基于视频透视吞咽功能研究评价针刺阿呛组穴联合康复训练治疗脑卒中后吞咽障碍的疗效分析
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摘要
目的基于视频透视吞咽功能研究(video fluoroscopic swallowing study,VFSS)评价针刺阿呛组穴联合康复训练治疗脑卒中后吞咽障碍的疗效。方法将50例脑卒中后吞咽功能障碍的患者,随机分为对照组和治疗组,每组25例。对照组仅采用康复训练,治疗组采用针刺阿呛组穴联合康复训练,比较两组患者治疗前及治疗30d后VFSS评分及功能性经口摄食量表(functional oral intake scale,FOIS)评分。结果两组治疗后FOIS评分均较治疗前升高,差异均有统计学意义(P<0.05),治疗组FOIS评分升高值显著大于对照组(P<0.05)。与治疗前比较,两组治疗后吞食稀钡、浓钡、糊钡、包钡的VFSS评分均显著升高,差异均有统计学意义(P<0.05);且治疗组治疗后吞食稀钡、浓钡、糊钡的VFSS评分升高值显著大于对照组(P<0.05)。结论针刺阿呛组穴联合康复训练可以在一定程度上改善脑卒中后吞咽障碍患者的吞咽功能。
Objective To evaluate the clinical effect of acupuncture at Aqiang point combined with rehabilitation training in the treatment of post-stroke dysphagia by video fluoroscopic swallowing study(VFSS).Methods Fifty patients with post-stroke dysphagia were randomly divided into treatment group and control group,with 25 cases in each group.The control group received rehabilitation training,while the treatment group was treated by acupuncture at Aqiang point combined with rehabilitation training.The two groups were compared in terms of VFSS and Functional Oral Intake Scale(FOIS)scores before and after 30 days of treatment.Results After treatment,both groups showed significant increases in FOIS score(P<0.05),and the treatment group had a significantly greater increase than the control group(P<0.05).In addition,both groups had significantly increased VFSS scores when swallowing thin,thick,paste,and coated barium after treatment(P<0.05),and the treatment group had significantly greater increases in VFSS scores when swallowing thin,thick,and paste barium compared with the control group(P<0.05).Conclusion Acupuncture at Aqiang point combined with rehabilitation training can improve the swallowing function of patients with post-stroke dysphagia.
Objective To evaluate the clinical effect of acupuncture at Aqiang point combined with rehabilitation training in the treatment of post-stroke dysphagia by video fluoroscopic swallowing study(VFSS).Methods Fifty patients with post-stroke dysphagia were randomly divided into treatment group and control group,with 25 cases in each group.The control group received rehabilitation training,while the treatment group was treated by acupuncture at Aqiang point combined with rehabilitation training.The two groups were compared in terms of VFSS and Functional Oral Intake Scale(FOIS)scores before and after 30 days of treatment.Results After treatment,both groups showed significant increases in FOIS score(P<0.05),and the treatment group had a significantly greater increase than the control group(P<0.05).In addition,both groups had significantly increased VFSS scores when swallowing thin,thick,paste,and coated barium after treatment(P<0.05),and the treatment group had significantly greater increases in VFSS scores when swallowing thin,thick,and paste barium compared with the control group(P<0.05).Conclusion Acupuncture at Aqiang point combined with rehabilitation training can improve the swallowing function of patients with post-stroke dysphagia.
引文
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[11]韩旭,徐树岭,马培锋,等.强刺激速刺阿呛穴治疗中风后吞咽困难疗效观察[J].针灸临床杂志,2016,32(8):64-66.
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[13]朱榕,张莉,杨平,等.导尿管球囊扩张术对神经源性环咽肌失迟缓症治疗效果的Meta分析[J].中国康复医学杂志,2018,33(5):573-577.
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[2]卒中患者吞咽障碍和营养管理中国专家组.卒中患者吞咽障碍和营养管理的中国专家共识(2013版)[J].中国卒中杂志,2013,8(12):973-983.
[3]董巍,方剑乔,陈丽芳,等.针刺配合康复训练治疗脑卒中后吞咽障碍疗效观察[J].上海针灸杂志,2013,32(5):337-339.
[4]周红霞,王彦华,程先宽.针刺阿呛组穴联合吞咽功能训练治疗脑卒中后吞咽障碍随机平行对照研究[J].实用中医内科杂志,2016,30(11):91-93.
[5]彭俊峰,李彦杰,李鸿章.针刺和电刺激联合康复训练治疗脑卒中后吞咽障碍患者的疗效观察[J].中华物理医学与康复杂志,2014,36(4):310-311.
[6]江云,胡贝贝,叶晔,等.神经肌肉电刺激联合康复训练治疗缺血性卒中患者咽期吞咽障碍的疗效观察[J].中华物理医学与康复杂志,2016,38(7):501-503.
[7]TIPPETT D C.Clinical challenges in the evaluation and treatment of individuals with poststroke dysphagia[J].Stroke Rehabil,2011,18(2):120-133.
[8]PROSIEGEL M,HLING R,HEINTZE M,et al.The localization of central pattern generators for swallowing in humans:a clinical-anatomical study on patients with unilateral paresis of the vagal nerve,Avellis'syndrome,Wallenberg's syndrome,posterior fossa tumours and cerebellar hemorrhage[J].Acta Neurochir Suppl,2005,93:85-88.
[9]赖日英,黄臻.脑卒中后吞咽障碍的临床研究与进展[J].世界临床医学,2016,10(13):102-105.
[10]王海琴.阿呛穴强刺激法联合摄食训练对中风后吞咽困难的疗效观察[J].针灸临床杂志,2017,33(9):44-47.
[11]韩旭,徐树岭,马培锋,等.强刺激速刺阿呛穴治疗中风后吞咽困难疗效观察[J].针灸临床杂志,2016,32(8):64-66.
[12]韦艳燕.吞咽训练及穴位按摩治疗脑卒中吞咽障碍的研究进展[J].护理学杂志,2016,31(5):106-110.
[13]朱榕,张莉,杨平,等.导尿管球囊扩张术对神经源性环咽肌失迟缓症治疗效果的Meta分析[J].中国康复医学杂志,2018,33(5):573-577.
[14]STOKELY S L,MOLFENTER S M,STEELE C M.Effects of barium concentration on oropharyngeal swallow timing measures[J].Dysphagia,2014,29(1):78-82.