[关键词]
[摘要]
【目的】 观察电针双翳风透廉泉联合肌电生物反馈治疗脑卒中后吞咽障碍的临床疗效。【方法】 选取2022年4月至2023年 5月邯郸明仁医院病房及门诊收治的94例明确诊断为脑卒中后吞咽障碍的患者为研究对象。按随机数字表将患者随机分为观 察组和对照组,每组各47例。2组患者均给予基础治疗,对照组给予肌电生物反馈治疗,观察组在对照组治疗的基础上,给 予电针双翳风透廉泉治疗。连续治疗4周。治疗1个月后,评价2组临床疗效,观察2组患者治疗前后中医证候评分和洼田 饮水试验评分的变化情况,以及吞咽功能评定量表(SSA)评分、功能性经口摄食量表(FOIS)评分和吞咽相关生活质量量表 (SWAL-QOL)评分的情况。比较 2 组患者治疗前后舌压的变化情况。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95.74%(45/ 47),对照组为76.60%(36/47)。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组患者中医证候评分、洼田饮水试验评分均明显改善(P < 0.05),且观察组在改善中医证候评分、洼田 饮水试验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 SSA、FOIS 评分均明显改善(P < 0.05),且观察组在改善SSA、FOIS评分方面明显优于对照组,差异均有统计学意义(P < 0.05)。(4)治疗后,2组患者的舌压 峰值、舌压平均值、舌压持续时间均明显改善(P < 0.05),且观察组在改善舌压峰值、舌压平均值、舌压持续时间方面明显 优于对照组,差异有统计学意义(P < 0.05)。(5)治疗后,2组患者生活质量评分均明显改善(P < 0.05),且观察组在改善患者 生活质量评分方面明显优于对照组,差异有统计学意义(P < 0.05)。(6)2组患者治疗期间均未出现明显不良反应,2组患者的 不良反应发生率比较,差异无统计学意义(P > 0.05)。【结论】 电针双翳风透廉泉联合肌电生物反馈治疗临床疗效较佳,可改 善脑卒中后吞咽障碍患者的吞咽功能及舌肌力量,降低中医证候积分,提高患者生活质量。
[Key word]
[Abstract]
Objective To observe the clinical efficacy of electroacupuncture of bilateral Yifeng(SJ17)points penetrating Lianquan(RN23)points combined with electromyographic biofeedback therapy(shortened as EMG biofeedback)in the treatment of post-stroke dysphagia. Methods A total of 94 cases of patients admitted to the wards and outpatient clinics of Handan Mingren Hospital with a definitive diagnosis of post-stroke dysphagia from April 2022 to May 2023 were selected for the study. The patients were randomly divided into observation group and control group according to the random number table method,with 47 cases in each group. Both groups of patients were given basic treatment,the control group was treated with EMG biofeedback,and the observation group was treated with electroacupuncture of bilateral Yifeng points penetrating Lianquan points on the basis of the treatment of the control group. The course of treatment covered four consecutive weeks. After one month of treatment,the clinical efficacy of the two groups was evaluated, and the changes in traditional Chinese medicine (TCM) syndrome scores and Kubota Water Swallowing Test scores,Standardized Swallowing Assessment(SSA)scores, Functional Oral Intake Scale(FOIS)scores, and Swallowing-Quality of Life(SWAL-QOL)scores before and after treatment were observed in the patients of the two groups. The changes of tongue pressure before and after treatment were compared between the two groups. The safety and the incidence of adverse reactions in the two groups were evaluated. Results(1)The total effective rate was 95.74%(45 / 47)in the observation group and 76.60%(36/47)in the control group. The efficacy of the observation group was superior to that of the control group, the difference being statistically significant(P < 0.05).(2)After treatment,the TCM syndrome scores and Kubota Water Swallowing Test scores of the patients in the two groups were improved significantly(P < 0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P < 0.05).(3)After treatment,SSA and FOIS scores of patients in the two groups were significantly improved(P < 0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P < 0.05).(4)After treatment,the peak tongue pressure,mean tongue pressure,duration of tongue pressure of the two groups were improved significantly(P < 0.05), and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P < 0.05).(5)After treatment,the quality of life scores of patients in the two groups were significantly improved(P < 0.05),and the improvement in the observation group was significantly superior to that in the control group,the difference being statistically significant(P < 0.05).(6)No obvious adverse reactions occurred during the treatment of the two groups of patients,the difference in the incidence of adverse reactions between the two groups of patients being not statistically significant(P > 0.05). Conclusion Electroacupuncture of bilateral Yifeng points penetrating Lianquan points combined with EMG biofeedback in the treatment of post-stroke dysphagia exerts certain efficacy,which can improve the swallowing function and tongue muscle strength,reduce TCM syndrome scores,and enhance patients quality of life.
[中图分类号]
R246.9
[基金项目]
河北省中医药管理局科研计划资助项目(编号:2024532)