口腔定位疗法联合特定穴位针刺对脑卒中后吞咽障碍的影响

关键词：脑卒中  吞咽障碍  口腔定位疗法  针刺

Keywords:stroke  dysphagia  oral placement therapy  acupuncture

摘要：

      摘要 目的：研究口腔定位疗法联合特定穴位针刺对脑卒中后吞咽障碍的影响。 方法：按照病例纳入标准，选择脑卒中后吞咽障碍患者78例，随机分成对照组和治疗组，每组各39例。两组患者同时接受常规疗法，2周为1个疗程，连续治疗2个疗程。治疗组在第一疗程加用廉泉、风池、金津、玉液针刺，第二疗程进一步加用口腔定位疗法。于第一疗程、第二疗程后分别采用标准吞咽功能评价量表对两组患者吞咽功能进行评定，并对其临床疗效进行比较。 结果：2个疗程后，两组患者的标准吞咽功能评价量表评分均低于治疗前（P＜0.001），且治疗组患者的标准吞咽功能评价量表评分低于对照组（P＜0.001）。治疗组第一、第二疗程的标准吞咽功能评价量表评分改善值及标准吞咽功能评价量表评分总改善值均高于对照组（P＜0.01）。此外，对照组患者2个疗程的标准吞咽功能评价量表评分改善值差异无显著性（P＞0.05），而治疗组患者第二疗程的标准吞咽功能评价量表评分改善值高于第一疗程（P＜0.05）。 结论：常规疗法联合特定穴位针刺能显著改善脑卒中后吞咽障碍，且疗效高于单纯常规疗法。此外，融入口腔定位疗法后的疗效明显优于单纯融入特定穴位针刺。

Abstract:

      Abstract Objective: To observe the effect of oral placement therapy(OPT) combined with acupuncture of specific points on dysphagia after stroke. Method: According to the case inclusion criteria, 78 patients with dysphagia after stroke were included and divided randomly into control group and treatment group, 39 cases in each group. Two groups of patients received conventional therapy, two weeks for a course, continuous two courses of treatment. The first course of treatment group subjoined acupuncture in Lianquan (RN23), Fengchi (GB20), Jinjin (Ex-HN12), Yuye (Ex-HN13), the second course of treatment group further subjoined OPT. Standardized swallowing assessment(SSA) was used to evaluate the swallowing function and clinical efficacy of the two groups of patients after the first course and second course of treatment. Result: After two courses of treatment, the total scores of SSA of the both groups were lower than that of their baseline evaluation (P＜0.001), and the total score of SSA in treatment group was lower than that in the control group (P＜0.001). The changes in scores of SSA of the first course, second course and the both two courses in the treatment group were all higher than that in the control group (P＜0.01). Moreover, in the control group, the changes in scores of SSA in two courses of treatment had no significant difference (P＞0.05), but in the treatment group, the change in score of SSA of the second course of treatment was higher than that in the first course of treatment (P＜0.05). Conclusion: Conventional therapy combined with acupuncture of specific points can obviously improve dysphagia after stroke, and its efficacy was higher than conventional therapy alone; especially, while integrating OPT into the therapy the efficacy was significantly better than only integrating acupuncture of specific points.