项丛刺疗法联合揿针埋针治疗脑卒中后吞咽障碍的临床疗效观察

Clinical efficacy of cervical cluster acupuncture combined with thumbtack needle-embedding therapy in the treatment of post-stroke dysphagia

目的探究项丛刺疗法联合揿针埋针治疗脑卒中后吞咽障碍(post-stroke dysphagia,PSD)的临床疗效。方法选取2019年3月至2022年1月保定市第二医院收治的80例PSD患者,采用随机数字表法分为观察组和对照组,各40例。对照组采用揿针埋针治疗,观察组采用项丛刺疗法联合揿针埋针治疗,两组干预隔日1次,均治疗2周。比较两组临床疗效、吞咽功能评价量表(standardized swallowing assessment,SSA)、洼田饮水试验、中医证候积分、吞咽造影数字化分析相关指标(咽收缩率和咽收缩持续时间)、表面肌电图(surface electromyography,sEMG)指标[持续时间和平均振幅值(averaged electromyography,AEMG)]及并发症发生率。结果与对照组(75.00%)比较,观察组总有效率(92.50%)升高(P<0.05)。与治疗前比较,两组治疗后洼田饮水试验评分、SSA评分、中医证候积分、咽收缩率以及颏下肌群、舌骨下肌群的AEMG和持续时间均降低(P<0.05),且观察组低于对照组(P<0.05);与治疗前比较,两组治疗后咽收缩持续时间增加(P<0.05),且观察组高于对照组(P<0.05)。两组并发症发生率差异无统计学意义(P>0.05)。结论项丛刺疗法联合揿针埋针治疗PSD效果显著,可提高患者吞咽功能,缓解症状,改善吞咽造影数字化分析、表面肌电图相关指标。

Objective To explore the clinical efficacy of cervical cluster acupuncture(CCA)combined with thumbtack needle-embedding therapy(TNET)in the treatment of post-stroke dysphagia(PSD).Methods A total of 80 patients with PSD admitted to the Second Hospital of Baoding from March 2019 to January 2022 were selected and divided into observation and control groups by random number table method,with 40 cases in each group.The control group was treated with TNET,and the observation group was treated with CCA combined with TNET.Both groups were treated once every other day for two weeks.Clinical efficacy,standardized swallowing assessment(SSA)score,water swallow test score,TCM syndrome score,relevant indicators of digitized videofluoroscopic swallow study(pharyngeal contraction rate and duration)and surface electromyography(sEMG)[duration and averaged electromyography(AEMG)],and complication incidence were compared between the two groups.Results The total effective rate of the observation group(92.50%)was significantly higher than that in the control group(75.00%)(P<0.05).Compared with before treatment,the water swallow test scores,SSA scores,TCM syndrome scores,pharyngeal contraction rate,and AEMG and duration of submental and infrahyoid muscle groups decreased in both groups after treatment(P<0.05),with the observation group showing greater reductions than the control group(P<0.05).Compared with before treatment,the duration of pharyngeal contraction in both groups increased after treatment(P<0.05),with the observation group showing a greater increase than the control group(P<0.05).There was no statistically significant difference in the complication incidence between the two groups(P>0.05).Conclusion CCA combined with TNET is effective in the treatment of PSD,thereby enhancing the swallowing function,alleviating symptoms,and improving the related indicators of digitized videofluoroscopic swallow study and sEMG.