Cao Xue, Zhang Hong-Juan, Xu Gang, Ma Xing-Xing, Pu Xiu-Ling, Ma Wen-Juan, Zhang Di, Tian Zhao-di, Zhang Wei-Hua
Department of Rehabilitation Medicine, Xianyang Central Hospital, Xianyang 712000, Shaanxi Province, China.
Department of Rehabilitation Medicine, Xi'an Third Hospital.
Zhongguo Zhen Jiu. 2023 Jun 12;43(6):611-4. doi: 10.13703/j.0255-2930.20220826-0002.
To observe the clinical efficacy on post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation.
Sixty patients with post-stroke dysphagia were randomly divided into an observation group and a control group, with 30 cases in each group. The neuromuscular electrical stimulation was adopted in the control group. Besides the treatment as the control group, in the observation group, the four-step acupuncture therapy for opening orifices and benefiting throat was supplemented. Step 1: the three areas of scalp acupuncture on the affected side were stimulated. Step 2: pricking method was operated on the posterior pharyngeal wall. Step 3: bleeding technique was operated at Jinjin (EX-HN 12) and Yuye (EX-HN 13). Step 4: deep insertion of needle was operated at three-pharynx points. The needles were retained for 30 min at the three areas of scalp acupuncture and the three-pharynx points. The intervention of each group was delivered once daily, 6 times a week, at the interval of 1 day. One course of treatment was 1 week and 4 successive courses were required. The rating of Kubota water swallow test, the score of standardized swallowing assessment (SSA) and the rating of Rosenbek penetration- aspiration scale (PAS) were observed before and after treatment in patients of the two groups. The incidence of clinical complications and clinical efficacy were compared between the two groups.
Compared with those before treatment, the rating of Kubota water swallow test, the scores of SSA and the rating of PAS of patients in the two groups were decreased after treatment (<0.01), and the values of the observation group were lower than those of the control group after treatment (<0.05). The incidence of clinical complications in the observation group was 13.3% (4/30), lower than 36.7% (11/30) in the control group (<0.05). The total effective rate in the observation group was 93.3% (28/30), which was better than 70.0% (21/30) in the control group (<0.05).
The four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation can improve the swallowing function of patients with post-stroke dysphagia and reduce the incidence of clinical complications.
观察开窍利咽四步针刺疗法联合神经肌肉电刺激治疗脑卒中后吞咽障碍的临床疗效。
将60例脑卒中后吞咽障碍患者随机分为观察组和对照组，每组30例。对照组采用神经肌肉电刺激治疗。观察组在对照组治疗的基础上，加用开窍利咽四步针刺疗法。第一步：刺激患侧头皮针三区；第二步：在咽后壁行点刺法；第三步：在金津（EX-HN 12）、玉液（EX-HN 13）行放血术；第四步：在三咽穴行深刺法。头皮针三区及三咽穴留针30分钟。每组干预每日1次，每周6次，间隔1天。1个疗程为1周，共需连续治疗4个疗程。观察两组患者治疗前后洼田水吞咽试验评分、标准吞咽功能评估（SSA）得分及藤岛一郎渗透-误吸量表（PAS）评分。比较两组临床并发症发生率及临床疗效。
与治疗前比较，两组患者治疗后洼田水吞咽试验评分、SSA得分及PAS评分均降低（P<0.01），且观察组治疗后各项指标值均低于对照组（P<0.05）。观察组临床并发症发生率为13.3%（4/30），低于对照组的36.7%（11/30）（P<0.05）。观察组总有效率为93.3%（28/30），优于对照组的70.0%（21/30）（P<0.05）。
开窍利咽四步针刺疗法联合神经肌肉电刺激可改善脑卒中后吞咽障碍患者的吞咽功能，降低临床并发症发生率。
