针刺改善卒中后假性球麻痹所致吞咽障碍的疗效观察
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摘要
目的:研究针刺改善卒中后假性球麻痹所致吞咽障碍的疗效。方法:符合纳入标准的吞咽障碍患者随机分入对照组和针刺组,最终入组的对照组14例、针刺组11例。对照组采用常规康复手法训练,针刺组在常规康复手法训练基础上进行针刺治疗。治疗前、治疗1、2周后分别利用吞咽障碍严重程度量表(SSS)和改良吞咽障碍能力评价表(MMASA)评估吞咽功能;治疗结束1个月随访,利用SSS量表评估吞咽功能。结果:治疗1、2周后,两组患者SSS评分有改善趋势,MMASA评分明显增加(P<0.01),但组间比较无差异。1个月后随访,针刺组SSS评分明显优于对照组(P<0.05)。结论:在康复手法训练基础上,配合针刺疗法更有助于卒中后假性球麻痹所致吞咽障碍的远期恢复。
Objective: To investigate the effects of acupuncture on post-stroke pseudobulbar palsy-induced dysphagia.Methods: Dysphagia patients met inclusion criteria were randomly divided into control group(14 cases) and acupuncture group(11 cases). The control group received the swallowing maneuvers. The acupuncture group received acupuncture therapy combined with swallowing maneuvers. The scores of swallow severity scale(SSS) and modified Mann assessment of swallowing ability(MMASA) were compared between two groups before treatment, 1 week and 2 week after treatment respectively. The SSS scores were compared between two groups at one month follow-up after treatment. Results: The score of SSS among the control group and acupuncture group at 1 week and 2 week after treatment had an improvement trend and the score of MMASA increased(P<0.01), though there was no significant difference between groups. The scores of SSS in acupuncture group was higher than that in control group at 1-month follow-up(P<0.05). Conclusion: Combined with the swallowing maneuvers, acupuncture treatment may facilitate the long-term recovery of post-stroke pseudobulbar palsy-induced dysphagia.
Objective: To investigate the effects of acupuncture on post-stroke pseudobulbar palsy-induced dysphagia.Methods: Dysphagia patients met inclusion criteria were randomly divided into control group(14 cases) and acupuncture group(11 cases). The control group received the swallowing maneuvers. The acupuncture group received acupuncture therapy combined with swallowing maneuvers. The scores of swallow severity scale(SSS) and modified Mann assessment of swallowing ability(MMASA) were compared between two groups before treatment, 1 week and 2 week after treatment respectively. The SSS scores were compared between two groups at one month follow-up after treatment. Results: The score of SSS among the control group and acupuncture group at 1 week and 2 week after treatment had an improvement trend and the score of MMASA increased(P<0.01), though there was no significant difference between groups. The scores of SSS in acupuncture group was higher than that in control group at 1-month follow-up(P<0.05). Conclusion: Combined with the swallowing maneuvers, acupuncture treatment may facilitate the long-term recovery of post-stroke pseudobulbar palsy-induced dysphagia.
引文
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[2]王英.“醒脑开窍”针法配合吞咽康复训练治疗中风后假性球麻痹疗效观察.山西中医,2017,33(2):43-44
[3]方君辉,朱文宗,宋丰军,等.深刺廉泉穴配合项十针治疗卒中后假性球麻痹临床观察.上海针灸杂志,2017,36(6):652-656
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[5]姚桂棉.针刺配合吞咽功能障碍训练治疗中风后假性延髓麻痹的疗效.内蒙古中医药,2017,36(14):123
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[8]陈玉玺.针刺联合吞咽训练治疗脑梗死后吞咽障碍患者的疗效观察.中国现代药物应用,2018,12(1):70-71
[9]李飞,汤敬一,程红亮,等.针刺加冷刺激配合舌肌训练对脑卒中吞咽障碍患者的康复疗效评价.中华中医药杂志,2012,27(9):2471-2474
[10]浦丽超.联用针刺疗法与吞咽训练法治疗脑卒中后吞咽障碍的效果研究.当代医药论丛,2017,15(8):36-37
[11]中华神经外科学会中华神经科学会.各类脑血管疾病诊断要点.中华神经外科杂志,1996,29(6):379-380
[12]刘诗丹,陈启波,李荣祝,等.综合康复训练治疗脑卒中吞咽障碍患者的临床疗效观察.中国康复医学杂志,2013,28(6):569-573
[13]Blumenfeld L,Hahn Y,Lepage A,et al.Transcutaneous electricalstimulation versus traditional dysphagia therapy:A nonconcurrentcohort study.Otolaryngol Head Neck Surg,2006,135(5):754-757
[14]汪洁,吴东宇,宋为群,等.表面电刺激治疗低位脑干梗死致严重吞咽困难及其机制.中国康复理论与实践,2009,15(1):54-57
[15]袁英,汪洁,吴东宇,等.经颅直流电刺激改善卒中后共济失调型吞咽障碍的疗效观察.中国康复医学杂志,2015,30(8):765-770
[16]Antonios N,Carnaby-Mann G,Crary M,et al.Analysis of a physiciantool for evaluating dysphagia on an inpatient stroke unit:themodified Mann Assessment of Swallowing Ability.J StrokeCerebrovasc Dis,2010,19(1):49-57
[17]宋书昌,卢智,王志勇,等.针刺治疗脑卒中后吞咽障碍研究进展.中西医结合心脑血管病杂志,2013,11(12):1511-1513
[18]周睿娴,张春红.针刺治疗脑卒中后吞咽障碍的临床研究进展.针灸临床杂志,2011,27(11):67-71
[19]刘茂祥,李铁成.针刺治疗脑卒中后假性球麻痹吞咽困难36例.长春中医药大学学报,2008,24(3):302
[20]陆军伟,孙建华.针灸治疗假性球麻痹所致的吞咽困难选穴规律研究.南京中医药大学学报,2009,25(1):62-64
[21]施杨婉琳,杨孝芳,崔瑾,等.假性球麻痹致吞咽困难针灸辨证选穴规律的回顾性分析.贵阳中医学院学报,2011,33(3):15-18
[22]郑宏,朱士文,杨福,等.冲脉理论针刺治疗中风后吞咽障碍疗效观察.中国针灸,2011,31(12):1067-1070
[23]张盘德,周惠嫦,姚红.针刺与吞咽训练辅助治疗脑卒中恢复期吞咽障碍的疗效对比观察.中华物理医学与康复杂志,2009,31(12):827-831
[24]楚佳梅,高维滨.项针对假性延髓麻痹病人TCD的影响.针灸临床杂志,2005,21(8):4-6
[25]楚佳梅,高维滨.项针对假性延髓麻痹病人BAEP的影响.中医药学刊,2006,24(11):2150-2151
[26]Zhang C H,Bian J L,Meng Z H,et al.Tongguan Liqiao acupuncturetherapy improves dysphagia after brainstem stroke.Neural RegenRes,2016,11(2):285-291
[27]胡建平,李银官,曹代荣,等.不同方法针刺内关穴f MRI比较研究.中国现代医生,2008,46(33):4-7,10
[28]宋晓晶,张栋.针刺合谷与光明穴在面部的红外热像显示研究.中国针灸,2010,30(1):51-54
[2]王英.“醒脑开窍”针法配合吞咽康复训练治疗中风后假性球麻痹疗效观察.山西中医,2017,33(2):43-44
[3]方君辉,朱文宗,宋丰军,等.深刺廉泉穴配合项十针治疗卒中后假性球麻痹临床观察.上海针灸杂志,2017,36(6):652-656
[4]孙玲莉,黄丽萍,张晓霞.针刺结合康复训练治疗中风后吞咽障碍临床研究.陕西中医,2017,38(10):1467-1468
[5]姚桂棉.针刺配合吞咽功能障碍训练治疗中风后假性延髓麻痹的疗效.内蒙古中医药,2017,36(14):123
[6]郑法文,吴子明,马景桐,等.针刺兴奋法治疗脑卒中假性延髓麻痹吞咽障碍临床观察.上海针灸杂志,2017,36(6):668-672
[7]田德龙,孟凡峰,陈洪芳,等.醒脑开窍针刺法联合吞咽康复训练治疗卒中后吞咽障碍临床研究.中国基层医药,2018,25(3):287-290
[8]陈玉玺.针刺联合吞咽训练治疗脑梗死后吞咽障碍患者的疗效观察.中国现代药物应用,2018,12(1):70-71
[9]李飞,汤敬一,程红亮,等.针刺加冷刺激配合舌肌训练对脑卒中吞咽障碍患者的康复疗效评价.中华中医药杂志,2012,27(9):2471-2474
[10]浦丽超.联用针刺疗法与吞咽训练法治疗脑卒中后吞咽障碍的效果研究.当代医药论丛,2017,15(8):36-37
[11]中华神经外科学会中华神经科学会.各类脑血管疾病诊断要点.中华神经外科杂志,1996,29(6):379-380
[12]刘诗丹,陈启波,李荣祝,等.综合康复训练治疗脑卒中吞咽障碍患者的临床疗效观察.中国康复医学杂志,2013,28(6):569-573
[13]Blumenfeld L,Hahn Y,Lepage A,et al.Transcutaneous electricalstimulation versus traditional dysphagia therapy:A nonconcurrentcohort study.Otolaryngol Head Neck Surg,2006,135(5):754-757
[14]汪洁,吴东宇,宋为群,等.表面电刺激治疗低位脑干梗死致严重吞咽困难及其机制.中国康复理论与实践,2009,15(1):54-57
[15]袁英,汪洁,吴东宇,等.经颅直流电刺激改善卒中后共济失调型吞咽障碍的疗效观察.中国康复医学杂志,2015,30(8):765-770
[16]Antonios N,Carnaby-Mann G,Crary M,et al.Analysis of a physiciantool for evaluating dysphagia on an inpatient stroke unit:themodified Mann Assessment of Swallowing Ability.J StrokeCerebrovasc Dis,2010,19(1):49-57
[17]宋书昌,卢智,王志勇,等.针刺治疗脑卒中后吞咽障碍研究进展.中西医结合心脑血管病杂志,2013,11(12):1511-1513
[18]周睿娴,张春红.针刺治疗脑卒中后吞咽障碍的临床研究进展.针灸临床杂志,2011,27(11):67-71
[19]刘茂祥,李铁成.针刺治疗脑卒中后假性球麻痹吞咽困难36例.长春中医药大学学报,2008,24(3):302
[20]陆军伟,孙建华.针灸治疗假性球麻痹所致的吞咽困难选穴规律研究.南京中医药大学学报,2009,25(1):62-64
[21]施杨婉琳,杨孝芳,崔瑾,等.假性球麻痹致吞咽困难针灸辨证选穴规律的回顾性分析.贵阳中医学院学报,2011,33(3):15-18
[22]郑宏,朱士文,杨福,等.冲脉理论针刺治疗中风后吞咽障碍疗效观察.中国针灸,2011,31(12):1067-1070
[23]张盘德,周惠嫦,姚红.针刺与吞咽训练辅助治疗脑卒中恢复期吞咽障碍的疗效对比观察.中华物理医学与康复杂志,2009,31(12):827-831
[24]楚佳梅,高维滨.项针对假性延髓麻痹病人TCD的影响.针灸临床杂志,2005,21(8):4-6
[25]楚佳梅,高维滨.项针对假性延髓麻痹病人BAEP的影响.中医药学刊,2006,24(11):2150-2151
[26]Zhang C H,Bian J L,Meng Z H,et al.Tongguan Liqiao acupuncturetherapy improves dysphagia after brainstem stroke.Neural RegenRes,2016,11(2):285-291
[27]胡建平,李银官,曹代荣,等.不同方法针刺内关穴f MRI比较研究.中国现代医生,2008,46(33):4-7,10
[28]宋晓晶,张栋.针刺合谷与光明穴在面部的红外热像显示研究.中国针灸,2010,30(1):51-54
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