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针刺联合传统康复训练对脑卒中后吞咽障碍患者的影响:一项随机对照试验。

Effects of Acupuncture Combined with Conventional Rehabilitation Training for Patients with Post-Stroke Dysphagia: A Randomized Controlled Trial.

作者信息

Xu Fangyuan, Zhang Yiting, Su Xingxing, Dai Fan, Ye Yu, Ling Meijuan, Hu Peijia, Cheng Hongliang

机构信息

The First Clinical Medical School, Anhui University of Chinese Medicine, Hefei, 230031, People's Republic of China.

Department of Neurology, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei, 230061, People's Republic of China.

出版信息

J Multidiscip Healthc. 2025 Jun 2;18:3139-3152. doi: 10.2147/JMDH.S526827. eCollection 2025.

Abstract

OBJECTIVE

Stroke is a significant global public health challenge. Evidence suggests that acupuncture contributes to the treatment and rehabilitation of post-stroke dysphagia (PSD), effectively improving swallowing function and enhancing patients' quality of life. This study aimed to examine the effects of acupuncture combined with conventional rehabilitation training (CRT) on swallowing function, neurotransmitter levels, nutritional status, and swallowing-related quality of life in patients with PSD.

METHODS

Following screening, 90 patients with PSD were randomly assigned to either the intervention group (receiving acupuncture combined with CRT) or the control group (receiving CRT only). Both groups underwent treatment six times per week for four weeks. Primary outcome measures included the standardized swallowing assessment (SSA), the modified Mann assessment of swallowing ability (MMASA), the water swallowing test (WST), and 5-hydroxytryptamine (5-HT) levels. Secondary outcomes assessed swallowing-related quality of life and nutritional indicators.

RESULTS

Compared with baseline data, both groups showed improvements after 2 and 4 weeks of treatment, with reductions in SSA scores and increases in MMASA, hemoglobin (HB), albumin (ALB), serum total protein (STP), swallowing quality of life questionnaire (SWAL-QoL) scores, and WST performance. And the intervention group exhibited significantly greater improvements than the control group at the fourth week. Notably, the 5-HT levels in the intervention group were significantly higher than those in the control group after 4 weeks (362.44±88.63 vs 310.16±86.79, = 0.006).

CONCLUSION

A 4-week course of acupuncture combined with CRT demonstrated significant benefits in enhancing swallowing function, neurotransmitter levels, nutritional status, and quality of life in patients with PSD.

摘要

目的

中风是一项重大的全球公共卫生挑战。有证据表明,针灸有助于中风后吞咽困难(PSD)的治疗和康复,能有效改善吞咽功能并提高患者的生活质量。本研究旨在探讨针灸联合传统康复训练(CRT)对PSD患者吞咽功能、神经递质水平、营养状况及吞咽相关生活质量的影响。

方法

经过筛选,90例PSD患者被随机分为干预组(接受针灸联合CRT)和对照组(仅接受CRT)。两组均每周接受6次治疗,为期4周。主要结局指标包括标准化吞咽评估(SSA)、改良曼氏吞咽能力评估(MMASA)、饮水吞咽试验(WST)和5-羟色胺(5-HT)水平。次要结局评估吞咽相关生活质量和营养指标。

结果

与基线数据相比,两组在治疗2周和4周后均有改善,SSA评分降低,MMASA、血红蛋白(HB)、白蛋白(ALB)、血清总蛋白(STP)、吞咽生活质量问卷(SWAL-QoL)评分及WST表现增加。且干预组在第4周时的改善明显大于对照组。值得注意的是,4周后干预组的5-HT水平显著高于对照组(362.44±88.63 vs 310.16±86.79,P = 0.006)。

结论

为期4周的针灸联合CRT疗程在增强PSD患者的吞咽功能、神经递质水平、营养状况和生活质量方面显示出显著益处。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c87b/12143297/a5f9a4da61f4/JMDH-18-3139-g0001.jpg

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