【目的】观察项针联合吞咽功能障碍治疗仪治疗脑梗死后吞咽功能障碍患者的临床疗效。 【方法】将80例脑梗死后吞咽 功能障碍患者随机分为观察组与对照组，每组各40例。对照组在常规治疗的基础上，给予吞咽功能障碍治疗仪治疗，观察 组在对照组治疗的基础上，给予项针治疗，连续治疗4周。治疗1个月后，评价2组临床疗效，观察2组患者治疗前后洼田 饮水试验 （WST） 评分和标准吞咽功能评价量表 （SSA） 评分的变化情况，以及2组患者吞咽时舌骨垂直与水平移动幅度的变化 情况。比较2组患者治疗前后血清P物质 （SP） 含量的变化情况。并评价2组的安全性及不良反应的发生情况。 【结果】 （1） 观 察组总有效率为90.00% （36/40） ，对照组为67.50% （27/40） 。观察组疗效优于对照组，差异有统计学意义 （P＜0.05） 。 （2） 治疗 后，2组患者的WST、SSA评分均明显改善 （P＜0.05） ，且观察组在改善WST、SSA评分方面明显优于对照组，差异有统计学 意义 （P＜0.05） 。 （3） 治疗后，2组患者的舌骨垂直位移、水平位移均明显改善 （P＜0.05） ，且观察组在改善舌骨垂直位移、水 平位移方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （4） 治疗后，2组患者的血清SP水平明显改善 （P＜0.05） ，且观察 组在改善血清SP水平方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （5） 观察组不良反应总发生率为5.00% （2/40） ；对 照组为25.00% （10/40） ；观察组的不良反应发生率明显低于对照组，差异有统计学意义 （P＜0.05） 。 【结论】项针联合吞咽功能 障碍治疗仪治疗脑梗死后吞咽功能障碍，能明显改善患者的吞咽功能，提高患者血清SP水平，增加舌骨位移距离，降低不 良反应发生率，临床疗效显著。

Objective To observe the clinical effect of nape needling combined with swallowing dysfunction therapeutic apparatus in the treatment of patients with swallowing dysfunction after cerebral infarction. Methods Eighty patients with swallowing dysfunction after cerebral infarction were randomly divided into observation group and control group，40 cases in each group. On the basis of routine treatment，the control group was treated with swallowing dysfunction therapeutic apparatus，and the observation group was treated with nape needling on the basis of the control group for 4 weeks. After 1 month of treatment，the clinical efficacy of the two groups was evaluated，and the changes of the water swallowing test （WST） score and the standard swallowing assessment （SSA） score were observed before and after treatment in the two groups，as well as the changes of the vertical and horizontal movement of the hyoid bone during swallowing in the two groups. The changes of serum substance P （SP）content were compared before and after treatment between the two groups. The safety and adverse reactions of the two groups were evaluated. Results （1） The total effective rate was 90.00%（36/40） in the observation group and 67.50% （27/40） in the control group. The curative effect of the observation group was superior to that of the control group，and the difference was statistically significant （P＜0.05） . （2） After treatment，the WST and SSA scores of the two groups were significantly improved （P＜0.05），and the improvement of WST and SSA scores in the observation group was significantly superior to that in the control group，the difference was statistically significant （P＜0.05） . （3） After treatment，the vertical and horizontal displacement of the hyoid bone in the two groups were significantly improved （P＜0.05），and the improvement of the vertical and horizontal displacement of the hyoid bone in the observation group was significantly superior to that in the control group，the difference was statistically significant （P＜0.05） . （4） After treatment，the serum SP level of the two groups was significantly improved （P＜ 0.05） ，and the observation group was significantly superior to the control group in improving the serum SP level， the difference was statistically significant （P＜0.05） . （5） The total incidence of adverse reactions in the observation group was 5.00%（2/40）；the control group was 25.00%（10/40）；the incidence of adverse reactions in the observation group was significantly lower than that in the control group，the difference was statistically significant （P＜0.05） . Conclusion Nape needling combined with swallowing dysfunction therapeutic apparatus in the treatment of swallowing dysfunction after cerebral infarction can significantly improve the swallowing function of patients，improve the serum SP level of patients，increase the displacement distance of hyoid bone，and reduce the incidence of adverse reactions.

R246.9

秦皇岛市科学技术研究与发展计划项目 （编号：202004A095）