was treated with electroacupuncture,and the observation group was treated with acupuncture at Hegu(LI4)and Jiache(ST6)on the basis of the control group.Both groups were treated for 1 months.The dysphagia,swallowing function,quality of life,TCM syndrome scores,clinical efficacy,hemorheological index and adverse reactions of the two groups were observed before and after treatment.Results After treatment,the score of water swallow test in the observation group was lower than that in the control group(P<0.05).The standard swallowing function rating scale score of the observation group was lower than that of the control group,while the dysphagia specific quality of life scale was higher than that of the control group(P<0.05).The scores of TCM syndromes in the observation group were lower than those in the control group(P<0.05).The total effective rate of the observation group was higher than that of the control group[95.00%(38/40)vs 78.57%(33/42)](P<0.05).After treatment,the values of whole blood viscosity ratio,plasma viscosity ratio,fibrinogen and hematocrit of the two groups were decreased on average,and the decrease range of the observation group was greater than that of the control group(P<0.05).During treatment,neither groups had complications such as aspiration pneumonia,increased body temperature or increased white blood cell count.Conclusion In the treatment of dysphagia after stroke,acupuncture at Hegu(LI4)and Jiache(ST6)combined with electroacupuncture can significantly reduce dysphagia,improve the swallowing function,the clinical symptoms and the quality of life,and thus the treatment effect is better and the safety is higher.