[穴位注射联合神经电刺激治疗脑卒中后吞咽障碍]

Ma Fei-Xiang, Cao Gui-Ping, Li Wan-Lang

Zhongguo Zhen Jiu. 2014 Dec;34(12):1169-73.

OBJECTIVE

To observe the effect differences on post-stroke dysphagia among acupoint injection combined with neural electrical stimulation, acupoint injection, neural electrical stimulation, and swallowing training respectively, so eligible intervention can be applied to this kind of disease.

METHODS

One hundred and eight-three patients of post-stroke dysphagia were randomized into a comprehensive treatment group (42 cases), an acupoint injection group (44 cases), a neural electrical stimulation group (49 cases) and a swallow training group (48 cases) and were treated with the comprehensive therapy of acupoint injection and neural electrical stimulation, acupoint injection, neural electrical stimulation and swallowing training separately. The treatments for 10 days made one session. There were 3 days at the interval among treatment sessions and 3 sessions were required totally. The cases in those treatment groups were blankly controlled with the other 47 patients of post-stroke dysphagia. All the patients received basic rehabilitation treatment. The modified water swallowing test was conducted to assess the efficacy before treatment, 10 days after treatment and 30 days after treatment in each group separately. The clinical efficacy, score of water swallowing test and improvement in water swallow test were compared among the groups.

RESULTS

After 10-day treatment, the differences in efficacy and score of water swallow test were not significant in each group (all P > 0.05). After 30-day treatment, the effective rate (94.29%, 33/35) in the comprehensive treatment group was apparently better than 68.75% (22/32) in the acupoint injection group, 80.00% (32/40) in the neural electrical stimulation group, 67.50% (27/40) in the swallowing training group and 42.86% (12/28) in the blank group separately. The score in water swallow test in the comprehensive treatment group was lower than that in each of the other groups (1.37 ± 0.60 vs 2.03 ± 1.00, 1.90 ± 0.90, 2.20 ± 0.72, 2.71 ± 0.90, all P < 0.05). The differences in the effective rate and score in water swallow test were not significant among the acupoint injection group, neural electrical stimulation group and swallowing training group (all P > 0.05), which indicated that the improvement in swallowing function in the comprehensive treatment group was significantly superior to the other groups (all P < 0.05).

CONCLUSION

The comprehensive therapy of acupoint injection and neural electrical stimulation achieves the much better efficacy on post-stroke dysphagia.

目的

观察穴位注射联合神经电刺激、穴位注射、神经电刺激以及吞咽训练分别对脑卒中后吞咽障碍的疗效差异，以便为该类疾病选择合适的干预措施。

方法

将183例脑卒中后吞咽障碍患者随机分为综合治疗组（42例）、穴位注射组（44例）、神经电刺激组（49例）和吞咽训练组（48例），分别给予穴位注射联合神经电刺激、穴位注射、神经电刺激以及吞咽训练进行治疗。治疗10天为1个疗程，疗程间间隔3天，共进行3个疗程。各治疗组病例与另外47例脑卒中后吞咽障碍患者进行空白对照。所有患者均接受基础康复治疗。分别于治疗前、治疗10天后、治疗30天后对各组患者进行改良饮水试验以评估疗效，比较各组的临床疗效、饮水试验评分及饮水试验改善情况。

结果

治疗10天后，各组疗效及饮水试验评分差异均无统计学意义（均P>0.05）。治疗30天后，综合治疗组有效率（94.29%，33/35）明显优于穴位注射组（68.75%，22/32）、神经电刺激组（80.00%，32/40）、吞咽训练组（67.50%，27/40）及空白组（42.86%，12/28）。综合治疗组饮水试验评分低于其他各组（1.37±0.60 vs 2.03±1.00、1.90±0.90、2.20±0.72、2.71±0.90，均P<0.05）。穴位注射组、神经电刺激组及吞咽训练组之间有效率及饮水试验评分差异均无统计学意义（均P>0.05），说明综合治疗组吞咽功能改善明显优于其他各组（均P<0.05）。