耳穴贴压联合血栓通注射液对缺血性脑卒中恢复期吞咽障碍及神经功能的影响

Effect of Auricular Point Sticking and Pressing Combined with Xueshuantong Injection on Dysphagia and Neurological Function in Convalescent Period of Ischemic Stroke

目的:观察耳穴贴压联合血栓通注射液对缺血性脑卒中恢复期吞咽障碍及神经功能的影响。方法:选取82例气虚血瘀证缺血性脑卒中恢复期患者,按随机数字表法分为对照组及治疗组各41例。对照组予以常规治疗,治疗组在对照组基础上予以耳穴贴压联合血栓通注射液治疗。2组均治疗4周。比较2组临床疗效,比较2组治疗前后吞咽功能[吞咽功能量表(SSA)、洼田饮水试验、Metrohealth评分]、神经功能[神经功能缺损评分(NIHSS)、加拿大神经病学量表(CNS)、神经恢复功能量表(MRS)]、血液流变学指标值、血清指标值[C-反应蛋白(CRP)、白细胞介素-6(IL-6)]的变化。结果:治疗4周后,治疗组临床疗效总有效率为95.12%,对照组为78.05%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组SSA评分、洼田饮水试验评分、Metrohealth评分均较治疗前下降(P<0.05),治疗组上述3项评分均低于对照组(P<0.05)。治疗后,2组NIHSS评分、MRS评分均较治疗前下降(P<0.05),CNS评分均较治疗前升高(P<0.05);治疗组NIHSS评分、MRS评分均低于对照组(P<0.05),CNS评分高于对照组(P<0.05)。治疗2周、4周后,2组全血高切黏度、血小板聚集率均较治疗前下降(P<0.05),治疗组全血高切黏度、血小板聚集率均低于同一时间段对照组(P<0.05)。治疗2周、4周后,2组血清CRP、IL-6水平均较治疗前下降(P<0.05),治疗组血清CRP、IL-6指标值均低于同一时间段对照组(P<0.05)。结论:耳穴贴压联合血栓通注射液能有效改善缺血性脑卒中恢复期患者的吞咽功能、神经功能,改善血液高凝状态,减少炎症反应,提高临床疗效。

Objective:To observe the effects of auricular point sticking and pressing combined with Xueshuantong Injection on dysphagia and neurological function in convalescent period of ischemic stroke.Methods:A total of 82 patients with ischemic stroke with qi deficiency and blood stasis syndrome were selected and divided into the control group and the treatment group according to random number table method,with 41 patients in each group.The control group was given routine treatment,and the treatment group was additionally given auricular point sticking and pressing combined with Xueshuantong Injection based on the treatment of the control group.Both groups were treated for four weeks.The clinical effects in the two groups were compared.The changes in swallowing function[Standardized Swallowing Assessment(SSA),Kubota Water Swallowing Test,Metrohealth scores],neurological function[National Institutes of Health Stroke Scale(NIHSS),Canadian Neurologic Scale(CNS)and Modified Rankin Scale(MRS)],values of hemorheological indexes,serum index values[C-reactive protein(CRP)and interleukin-6(IL-6)]were compared between the two groups before and after treatment.Results:After four weeks of treatment,the total effective rate of clinical effect was 95.12%in the treatment group and 78.05%in the control group,the difference being significant(P<0.05).After treatment,SSA scores,Kubota Water Swallowing Test scores and Metrohealth scores in the two groups were all decreased when compared with those before treatment(P<0.05),and the above three scores in the treatment group were lower than those in the control group(P<0.05).After treatment,NIHSS scores and MRS Scores in the two groups were decreased when compared with those before treatment(P<0.05),and CNS scores were increased when compared with those before treatment(P<0.05);NIHSS score and MRS score in the treatment group were lower than those in the control group(P<0.05),and CNS score was higher than that in the control group(P<0.05).After two and four weeks of treatment,whole blood high shear viscosity and platelet aggregation rates in the two groups were reduced when compared with those before treatment(P<0.05),and the whole blood high shear viscosity and platelet aggregation rate in the treatment group were lower than those in the control group in the same time period(P<0.05).After two and four weeks of treatment,the values of CRP and IL-6 in serum in the two groups were decreased when compared with those before treatment(P<0.05),and the values of CRP and IL-6 in serum in the treatment group were lower than those in the control group in the same time period(P<0.05).Conclusion:Auricular point sticking and pressing combined with Xueshuantong Injection for patients in convalescent period of ischemic stroke can effectively improve their swallowing function,neurological function and hypercoagulable state,reduce inflammatory responses and enhance the clinical effect.