互动式针刺法对卒中后假性延髓麻痹吞咽困难的疗效

关键词：假性延髓麻痹  吞咽困难  针刺疗法  脑干听觉诱发电位

Keywords:pseudobulbar paralysis  dysphagia  acupuncture  kinesitherapy  brainstem auditory evoked potentials

摘要：

      摘要 目的：观察互动式针刺法治疗脑卒中后假性延髓麻痹吞咽障碍的临床疗效。 方法：脑卒中后假性延髓麻痹所致吞咽障碍患者90例，随机分为对照组30例、普针组30例、治疗组30例。各组患者均给予脑卒中常规处理、吞咽功能训练，普针组患者另给予常规针刺治疗，治疗组取额中线、廉泉、夹廉泉加用互动式针刺法。分别于治疗前、治疗3周和6周后，采用洼田饮水试验评价患者吞咽功能，观察脑干听觉诱发电位（BAEP）的变化。 结果：与治疗前相比，三组患者治疗后吞咽功能有所改善，能有效缩短BAEP各波潜伏期和峰间潜伏期（P＜0.05），且随治疗时间的延长，疗效更加显著（P＜0.01）。 结论：互动式针刺法可能通过促进大脑皮质功能及脑干的吞咽反射恢复而发挥其治疗脑卒中后假性延髓麻痹吞咽障碍的作用。

Abstract:

      Abstract Objective: To observe the clinical therapeutic effect of acupuncture kinesitherapy on dysphagia caused by pseudobulbar paralysis after stroke. Method: Ninety patients were randomly divided into control group, acupuncture group, therapy group (n=30). Patients in all groups were given routine treatment and swallowing training. In addition, the patients in acupuncture group were given routine acupuncture and therapy group given acupuncture kinesitherapy simultaneously at ezhongxian, lianquan(RN23), jialianquan points. Water drinking test and brainstem auditory evoked potential(BAEP) was used to assess swallowing function before and 3 weeks, 6 weeks after treatment. Result: The patients got improvement of swallowing function in each group, significant improvement in acupuncture group and therapy group after treatment, demonstrated by water drinking test and brainstem auditory evoked potential(BAEP). Moreover,the patients got significant improvement in therapy group after long time therapy. Conclusion: The acupuncture kinesitherapy has obvious therapeutic effect on dysphagia caused by pseudobulbar paralysis after stroke. Its possible functional mechanism is promoting the cerebral cortex's and the brainstem's function recovery.