【目的】 观察电针任督脉经穴治疗缺血性脑卒中（AIS）合并吞咽功能障碍的临床疗效，并探讨其可能的作用机制。 【方法】 选取 2020年 12月至 2023年 12月浙江中医药大学附属杭州市中医院病房及门诊收治的 120例明确诊断为 AIS合并吞 咽功能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 60例。对照组给予常规吞咽训练， 观察组在对照组治疗的基础上，给予电针任督脉经穴治疗。共治疗4周。治疗1个月后，评价2组临床疗效。观察2组患者 治疗前后标准吞咽功能评定量表（SSA）评分和美国国立卫生研究所脑卒中量表（NIHSS）评分的变化情况，以及舌骨喉活动度、 洼田氏饮水试验评分的情况。比较 2组患者治疗前后脑微循环指标、中文版吞咽障碍生活质量量表（EDQoL）评分的变化情 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 95.00%（57/60），对照组为 76.67%（46/60）， 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SSA评分、NIHSS评分均明显改善（P＜0.05）， 且观察组在改善SSA评分、NIHSS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组患者的甲状软骨 前移、甲状软骨上移、舌骨前移、舌骨上移均明显改善（P＜0.05），且观察组在改善甲状软骨前移、甲状软骨上移、舌骨前 移、舌骨上移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组患者的洼田氏饮水试验评分明显改善 （P＜0.05），且观察组在改善洼田氏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）。（5）治疗后，2组患者 的大脑动脉最大峰值（Vs）、血流平均流速（Vm）、血管阻力指数（RI）明显改善（P＜0.05），且观察组在改善大脑动脉 Vs、 Vm、RI方面明显优于对照组，差异有统计学意义（P＜0.05）。（6）治疗后，2组患者的 EDQoL评分明显改善（P＜0.05），且观 察组在改善 EDQoL 评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（7）观察组不良反应总发生率为 1.67%（1/60）， 对照组为11.67%（7/60），观察组不良反应总发生率明显低于对照组，差异有统计学意义（P＜0.05）。【结论】 电针任督脉经穴 治疗AIS合并吞咽功能障碍可有效减轻患者的吞咽障碍及神经功能受损程度，改善舌骨喉活动度及脑微循环，提高患者的生 存质量，降低吸入性肺炎等不良事件发生率，疗效显著。

Objective To evaluate the clinical efficacy of electroacupuncture at acupoints distributed on conception vessel（CV） and governor vessel（GV） in treating ischemic stroke（AIS） complicated with dysphagia and explore its potential mechanism. Methods A total of 120 patients diagnosed with AIS complicated with dysphagia at Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University from December 2020 to December 2023 were enrolled and randomly divided into an observation group and a control group，with 60 patients per group. The control group received conventional swallowing training， while the observation group received additional electroacupuncture at acupoints distributed on CV and GV. The treatment lasted for 4 weeks. After 1 month of treatment，clinical efficacy was assessed，and the changes in Standardized Swallowing Assessment （SSA） scores，National Institutes of Health Stroke Scale（NIHSS） scores，hyolaryngeal mobility（thyroid cartilage anterior/superior displacement，hyoid bone anterior/superior displacement）， and KubotaWater Swallowing Test scores were observed. Cerebral microcirculation parameters and the Chinese version of the Eating/Drinking Quality of Life（EDQoL） questionnaire were also compared. Safety and adverse events were evaluated. Results（1） The total effective rate in the observation group was 95.00%（57/60）， compared to 76.67%（46/60） in the control group， demonstrating statistically superior therapeutic efficacy in the observation group（P＜0.05）.（2） After treatment，both groups showed significant improvements in SSA scores and NIHSS scores（P＜0.05），with the observation group exhibiting markedly better enhancement in both SSA and NIHSS scores compared to the control group， showing statistically significant differences（P＜0.05）.（3） After intervention， significant improvements were observed in anterior displacement of thyroid cartilage，superior displacement of thyroid cartilage，anterior displacement of hyoid bone，and superior displacement of hyoid bone in both groups（P＜0.05）. The observation group outperformed the control group in all these laryngeal kinematic parameters with statistically significant differences（P＜0.05）.（4） Both groups demonstrated significant improvement in Kubota Water Swallowing Test scores after treatment（P＜0.05），with the observation group displaying statistically greater improvement than the control group（P＜0.05）.（5） Cerebral arterial parameters including peak systolic velocity（Vs）， mean velocity （Vm）， and resistance index（RI） were significantly improved in both groups after treatment（P＜0.05）. The observation group showed superior enhancement in these cerebrovascular hemodynamic indices compared to the control group（P＜0.05）.（6） Significant improvements in EDQoL scores were observed in both groups after treatment（P＜0.05），with the observation group achieving statistically greater improvement than the control group （P＜0.05）（. 7） The total incidence of adverse reactions was 1.67%（1/60） in the observation group versus 11.67% （7/60） in the control group，indicating a statistically significant lower adverse event rate in the observation group （P＜0.05）. Conclusion Electroacupuncture at acupoints distributed on CV and GV effectively alleviates dysphagia and neurological impairment，improves hyolaryngeal mobility and cerebral microcirculation，enhances quality of life， and reduces adverse events such as aspiration pneumonia in AIS patients complicated with dysphagia.

R246.9

国家重点研究计划课题资助项目（编号：2020YFC2004303）；浙江省中医药科技计划项目（编号：2023ZL524）