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[基于表面肌电图观察贺氏针灸疗法治疗中风后吞咽障碍的疗效:一项随机对照试验]

[Observation on the efficacy of post-stroke dysphagia treated with He's acupuncture therapy through surface electromyography: a randomized controlled trial].

作者信息

Liu Lu, Lü Tian-Li, Nie Li-Min, Tian Wei, Zhao Luo-Peng, Li Bin

机构信息

Beijing Hospital of Traditional Chinese Medicine Affiliated to Capital Medical University, Beijing Key Laboratory of Acupuncture Neuromodulation, Beijing 100010, China.

出版信息

Zhen Ci Yan Jiu. 2022 Mar 25;47(3):256-61. doi: 10.13702/j.1000-0607.20210197.

Abstract

OBJECTIVE

To observe the clinical therapeutic effect on post-stroke dysphagia treated with He's (triple promotion) acupuncture therapy through surface electromyography (sEMG).

METHODS

A total of 60 patients with post-stroke dysphagia were divided into a routine treatment group and a He's acupuncture therapy group, using blocked randomization, 30 cases in each one. In the routine treatment group, the secondary prevention and swallowing rehabilitation training were adopted. In the He's acupuncture therapy group, on the base of the treatment as the routine treatment group, (mild promotion, routine acupuncture at bilateral Fengchi [GB20], Fengfu [GV16], Yifeng [TE17], Lianquan [CV23], Jia-lianquan [Extra], Fenglong [ST40] and Tongli [HT5], needle retaining for 30 min, 5 treatments a week), (warm promotion, pricking with fire needle at bilateral GB20 and CV23, twice a week) and (strong promotion, blood-letting with three-edge needle at Jinjin [EX-HN12], Yuye [EX-HN13] and Yanhoubi [Extra], twice a week) treatment was added. The therapy was given consecutively for 4 weeks in each group. The score of fiberoptic endoscopic examination of swallowing (FEES) and Rosenbek-penetration-aspiration scale (PAS), the score of swallowing grading scale, the score of the modified Mann assessment of swallowing ability (MMASA) and the peak amplitude of sEMG were recorded before and after treatment in patients.

RESULTS

Compared with before treatment, the score of FEES and PAS after treatment was decreased (<0.05), the scores of swallowing grading scale and MMASA after treatment were increased in both routine treatment group and He's santong acupuncture therapy group (<0.05), the peak amplitude of sEMG was increased (<0.05) in the He's santong acupuncture therapy group and decreased (<0.05) in the routine treatment group. Compared with the routine treatment group, the score of FEES and PAS was decreased (<0.05), the scores of swallowing grading scale and peak amplitude of sEMG were increased in the He's acupuncture therapy group (<0.05).

CONCLUSION

He's acupuncture therapy is obviously effective on post-stroke dysphagia, which may be related to its effects in increasing the contraction of swallowing-related muscles and improving the peak amplitude of hyoid muscle group.

摘要

目的

通过表面肌电图(sEMG)观察贺氏三通法针刺治疗脑卒中后吞咽障碍的临床疗效。

方法

将60例脑卒中后吞咽障碍患者采用区组随机化法分为常规治疗组和贺氏针法组,每组30例。常规治疗组采用二级预防及吞咽康复训练。贺氏针法组在常规治疗组的基础上,增加轻通法(常规针刺双侧风池[GB20]、风府[GV16]、翳风[TE17]、廉泉[CV23]、夹廉泉[奇穴]、丰隆[ST40]、通里[HT5],留针30分钟,每周治疗5次)、温通法(火针点刺双侧GB20、CV23,每周2次)和重通法(三棱针点刺金津[EX-HN12]、玉液[EX-HN13]、咽后壁[奇穴],每周2次)治疗。两组均连续治疗4周。记录患者治疗前后吞咽功能纤维内镜检查(FEES)评分、Rosenbek渗透-误吸量表(PAS)评分、吞咽分级量表评分、改良Mann吞咽能力评估量表(MMASA)评分及sEMG的波幅峰值。

结果

与治疗前比较,常规治疗组和贺氏三通针法组治疗后FEES及PAS评分降低(P<0.05),吞咽分级量表及MMASA评分升高(P<0.05);贺氏三通针法组sEMG波幅峰值升高(P<0.05),常规治疗组降低(P<0.05)。与常规治疗组比较,贺氏三通针法组FEES及PAS评分降低(P<0.05),吞咽分级量表评分及sEMG波幅峰值升高(P<0.05)。

结论

贺氏三通法针刺治疗脑卒中后吞咽障碍疗效显著,可能与其增强吞咽相关肌肉收缩及提高舌骨肌群波幅峰值有关。

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