在标准吞咽训练基础上增加特定针灸疗法是否能改善中风后吞咽困难患者的治疗效果？一项随机对照试验。

Does the addition of specific acupuncture to standard swallowing training improve outcomes in patients with dysphagia after stroke? a randomized controlled trial.

作者信息

Xia Wenguang, Zheng Chanjuan, Zhu Suiqiang, Tang Zhouping

机构信息

Department of Physical Medicine and Rehabilitation, Hubei Xinhua Hospital, Wuhan, China

Department of Physical Medicine and Rehabilitation, Hubei Xinhua Hospital, Wuhan, China.

出版信息

Clin Rehabil. 2016 Mar;30(3):237-46. doi: 10.1177/0269215515578698. Epub 2015 Mar 26.

DOI:10.1177/0269215515578698

PMID:25819076

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC4767143/

Abstract

OBJECTIVE

To assess the effect of adding acupuncture to standard swallowing training for patients with dysphagia after stroke.

DESIGN

Single-blind randomized controlled trial.

SETTING

Inpatient and outpatient clinics.

SUBJECTS

A total of 124 patients with dysphagia after stroke were randomly divided into two groups: acupuncture and control.

INTERVENTIONS

The acupuncture group received standard swallowing training and acupuncture treatment. In comparison, the control group only received standard swallowing training. Participants in both groups received six days of therapy per week for a four-week period.

MAIN MEASURES

The primary outcome measures included the Standardized Swallowing Assessment and the Dysphagia Outcome Severity Scale. The secondary outcome measures included the Modified Barthel Index and Swallowing-Related Quality of Life, which were assessed before and after the four-week therapy period.

RESULTS

A total of 120 dysphagic subjects completed the study (60 in acupuncture group and 60 in control group). Significant differences existed in the Standardized Swallowing Assessment, Dysphagia Outcome Severity Scale, Modified Barthel Index, and Swallowing-Related Quality of Life scores of each group after the treatment (P < 0.01). After the four-week treatment, the Standardized Swallowing Assessment (mean difference - 2.9; 95% confidence interval (CI) - 5.0 to - 0.81; P < 0.01), Dysphagia Outcome Severity Scale (mean difference 2.3; 95% CI 0.7 to 1.2; P < 0.01), Modified Barthel Index (mean difference 17.2; 95% CI 2.6 to 9.3; P < 0.05) and Swallowing-Related Quality of Life scores (mean difference 31.4; 95% CI 3.2 to 11.4; P < 0.01) showed more significant improvement in the acupuncture group than the control group.

CONCLUSIONS

Acupuncture combined with the standard swallowing training may be beneficial for dysphagic patients after stroke.

摘要

目的

评估在标准吞咽训练基础上增加针刺疗法对中风后吞咽困难患者的疗效。

设计

单盲随机对照试验。

地点

住院部和门诊部。

研究对象

总共124例中风后吞咽困难患者被随机分为两组：针刺组和对照组。

干预措施

针刺组接受标准吞咽训练和针刺治疗。相比之下，对照组仅接受标准吞咽训练。两组参与者每周接受6天治疗，为期4周。

主要测量指标

主要结局指标包括标准化吞咽评估和吞咽障碍结局严重程度量表。次要结局指标包括改良巴氏指数和吞咽相关生活质量，在为期4周的治疗期前后进行评估。

结果

共有120例吞咽困难受试者完成研究（针刺组60例，对照组60例）。治疗后，两组在标准化吞咽评估、吞咽障碍结局严重程度量表、改良巴氏指数和吞咽相关生活质量评分方面存在显著差异（P<0.01）。经过4周治疗后，针刺组在标准化吞咽评估（平均差值-2.9；95%置信区间（CI）-5.0至-0.81；P<0.01）、吞咽障碍结局严重程度量表（平均差值2.3；95%CI0.7至1.2；P<0.01）、改良巴氏指数（平均差值17.2；95%CI2.6至9.3；P<0.05）和吞咽相关生活质量评分（平均差值31.4；95%CI3.2至11.4；P<0.01）方面的改善比对照组更显著。