针刺治疗脑卒中后假性延髓性麻痹的临床研究
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摘要
目的观察针刺治疗脑卒中后假性延髓性麻痹的吞咽、言语功能障碍的临床疗效并探讨其作用机制。方法 80例患者随机分为治疗组与对照组各40例。对照组依照指南给予规范西医治疗和康复训练,治疗组在对照组的基础上,增加针刺治疗。均连续治疗两个疗程。观察两组治疗方法对吞咽、言语障碍的临床疗效。结果两组治疗前吞咽、言语功能评级比较,差别均不大(均P> 0.05)。治疗后两组吞咽、言语功能评级与治疗前比较均改善(均P <0.05),且治疗组吞咽、言语功能评级改善优于对照组(均P <0.05)。治疗后,治疗组总有效率为77.50%,高于对照组的70.00%(P <0.05)。两组治疗期间均未见明显不良反应。结论针刺治疗假性延髓性麻痹的临床疗效显著。
Objective: To observe the clinical efficacy of acupuncture on swallowing and speech dysfunction of pseudobulbar paralysis after stroke. Methods: 80 patients were randomly divided into the treatment group and the control group. The control group was given standardized Western medicine treatment and rehabilitation training according to the guidelines. The treatment group increased acupuncture treatment on the basis. Both were treated continuously for two courses. The clinical effects of two groups on dysphagia and speech disordero were observed.Results: There was no significant difference in swallowing and speech function rating between the two groups before treatment(all P > 0.05). After treatment,the state was improved compared with those before treatment(all P <0.05),and those of the treatment group were better than those of the control group(all P < 0.05). After treatment,the total effective rate of the treatment group was 77.50%,higher than 70.00% of the control group(P < 0.05).There were no obvious adverse reactions during the treatment period in both groups. Conclusion: The clinical effect of acupuncture on pseudobulbar paralysis is significant.
Objective: To observe the clinical efficacy of acupuncture on swallowing and speech dysfunction of pseudobulbar paralysis after stroke. Methods: 80 patients were randomly divided into the treatment group and the control group. The control group was given standardized Western medicine treatment and rehabilitation training according to the guidelines. The treatment group increased acupuncture treatment on the basis. Both were treated continuously for two courses. The clinical effects of two groups on dysphagia and speech disordero were observed.Results: There was no significant difference in swallowing and speech function rating between the two groups before treatment(all P > 0.05). After treatment,the state was improved compared with those before treatment(all P <0.05),and those of the treatment group were better than those of the control group(all P < 0.05). After treatment,the total effective rate of the treatment group was 77.50%,higher than 70.00% of the control group(P < 0.05).There were no obvious adverse reactions during the treatment period in both groups. Conclusion: The clinical effect of acupuncture on pseudobulbar paralysis is significant.
引文
[1]孙伟平,阿依古丽艾山,王欣华,等. 115例急性脑卒中患者标准吞咽功能评估[J].中国康复理论与实践,2006,12(4):282-284.
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[10]张慧永,马晓俊,丁亮吾.针刺阿呛穴治疗脑卒中假性球麻痹吞咽困难的中西医机制探讨[J].中医研究:2012,25(3):53-55.
[11]吴远华,朱广旗.四步针刺法配合吞咽障碍治疗仪治疗脑卒中后假性延髓麻痹的疗效[J].中国老年学杂志,2013,33(1):172-173.
[12]贾金金,吴立峰.舌三针配合Vitalstim吞咽治疗仪治疗急性缺血性脑梗死吞咽障碍的临床观察[J].中国中医急症,2018,27(3):515-518.
[13]龚丹,郑建刚.针刺风池透喉结翳风透喉结为主治疗假性球麻痹40例临床观察[J].四川中医,2015,33(5):163-164.
[14]罗文舒.针刺任脉对脑梗塞假性延髓麻痹BAEP的影响[J].辽宁中医药大学学报,2010,12(3):78-79.
[15]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[J].上海针灸杂志,2017,36(6):652-656.
[16]窦祖林,兰月,于帆,等.吞咽造影数字化分析脑干卒中后吞咽障碍患者疗效评估的应用[J].中国康复医学杂志,2013,28(9):799-805.
[17]兰月,徐光青,窦祖林,等.改良球囊扩张术对脑干卒中后吞咽障碍患者食管约肌功能的影响[J].中华医学杂志,2013,93(33):2631-2636.
[18]柳敏,张贤明,余皓,等.针灸联合补肾益髓开窍方治疗急性卒中后吞咽障碍的临床研究[J].中国中医急救,2015,24(1):63-65.
[19]丁玲,汤显靖,杨小飞,等.吞咽治疗仪联合电针治疗卒中后吞咽障碍对卒中相关性肺炎发生率的影响[J].卒中与神经疾病杂志,2013,20(1):39-41.
[20]王可博,郑秀华,朱凌峰,等.脑梗死早期行针灸联合康复疗法对身体功能和生活质量的影响[J].中国中医急症,2018,27(4):668-670.
[2]卫健华.舌咽针治疗中风假性球麻痹吞咽困难的临床观察[J].光明中医:2012,27(1):95-96.
[3]高维滨,刘勇,倪金霞,等.项针治疗中风后假性延髓麻痹的临床研究[J].上海针灸杂志,2009,28(1):18-20.
[4]王笑中,焦守恕.神经系统疾病症候学[M].北京:人民卫生出版社,1979:234-245.
[5]贾建平,崔丽英,王伟,等.神经病学[M].北京:人民卫生出版社,2008:213-214.
[6]中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2014[J].中华神经科杂志,2015,48(4):246-257.
[7]中华医学会神经病学分会神经康复学组.中国脑卒中康复治疗指南2011[J].中国康复理论与实践,2012,18(4):301-318.
[8] Han TR,Paik NJ,Park JW. Quantifying swallowing functionafter stroke functional dysphag ia scale based on videflu-oroscopic studies[J]. Arch Phys Med Rehabi,2001,82(5):677-682.
[9]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55-56.
[10]张慧永,马晓俊,丁亮吾.针刺阿呛穴治疗脑卒中假性球麻痹吞咽困难的中西医机制探讨[J].中医研究:2012,25(3):53-55.
[11]吴远华,朱广旗.四步针刺法配合吞咽障碍治疗仪治疗脑卒中后假性延髓麻痹的疗效[J].中国老年学杂志,2013,33(1):172-173.
[12]贾金金,吴立峰.舌三针配合Vitalstim吞咽治疗仪治疗急性缺血性脑梗死吞咽障碍的临床观察[J].中国中医急症,2018,27(3):515-518.
[13]龚丹,郑建刚.针刺风池透喉结翳风透喉结为主治疗假性球麻痹40例临床观察[J].四川中医,2015,33(5):163-164.
[14]罗文舒.针刺任脉对脑梗塞假性延髓麻痹BAEP的影响[J].辽宁中医药大学学报,2010,12(3):78-79.
[15]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[J].上海针灸杂志,2017,36(6):652-656.
[16]窦祖林,兰月,于帆,等.吞咽造影数字化分析脑干卒中后吞咽障碍患者疗效评估的应用[J].中国康复医学杂志,2013,28(9):799-805.
[17]兰月,徐光青,窦祖林,等.改良球囊扩张术对脑干卒中后吞咽障碍患者食管约肌功能的影响[J].中华医学杂志,2013,93(33):2631-2636.
[18]柳敏,张贤明,余皓,等.针灸联合补肾益髓开窍方治疗急性卒中后吞咽障碍的临床研究[J].中国中医急救,2015,24(1):63-65.
[19]丁玲,汤显靖,杨小飞,等.吞咽治疗仪联合电针治疗卒中后吞咽障碍对卒中相关性肺炎发生率的影响[J].卒中与神经疾病杂志,2013,20(1):39-41.
[20]王可博,郑秀华,朱凌峰,等.脑梗死早期行针灸联合康复疗法对身体功能和生活质量的影响[J].中国中医急症,2018,27(4):668-670.