电针“吞咽康复组穴”对脑干梗死后咽期吞咽障碍患者腭咽闭锁能力和咽缩肌运动能力的影响

关键词：脑干梗死  咽期吞咽障碍  腭咽闭锁能力  咽缩肌运动能力  电针  随机对照试验

Keywords:brainstem infarction  pharyngeal dysphagia  velopharyngeal atresia  motor ability of pharyngeal constrictor  electroacupuncture  randomized controlled trial

摘要：

      摘要 目的：观察电针“吞咽康复组穴”对脑干梗死后咽期吞咽障碍患者腭咽闭锁能力和咽缩肌运动能力的影响。 方法：将70例脑干梗死后咽期吞咽障碍患者，随机分为对照组和试验组，对照组患者接受常规对症治疗及吞咽康复训练，试验组患者在对照组的基础上给予“吞咽康复组穴”电针治疗。每天1次，每次30min，10次为1疗程，中间休息2天，再治疗1个疗程。共治疗2个疗程。比较两组患者治疗前后腭咽闭锁能力评分、咽缩肌向前下方突出的最大距离以及渗漏误吸量表（PAS）评分的变化。 结果：干预1个疗程后：试验组患者的腭咽闭锁能力评分、咽缩肌向前下方突出的最大距离较干预前增加（P＜0.01），PAS评分较干预前降低（P＜0.01）；与干预前相比，对照组患者的腭咽闭锁能力（P＜0.05）和咽缩肌向前下方突出的最大距离（P＜0.01）增加，PAS评分降低（P＜0.05）；试验组患者各项指标的改善优于对照组（P＜0.05）。干预2个疗程后：试验组患者的各项指标较干预前和干预1个疗程后显著改善（P＜0.01）；对照组患者的腭咽闭锁能力评分高于干预前（P＜0.01）和干预1个疗程（P＜0.05），其余各项指标较前两个时间点显著改善（P＜0.01）；试验组各项指标较对照组患者显著改善（P＜0.01）。 结论：电针“吞咽康复组穴”是治疗脑干梗死后咽期吞咽障碍的安全有效手段。

Abstract:

      Abstract Objective： To observe the effect of electroacupuncture at "swallowing rehabilitation group points" on velopharyngeal atresia and motor function of the pharyngeal constrictor in patients with pharyngeal dysphagia after brainstem infarction. Method： Seventy patients with pharyngeal dysphagia after brainstem infarction were randomly divided into control and experimental groups. The control group were given routine symptomatic treatment and swallowing rehabilitation training， while the experimental group were given additional electroacupuncture at " swallowing rehabilitation group points ". The treatment was administered once daily for 30 minutes per session, with 10 sessions constituting one treatment course, followed by a 2-day rest period, and then another course， for a total of 2 courses. The outcomes measured included scores of velopharyngeal atresia， the maximum distance of pharyngeal constrictor protruding forward and downward， and the scores of penetration aspiration scale（PAS） were compared between the two groups before and after treatment. Result： After one course of intervention, the experimental group showed significant improvements in velopharyngeal atresia scores and the maximum distance of pharyngeal constrictor protrusion（P<0.01），and with a reduction in PAS score（P<0.01）. In control group, there were also improvements in velopharyngeal atresia scores（P<0.05） and the maximum distance of pharyngeal constrictor protrusion（P<0.01） with a decrease in PAS score decreased（P<0.05）. The experimental group demonstrated superior improvements compared to the control group（P<0.05）. After two courses of intervention, the experimental group exhibited further significant improvements in all measured indices（P<0.01）. The control group also showed enhanced velopharyngeal atresia scores compared to pre-intervention（P<0.01） and after one course（P<0.05）， with significant improvements in other indices （P<0.01）. The indexes in the experimental group were significantly improved compared with those in the control group （P<0.01）. Conclusion： Electroacupuncture at "swallowing rehabilitation group points" is a safe and effective method for treating pharyngeal dysphagia after brainstem infarction.