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磁珠耳针联合导管球囊扩张术治疗脑卒中后环咽肌功能障碍的随机对照试验

[Auricular acupuncture of magnetic pellet combined with catheter balloon dilatation in treatment of post-stroke cricopharyngeus muscle dysfunction: a randomized controlled trial].

作者信息

Gao Ling, Xie Luan, Li Xiang-Liang, Shi Zhen-Guo, Jin Hai-Peng

机构信息

College of Acupuncture and Moxibustion, Fujian University of TCM, Fuzhou 350122, China.

Department of Rehabilitation, Xiamen Hospital of TCM, Xiamen 361009, Fujian Province.

出版信息

Zhongguo Zhen Jiu. 2022 Oct 12;42(10):1083-8. doi: 10.13703/j.0255-2930.20211228-k0008.

Abstract

OBJECTIVE

To observe the clinical efficacy on post-stroke cricopharyngeus muscle dysfunction treated with auricular acupuncture of magnetic pellet combined with catheter balloon dilatation, and the effect on the adverse reaction during catheter balloon dilatation and the patients' quality of life.

METHODS

A total of 106 patients with post-stroke cricopharyngeus muscle dysfunction were randomly divided into an observation group (53 cases, 3 cases dropped off, 1 case excluded) and a control group (53 cases, 5 cases dropped off). The catheter balloon dilatation was provided in the control group, once a day. In the observation group, on the base of the treatment as the control group, auricular acupuncture of magnetic pellet was added. Before catheter balloon dilatation, the magnetic pellet was pressed at Yanhou (TG), Xin (CO), Naogan (AT), etc. These auricular points were pressed 5 min, as well as in every morning and evening for another 5 min, totally 3 times a day. The auricular acupuncture of magnetic pellet was applied on the ears alternatively each time, once every 3 days. One session treatment contained 6 days and 4 sessions of treatment were required in both groups. Before and after treatment, the scores of standardized swallowing assessment (SSA), Rosenbek penetration-aspiration scale (PAS) and swallowing quality of life (SWAL-QOL) were observed in both groups. Separately, on day 1 (T1) of treatment, in 2 weeks into treatment (T2) and on the last day of treatment (T3), the score of visual analogue scale (VAS) was recorded in both groups. The incidence of nausea and vomiting and the clinical efficacy were compared between the two groups.

RESULTS

After treatment, SSA and PAS scores were reduced (<0.05) and SWAL-QOL scores were increased (<0.05) in both groups compared with those before treatment, and the changes in the observation group were larger than those in the control group (<0.05). At T2 and T3, VAS scores were lower than those at T1 in both groups (<0.05), while VAS score at each time point in the observation group was lower than that of the control group (<0.05). The incidence of nausea and vomiting in the observation group was 51.0% (25/49), lower than the control group (79.2%, 38/48, <0.05). The total effective rate was 95.9% (47/49) in the observation group, better than the control group (87.5%, 42/48, <0.05).

CONCLUSION

Auricular acupuncture of magnetic pellet combined with catheter balloon dilatation effectively improve the swallowing function, relieve the discomforts during the dilatation and promote the quality of life in patients with post-stroke cricopharyngeus muscle dysfunction.

摘要

目的

观察磁珠耳穴针刺联合导管球囊扩张术治疗脑卒中后环咽肌功能障碍的临床疗效,以及对导管球囊扩张术中不良反应和患者生活质量的影响。

方法

将106例脑卒中后环咽肌功能障碍患者随机分为观察组(53例,脱落3例,剔除1例)和对照组(53例,脱落5例)。对照组给予导管球囊扩张术,每日1次。观察组在对照组治疗基础上增加磁珠耳穴针刺。在导管球囊扩张术前,按压咽喉(TG)、心(CO)、脑干(AT)等耳穴,每个耳穴按压5分钟,每天早晚各按压5分钟,共3次。每次交替双耳进行磁珠耳穴针刺,每3天1次。1个疗程为6天,两组均需治疗4个疗程。观察两组治疗前后标准化吞咽评估(SSA)、Rosenbek渗透-误吸量表(PAS)及吞咽生活质量(SWAL-QOL)评分。分别于治疗第1天(T1)、治疗2周(T2)及治疗最后1天(T3)记录两组视觉模拟评分(VAS)。比较两组恶心呕吐发生率及临床疗效。

结果

治疗后,两组SSA和PAS评分均降低(<0.05),SWAL-QOL评分均升高(<0.05),且观察组变化幅度大于对照组(<0.05)。在T2和T3时,两组VAS评分均低于T1时(<0.05),且观察组各时间点VAS评分均低于对照组(<0.05)。观察组恶心呕吐发生率为51.0%(25/49),低于对照组(79.2%,38/48,<0.05)。观察组总有效率为95.9%(47/49),优于对照组(87.5%,42/48,<0.05)。

结论

磁珠耳穴针刺联合导管球囊扩张术可有效改善脑卒中后环咽肌功能障碍患者的吞咽功能,缓解扩张术中不适,提高患者生活质量。

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