头项针结合辩证取穴治疗中风后恢复期假性延髓麻痹的临床观察
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摘要
目的：
通过观察头项针结合辨证取穴治疗中风后恢复期PBP的临床疗效,为临床多种疗法联合应用提供客观依据。
方法：
1、将符合标准的60例患者随机分为治疗组和对照组各30例,治疗组采用头项针结合辨证取穴治疗,对照组采用传统头颈项部常用腧穴结合辨证取穴治疗。两组头部穴位均施以约200转/min捻转手法,其余穴位进针后提插或捻转行针使得气,施平补平泻手法；每穴每次1min。留针30min,期间每隔10min行针1次,每日针刺2次。两组均以6d为一个疗程,休息1d后进行第2个疗程,连续治疗3个疗程后,判定临床疗效。
2、以吞咽功能和言语功能为观察指标,疗效的评定在患者入院时及治疗3周后各评定一次,进行疗前、疗后及组间疗效的观察。
3、统计学方法：利用软件SPSS17.0进行统计学分析处理,单向有序等级资料用Ridit分析,计数资料用x2检验,P<0.05有统计学意义。
结果：
1、治疗组、对照组疗后的吞咽功能均有改善(p<0.05),且治疗组疗后的吞咽功能优于对照组(p<0.05)。
2、治疗组、对照组疗后的言语功能均有改善(p<0.05),且治疗组疗后的言语功能优于对照组(p<0.05)。
3、治疗组、对照组疗后各证型间疗效比较无统计学意义(p>0.05)。
结论：
1、头项针结合辨证取穴治疗中风后恢复期PBP,能够明显提高患者吞咽和言语功能分级,疗效显著。
2、辨证取穴对中风后恢复期PBP各证型间疗效无统计学意义,但由于本研究中病例数较少,有待进一步研究。
Objective,
To observe the clinical efficacy that patients treated with scalp-nape acupuncture and compatible acupoints according to syndrome differentiation who were suffering from poststroke pseudobulbar palsy, in order to provide an objective basis for clinical application.
Methods,
1.The 60 patients were randomly divided into two groups, there were 30 cases in each group. One group was treated with the scalp and nape acupoints, and a second group was treated with traditional scalp and neck acupoints as a control, each group added the compatible acupoints according to syndrome differentiation. the twisting speed of acupoints on the scalp should be approximately 200 times/minute. The acupoints on the other areas were lifted and thrusted as well as twirled and rotateed with mild reinfocing and reducing method. Twist the needle continuously for 1 minute after the needle has been inserted, and retain the needle for 30 minutes. Repeat this manipulation 2 times, then withdraw the needle. Patients were punctured 2 times every day. There was one day break after 6 days treatment, then another round of treatment will begin.
2.The capability classification of swallowing and speech were observed and assessed between pre-treatment and post-treatment(after 3 rounds)in each group.
3.Statistical method:Makes statistics analysis processing using the SPSS17.0 software, Ridit analysis with unidirectional ordinal rank data, the chi-aquare test with count data, P<0.05 has statistical significance.
Results,
1.After treatment of the two groups, the comparison of patients' swallowing capability and speech capability between the treatment group and the control group showed significant differences(p<0.05).
2. The comparison of capability classification of swallowing and speech between pre-treatment and post-treatment in each group, the differences were both significant (p<0.05). And the treatment efficacy of the treatment group was obviously better than the control group.
3. The comparison of effect of different TCM types, there were no significant difference in each group.
Conclusion,
1.Treatment with scalp-nape acupuncture and compatible acupoints according to syndrome differentiation in patients suffering from pseudobulbar palsy, can significantly improve the capability classification of swallowing and speech.
2. The comparison the curative effect of different TCM types,there were no significant difference in statistics.The study despite the small number of cases shows that it is far from complete and it requires further research.
通过观察头项针结合辨证取穴治疗中风后恢复期PBP的临床疗效,为临床多种疗法联合应用提供客观依据。
方法：
1、将符合标准的60例患者随机分为治疗组和对照组各30例,治疗组采用头项针结合辨证取穴治疗,对照组采用传统头颈项部常用腧穴结合辨证取穴治疗。两组头部穴位均施以约200转/min捻转手法,其余穴位进针后提插或捻转行针使得气,施平补平泻手法；每穴每次1min。留针30min,期间每隔10min行针1次,每日针刺2次。两组均以6d为一个疗程,休息1d后进行第2个疗程,连续治疗3个疗程后,判定临床疗效。
2、以吞咽功能和言语功能为观察指标,疗效的评定在患者入院时及治疗3周后各评定一次,进行疗前、疗后及组间疗效的观察。
3、统计学方法：利用软件SPSS17.0进行统计学分析处理,单向有序等级资料用Ridit分析,计数资料用x2检验,P<0.05有统计学意义。
结果：
1、治疗组、对照组疗后的吞咽功能均有改善(p<0.05),且治疗组疗后的吞咽功能优于对照组(p<0.05)。
2、治疗组、对照组疗后的言语功能均有改善(p<0.05),且治疗组疗后的言语功能优于对照组(p<0.05)。
3、治疗组、对照组疗后各证型间疗效比较无统计学意义(p>0.05)。
结论：
1、头项针结合辨证取穴治疗中风后恢复期PBP,能够明显提高患者吞咽和言语功能分级,疗效显著。
2、辨证取穴对中风后恢复期PBP各证型间疗效无统计学意义,但由于本研究中病例数较少,有待进一步研究。
Objective,
To observe the clinical efficacy that patients treated with scalp-nape acupuncture and compatible acupoints according to syndrome differentiation who were suffering from poststroke pseudobulbar palsy, in order to provide an objective basis for clinical application.
Methods,
1.The 60 patients were randomly divided into two groups, there were 30 cases in each group. One group was treated with the scalp and nape acupoints, and a second group was treated with traditional scalp and neck acupoints as a control, each group added the compatible acupoints according to syndrome differentiation. the twisting speed of acupoints on the scalp should be approximately 200 times/minute. The acupoints on the other areas were lifted and thrusted as well as twirled and rotateed with mild reinfocing and reducing method. Twist the needle continuously for 1 minute after the needle has been inserted, and retain the needle for 30 minutes. Repeat this manipulation 2 times, then withdraw the needle. Patients were punctured 2 times every day. There was one day break after 6 days treatment, then another round of treatment will begin.
2.The capability classification of swallowing and speech were observed and assessed between pre-treatment and post-treatment(after 3 rounds)in each group.
3.Statistical method:Makes statistics analysis processing using the SPSS17.0 software, Ridit analysis with unidirectional ordinal rank data, the chi-aquare test with count data, P<0.05 has statistical significance.
Results,
1.After treatment of the two groups, the comparison of patients' swallowing capability and speech capability between the treatment group and the control group showed significant differences(p<0.05).
2. The comparison of capability classification of swallowing and speech between pre-treatment and post-treatment in each group, the differences were both significant (p<0.05). And the treatment efficacy of the treatment group was obviously better than the control group.
3. The comparison of effect of different TCM types, there were no significant difference in each group.
Conclusion,
1.Treatment with scalp-nape acupuncture and compatible acupoints according to syndrome differentiation in patients suffering from pseudobulbar palsy, can significantly improve the capability classification of swallowing and speech.
2. The comparison the curative effect of different TCM types,there were no significant difference in statistics.The study despite the small number of cases shows that it is far from complete and it requires further research.
引文
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