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针刺结合呼吸训练治疗脑卒中后吞咽困难的临床试验

[Clinical trials of needling combined with respiratory training for post-stroke dysphagia].

作者信息

Li Zhang-Han, Li Hua-Mao, Ai Nian-Nian

机构信息

Department of Rehabilitation and Physiotherapy, Hankou Branch of the Central Theater General Hospital of PLA, Wuhan 430010, China.

出版信息

Zhen Ci Yan Jiu. 2021 Oct 25;46(10):875-9. doi: 10.13702/j.1000-0607.201011.

Abstract

OBJECTIVE

To observe the clinical effect of Xingnao Kaiqiao needling combined with respiratory training on swallowing function, quality of life and throat surface muscle function in patients with post-stroke dysphagia.

METHODS

A total of 124 patients with post-stroke dysphagia were randomized into an observation group and a control group, 62 cases in each group. On the basis of conventional western medication treatment, respiratory training was applied in the control group, once daily, 5 times a week for 4 weeks. On the base of the treatment as the control group, needling was applied at Neiguan (PC6), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), Yifeng (SJ17), posterior pharyngeal wall, Shuigou (GV26) and Lianquan (CV23) in the observation group, once daily, 6 times a week for 4 weeks. Before and after treatment, the Kubota water swallowing test (KWST) scale, swallowing function, swallowing-quality of life (SWAL-QOL) scale, maximum amplitude of pharyngeal surface electromyography (sEMG), and complications of dysphagia were observed and recorded.

RESULTS

After the treatment, self-comparison showed that the KWST and swallowing function scores were significantly decreased (<0.05), the SWAL-QOL score and sEMG were notably increased in both groups (<0.05) in comparison with their own pre-treatment. The KWST and swallowing function scores were obviously lower in the observation group than in the control group (<0.05), whereas the SWAL-QOL score and sEMG were evidently higher in the observation group than in the control group (<0.05). The total effective rate of the observation group was 95.16% (59/62), which was higher than 80.65% (50/62) of the control group (<0.05). The incidence of dysphagia complications in the observation group was 24.19% (15/62), which was lower than 50.00% (31/62) of the control group (<0.01).

CONCLUSION

Xingnao Kaiqiao needling combined with respiratory training in the treatment of post-stroke dysphagia can increase the activity of throat muscles, promote the swallowing function, improve the quality of life, and reduce the incidence of dysphagia related complications.

摘要

目的

观察醒脑开窍针刺联合呼吸训练对脑卒中后吞咽障碍患者吞咽功能、生活质量及咽喉表面肌肉功能的临床疗效。

方法

将124例脑卒中后吞咽障碍患者随机分为观察组和对照组,每组62例。对照组在常规西药治疗的基础上进行呼吸训练,每天1次,每周5次,共4周。观察组在对照组治疗的基础上,针刺内关(PC6)、三阴交(SP6)、风池(GB20)、完骨(GB12)、翳风(SJ17)、咽后壁、水沟(GV26)和廉泉(CV23),每天1次,每周6次,共4周。观察并记录治疗前后洼田饮水试验(KWST)量表、吞咽功能、吞咽生活质量(SWAL-QOL)量表、咽喉表面肌电图(sEMG)最大波幅及吞咽障碍并发症情况。

结果

治疗后,两组自身比较,KWST及吞咽功能评分均显著降低(<0.05),SWAL-QOL评分及sEMG均较治疗前明显升高(<0.05)。观察组KWST及吞咽功能评分明显低于对照组(<0.05),而观察组SWAL-QOL评分及sEMG明显高于对照组(<0.05)。观察组总有效率为95.16%(59/62),高于对照组的80.65%(50/62)(<0.05)。观察组吞咽障碍并发症发生率为24.19%(15/62),低于对照组的50.00%(31/62)(<0.01)。

结论

醒脑开窍针刺联合呼吸训练治疗脑卒中后吞咽障碍可提高咽喉部肌肉活动度,促进吞咽功能,改善生活质量,降低吞咽障碍相关并发症的发生率。

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