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针刺治疗中风后吞咽困难的疗效:一项多中心随机对照试验。

Therapeutic effect of acupuncture on post-stroke dysphagia: A multicenter, randomized controlled trial.

作者信息

Zhang Shiqiang, Liang Biying, Tang Qiang, Gao Weibin, Li Hongyu, Wu Minmin, Wang Xue, Zhu Luwen

机构信息

Heilongjiang University of Chinese Medicine, Harbin, China; Cangzhou Hospital of Integrated Traditional Chinese and Western of Hebei Province, Cangzhou, China.

The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China.

出版信息

Complement Ther Med. 2025 Sep;92:103200. doi: 10.1016/j.ctim.2025.103200. Epub 2025 Jun 21.

Abstract

BACKGROUND

Dysphagia is a common complication of stroke, significantly affecting patient prognosis and quality of life. Acupuncture is commonly used for treating post-stroke dysphagia in China, often combined with traditional swallowing rehabilitation training. However, the therapeutic effect of acupuncture alone on post-stroke dysphagia remains unclear.

OBJECTIVE

To compare the clinical efficacy of acupuncture and traditional swallowing rehabilitation training in patients with post-stroke dysphagia.

METHOD

A multicenter, evaluator-blind, randomized controlled trial was conducted to recruit participants with post-stroke dysphagia. The experimental group received acupuncture treatment, whereas the control group received traditional swallowing rehabilitation training for 2 weeks. The Standardized Swallowing Assessment score and modified Barthel Index were compared between groups 1 and 2 weeks after the intervention. Surface electromyography (sEMG) was used to quantitatively evaluate the electromyographic activity in the suprahyoid and infrahyoid hyoid muscle groups.

RESULT

Overall, 254 participants were included. After 1 week of intervention, there was no significant between-group difference in efficacy (p > 0.05). After 2 weeks of intervention, the Standardized Swallowing Assessment score of the experimental group showed a greater decrease (-1.56, 95 %CI [-2.83, -0.29], p < 0.05). There was no significant between-group difference in the modified Barthel Index (2.00, 95 %CI [-2.00, 6.00], p > 0.05). sEMG analysis showed that after 2 weeks of intervention, participants in the experimental group experienced greater increase in the root mean square value of the suprahyoid muscle group during fluid swallowing (1.02, 95 %CI [0.11, 2.27], p < 0.05).

CONCLUSION

Acupuncture may improve the swallowing function in patients with post-stroke dysphagia, offering therapeutic advantages for patients with pharyngeal phase dysphagia.

REGISTRATION

This study registered with the ClinicalTrials.gov Identifier: ChiCTR2000030994.

摘要

背景

吞咽困难是中风的常见并发症,严重影响患者预后和生活质量。在中国,针灸常用于治疗中风后吞咽困难,常与传统吞咽康复训练相结合。然而,单独使用针灸治疗中风后吞咽困难的疗效仍不明确。

目的

比较针灸与传统吞咽康复训练对中风后吞咽困难患者的临床疗效。

方法

进行一项多中心、评估者盲法、随机对照试验,招募中风后吞咽困难的参与者。实验组接受针灸治疗,而对照组接受为期2周的传统吞咽康复训练。在干预后1周和2周比较两组的标准化吞咽评估评分和改良巴氏指数。使用表面肌电图(sEMG)定量评估舌骨上肌群和舌骨下肌群的肌电活动。

结果

总共纳入了254名参与者。干预1周后,组间疗效无显著差异(p>0.05)。干预2周后,实验组的标准化吞咽评估评分下降幅度更大(-1.56,95%CI[-2.83,-0.29],p<0.05)。改良巴氏指数组间无显著差异(2.00,95%CI[-2.00,6.00],p>0.05)。sEMG分析显示,干预2周后,实验组参与者在吞咽液体时舌骨上肌群的均方根值增加幅度更大(1.02,95%CI[0.11,2.27],p<0.05)。

结论

针灸可能改善中风后吞咽困难患者的吞咽功能,为咽期吞咽困难患者提供治疗优势。

注册情况

本研究已在ClinicalTrials.gov注册,标识符:ChiCTR2000030994。

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