咽三针点按联合摄食-吞咽训练在脑卒中后吞咽障碍患者康复治疗中的应用

Application of point-pressing manipulation at pharyngeal three acupoints combined with ingestion-swallowing training in rehabilitation treatment of patients with post-stroke dysphagia

目的:探究咽三针点按联合摄食-吞咽训练在脑卒中后吞咽障碍(PSD)患者康复治疗中的应用。方法:选取2022年1月~2023年9月本院收治的126例PSD患者,随机分为两组(63例/组)。对照组采用常规的摄食-吞咽训练进行治疗,实验组采用咽三针点按联合摄食-吞咽训练进行治疗。观察两组治疗前后临床疗效,证候积分,吞咽功能,舌骨喉复合体动度指标,营养指标[血清白蛋白(ALB),血红蛋白(Hb),血清前白蛋白(PA)水平],并观察治疗过程中的不良反应。结果:实验组治疗后临床疗效、洼田饮水试验分级分布情况、舌骨喉复合体动度指标均优于对照组(P<0.05),临床证候积分低于对照组(P<0.05),ALB,Hb,PA水平均高于对照组(P<0.05),两组治疗过程中无明显不良反应。结论:咽三针点按联合摄食-吞咽训练应用于PSD患者康复治疗中,可改善患者的吞咽功能,增加舌骨喉复合体的运动范围,提升其营养状态。

Objective:To explore the application of point-pressing manipulation at pharyngeal three acupoints combined with ingestion-swallowing training in rehabilitation treatment of patients with post-stroke dysphagia(PSD).Methods:A total of 126patients with PSD admitted to the hospital were enrolled and randomly divided into control group(routine ingestion-swallowing training)and experimental group(point-pressing manipulation at pharyngeal three acupoints combined with ingestion-swallowing training)between January 2022 and September 2023,63 cases in each group.The clinical curative effect,scores of syndromes,swallowing function,movement indexes of hyolaryngeal complex and nutritional indexes[serum albumin(ALB),hemoglobin(Hb),serum prealbumin(PA)]before and after treatment,and adverse reactions during treatment in the two groups were observed.Results:After treatment,clinical curative effect,grading of water swallow test and movement indexes of hyolaryngeal complex in experimental group were all better than those in control group(P<0.05),scores of clinical syndromes were lower than those in control group(P<0.05),and levels of ALB,Hb and PA were higher than those in control group(P<0.05).There were no obvious adverse reactions in either group during treatment.Conclusion:Application of point-pressing manipulation at pharyngeal three acupoints combined with ingestion-swallowing training in rehabilitation treatment of PSD patients can improve swallowing function,increase movement range of hyolaryngeal complex and improve nutritional status.