Chen Dan, Guo Haiying
Second Clinical Medical School, Nanjing University of CM, Nanjing 210023, Jiangsu Province, China.
Zhongguo Zhen Jiu. 2018 Apr 12;38(4):364-8. doi: 10.13703/j.0255-2930.2018.04.006.
To compare the therapeutic effects on dysphagia in post-stroke pseudobulbar palsy between the combined treatment with acupuncture and rehabilitation training and the combined treatment with low-frequency electrical therapy and rehabilitation training and to explore its more effective therapy, using the ultrasonographic examination.
A total of 60 patients of dysphagia in post-stroke pseudobulbar palsy were randomly assigned into an observation group and a control group, 30 cases in each one. The rehabilitation treatment was provided in the two groups. Additionally, in the observation group, acupuncture was used at the three-tongue points [Shanglianquan (Extra), located in the depression between the lingual bone and the border of lower jaw, 1 inferior to the midline of the jaw; and the other two points, located at 0.8 bilateral to Shanglianquan (Extra)], bilateral Fengchi (GB 20) and Fengfu (GV 16). After arrival of , the last two tongue-points were stimulated with electricity, with disperse-dense wave, periodically at 2 Hz, 10 Hz and 100 Hz, at the interval of 3 s, lasting for 30 min. Bilateral Fengchi (GB 20) was stimulated with electricity, with disperse-dense wave and the same frequency as above, lasting for 30 min. In the control group, the low-frequency electrical stimulation was adopted. The electrodes were placed on the bilateral sides of the midline of the throat, 30 min each time. The treatment was for 1 month in the two groups, once a day. The scores of the standardized swallowing assessment (SSA) and the videofluoroscopy swallowing study (VFSS) were observed and the reducing rate of the hyoid-thyroid cartilage distance was determined with ultrasound quantitative measure.
After treatment, SSA scores of the two groups were all lower than those before treatment and VFSS scores were higher than those before treatment (all <0.05). The above scores in the observation group were better than those in the control group (both <0.05). The reducing rates of the hyoid-thyroid cartilage distance were higher than those before treatment in the two groups (both <0.05). The result in the observation group was higher than that in the control group (<0.05).
The treatments with acupuncture and rehabilitation training or with the low-frequency electrical therapy and rehabilitation obtain the effects on dysphagia in post-stroke pseudobulbar palsy in the patients. The effects of the combined treatment with acupuncture and rehabilitation training are better. The ultrasonographic technology effectively and quantitatively analyzes the changes in the glossopharyngeal complex in the patients of dysphagia.
采用超声检查，比较针刺联合康复训练与低频电疗法联合康复训练对脑卒中后假性延髓麻痹吞咽困难的治疗效果，探索更有效的治疗方法。
将60例脑卒中后假性延髓麻痹吞咽困难患者随机分为观察组和对照组，每组30例。两组均给予康复治疗。此外，观察组采用针刺“三舌穴”[上廉泉（奇穴），位于舌骨与下颌缘之间的凹陷处，下颌中线下方1寸；另外两点，位于上廉泉（奇穴）旁开0.8寸双侧]、双侧风池（GB20）、风府（GV16）。针刺得气后，后两舌穴接电针，采用疏密波，频率分别为2Hz、10Hz、100Hz，交替进行，间隔3s，持续30min。双侧风池（GB20）接电针，采用疏密波，频率同前，持续30min。对照组采用低频电刺激，电极置于双侧喉中线旁，每次30min。两组均治疗1个月，每日1次。观察标准吞咽评估（SSA）评分、电视荧光吞咽造影检查（VFSS）评分，并采用超声定量测量舌骨-甲状软骨距离缩小率。
治疗后，两组SSA评分均低于治疗前，VFSS评分均高于治疗前（均P<0.05）。观察组上述评分均优于对照组（均P<0.05）。两组舌骨-甲状软骨距离缩小率均高于治疗前（均P<0.05）。观察组结果高于对照组（P<0.05）。
针刺联合康复训练或低频电疗法联合康复训练对脑卒中后假性延髓麻痹吞咽困难患者均有治疗效果。针刺联合康复训练效果更佳。超声技术能有效、定量分析吞咽困难患者舌咽复合体的变化。
