通督调神针刺联合低频脉冲穴位电刺激治疗脑卒中后吞咽障碍(假性球麻痹)临床研究

Clinical Observation on the Treatment of Dysphagia After Stroke(Pseudobulbar Paralysis)with Tongdu Tiaoshen Acupuncture Combined with Low-frequency Pulse Acupoint Electrical Stimulation

目的观察通督调神针刺联合低频脉冲穴位电刺激对脑卒中后吞咽障碍(DAS)(假性球麻痹)的临床疗效。方法按随机数字表法将60例DAS(假性球麻痹)患者按入院顺序随机分为治疗组与对照组各30例;两组患者均接受脑卒中西医常规治疗,并统一进行吞咽功能康复训练;对照组予普通针刺法,治疗组予通督调神针刺联合低频脉冲穴位电刺激治疗。所有患者治疗6 d为1个疗程,疗程间休息1 d,共治疗2个疗程。2个疗程后比较两组标准吞咽功能评价量表(SSA)、洼田饮水试验等级评分,并评价两组临床疗效。结果1)两组SSA量表评分在治疗后均较前降低(P<0.05),且治疗组SSA评分比对照组降低更明显(P<0.05)。2)治疗后两组患者洼田饮水试验评分比较,差异有统计学意义(P<0.05)。3)治疗组总有效率为83.33%,显著高于对照组的60.00%(P<0.05)。结论通督调神针刺联合低频脉冲穴位电刺激治疗在降低SSA评分及洼田饮水试验等级评分能力上均优于普通针刺法,可明显改善DAS(假性球麻痹)患者的吞咽功能。

Objective:To observe the clinical efficacy of Tongdu Tiaoshen acupuncture combined with low-frequency pulse acupoint electrical stimulation on Dysphagia After Stroke(DAS)(pseudobulbar paralysis)after stroke.Methods:60 patients with DAS(pseudobulbar paralysis)were randomly divided into a treatment group and a control group using a random number table method,with 30 cases in each group.Both group received routine western medicine treatment for stroke and underwent unified swallowing function rehabilitation training;the control group was treated with ordinary acupuncture,while the treatment group was treated with Tongdu Tiaoshen acupuncture combined with low-frequency pulse acupoint electrical stimulation.All patients were treated for 6 days per week as one course of treatment,with a 1-day break between the courses,for a total of 2 courses of treatment.After two courses of treatment,the Standardized Swallowing Assessment(SSA)and Wada Drinking Water Test scores between the two groups were compared,and the clinical efficacies of the two groups were evaluated.Results:1)The SSA score of both groups decreased after treatment compared with before(P<0.05),and the SSA score of the treatment group decreased more significantly than that of the control group(P<0.05).2)There was a statistically significant difference in the Wada Drinking Water Test scores between the two groups after treatment(P<0.05).3)The total effective rate of the treatment group(83.33%)was significantly higher than that of the control group(60.00%)(P<0.05).Conclusion:The combination of Tongdu Tiaoshen acupuncture and low-frequency pulse acupoint electrical stimulation has a better ability to reduce SSA scores and Wada Drinking Water Test scores than ordinary acupuncture,which can significantly improve the swallowing function of DAS(pseudobulbar paralysis)patients.