温针灸法配合功能训练改善老年帕金森病患者吞咽功能障碍分析
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摘要
目的:分析温针灸法配合功能训练改善老年帕金森病患者吞咽功能障碍。方法:随机选取2015年2月—2017年2月我院收治的老年帕金森病患者80例,依据康复方法将这些患者分为功能训练组(对照组,n=40)和温针灸法配合功能训练组(研究组,n=40)两组,对两组患者的吞咽功能、临床疗效、营养指标进行统计分析。结果:两组患者治疗后的洼田饮水试验1级、2级比例均显著高于治疗前(P<0.05),3级、4级、5级比例均显著低于治疗前(P<0.05);治疗前两组患者的洼田饮水试验1级、2级、3级、4级、5级比例之间的差异均不显著(P>0.05),治疗后研究组患者的洼田饮水试验1级、2级比例均显著高于对照组(P<0.05),3级、4级、5级比例均显著低于对照组(P<0.05)。研究组患者治疗的总有效率85.0%(34/40)显著高于对照组55.0%(22/40)(P<0.05)。两组患者治疗后的BMI、AMC、TSF、Hb、PA、ALB水平均显著高于治疗前(P<0.05);治疗前两组患者的BMI、AMC、TSF、Hb、PA、ALB水平之间的差异均不显著(P>0.05),治疗后研究组患者的BMI、AMC、TSF、Hb、PA、ALB水平均显著高于对照组(P<0.05)。结论:温针灸法配合功能训练较单独功能训练更能有效改善老年帕金森病患者吞咽功能障碍。
Objective:To analyze the effect of warming acupuncture moxibustion combined with functional training on dysphagia in elderly patients with Parkinson's disease. Methods:80 cases of elderly patients with Parkinson's disease from February 2013 to February 2017 in our hospital were randomly selected,these patients were divided into functional training group(control group,n=40)and warming acupuncture moxibustion combined with functional training group(study group,n=40)according to the rehabilitation methods. The pharynx functions,clinical efficacy and nutritional indexes of the two groups were statistically analyzed. Results:The grade 1 and 2 ratios in the potable water test after treatment of the two groups were significantly higher(P<0.05),and the grade 3,4 and 5 ratios were significantly lower than before treatment(P<0.05),and the differences of 1,2,3,3,4 and 5 ratios before treatment between the two groups were no significant(P>0.05). The grade 1 and 2 ratios after treatment of the study group were significantly higher(P<0.05),and the grade 3,4 and 5 ratios were significantly lower than the control group(P<0.05). The total effective rate of the study group 85.0%(34/40)was significantly higher than the control group 55.0%(22/40)(P<0.05). The BMI,AMC,TSF,Hb,PA and ALB levels after treatment of the two groups were significantly higher than before treatment(P<0.05),and the differences of BMI,AMC,TSF,Hb,PA,ALB levels before treatment between the two groups were not significant(P>0.05). The BMI,AMC,TSF,Hb,PA,ALB levels after treatment of the study group were significantly higher than the control group(P<0.05). Conclusion:Warming acupuncture moxibustion combined with functional training is more effective than functional training alone in improving swallowing dysfunction of elderly patients with Parkinson's disease.
Objective:To analyze the effect of warming acupuncture moxibustion combined with functional training on dysphagia in elderly patients with Parkinson's disease. Methods:80 cases of elderly patients with Parkinson's disease from February 2013 to February 2017 in our hospital were randomly selected,these patients were divided into functional training group(control group,n=40)and warming acupuncture moxibustion combined with functional training group(study group,n=40)according to the rehabilitation methods. The pharynx functions,clinical efficacy and nutritional indexes of the two groups were statistically analyzed. Results:The grade 1 and 2 ratios in the potable water test after treatment of the two groups were significantly higher(P<0.05),and the grade 3,4 and 5 ratios were significantly lower than before treatment(P<0.05),and the differences of 1,2,3,3,4 and 5 ratios before treatment between the two groups were no significant(P>0.05). The grade 1 and 2 ratios after treatment of the study group were significantly higher(P<0.05),and the grade 3,4 and 5 ratios were significantly lower than the control group(P<0.05). The total effective rate of the study group 85.0%(34/40)was significantly higher than the control group 55.0%(22/40)(P<0.05). The BMI,AMC,TSF,Hb,PA and ALB levels after treatment of the two groups were significantly higher than before treatment(P<0.05),and the differences of BMI,AMC,TSF,Hb,PA,ALB levels before treatment between the two groups were not significant(P>0.05). The BMI,AMC,TSF,Hb,PA,ALB levels after treatment of the study group were significantly higher than the control group(P<0.05). Conclusion:Warming acupuncture moxibustion combined with functional training is more effective than functional training alone in improving swallowing dysfunction of elderly patients with Parkinson's disease.
引文
[1]李少芳,麦训良,刘丽红,等.吞糊试验和才藤氏评级法在帕金森吞咽障碍老年病人吞咽训练中的应用观察[J].护理研究,2012,26(35):3312-3314.
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[11]陈慧芳,廖玉明,王博禹,等.生物反馈配合门德尔松手法对脑卒中合并假性球麻痹致吞咽障碍的康复治疗的研究[J].中国医药导报,2015,17(1):20-23.
[12]陈艳红,杨凤翔,张东云,等.电针联合康复训练治疗帕金森病的临床研究[J].中国康复,2012,27(6):426-428.
[13]Olchik MR,Ghisi M,Ayres A,et al.The impact of deep brain stimulation on the quality of life and swallowing in individuals with Parkinson's disease[J].Int Arch Otorhinolaryngol,2018,22(2):125-129.
[14]Lee HH,Seo HG,Kim KD,et al.Characteristics of early oropharyngeal dysphagia in patients with multiple system atrophy[J].Neurodegener Dis,2018,18(2-3):84-90.
[15]Sato H,Yamamoto T,Sato M,et al.Dysphagia causes symptom fluctuations after oral L-DOPA treatment in a patient with Parkinson disease[J].Case Rep Neurol,2018,10(1):101-107.
[2]庞灵恩,尹震宇,管得宁,等.肠内混悬液营养对急性脑卒中吞咽困难病人的影响[J].肠外与肠内营养杂志,2013,20(1):42-43.
[3]孙连珠,马睿杰.帕金森病伴吞咽困难的针灸治疗进展[J].神经病学与神经康复学杂志,2011,8(3):158-160.
[4]徐素琴.针刺联合莫沙必利预防脑卒中后吸入性肺炎的临床观察[J].中国老年学杂志,2012,32(4):804-805.
[5]陈忻,郭春彦,熊珮,等.中药治疗帕金森病的用药概况及其药理作用分析[J].中药新药与临床药理,2012,23(6):690-695.
[6]陈炳,陈建飞,张垣,等.盐酸多奈哌齐及康复训练对帕金森病患者认知功能障碍的影响[J].中国民康医学,2012,24(10):1153-1155.
[7]韩婕,阎文静,戴玲莉,等.表面肌电图在脑卒中吞咽障碍患者康复疗效评估中的应用研究[J].中国康复医学杂志,2013,28(6):579-581.
[8]翁子梅,饶晓丹,肖丹,等.针刺联合规律康复训练治疗帕金森病的效果观察[J].全科护理,2012,10(31):2897-2898.
[9]张杰,李进让.成人反复唾液吞咽试验观察[J].中国耳鼻咽喉头颈外科,2013,20(7):373-375.
[10]李洁霞,黄格朗.脑卒中后吞咽障碍的康复进展[J].护理实践与研究,2012,9(7):116-117.
[11]陈慧芳,廖玉明,王博禹,等.生物反馈配合门德尔松手法对脑卒中合并假性球麻痹致吞咽障碍的康复治疗的研究[J].中国医药导报,2015,17(1):20-23.
[12]陈艳红,杨凤翔,张东云,等.电针联合康复训练治疗帕金森病的临床研究[J].中国康复,2012,27(6):426-428.
[13]Olchik MR,Ghisi M,Ayres A,et al.The impact of deep brain stimulation on the quality of life and swallowing in individuals with Parkinson's disease[J].Int Arch Otorhinolaryngol,2018,22(2):125-129.
[14]Lee HH,Seo HG,Kim KD,et al.Characteristics of early oropharyngeal dysphagia in patients with multiple system atrophy[J].Neurodegener Dis,2018,18(2-3):84-90.
[15]Sato H,Yamamoto T,Sato M,et al.Dysphagia causes symptom fluctuations after oral L-DOPA treatment in a patient with Parkinson disease[J].Case Rep Neurol,2018,10(1):101-107.