廉泉穴不同针刺深度联合冰刺激治疗脑卒中后吞咽障碍患者临床疗效研究

目的:观察廉泉穴不同针刺深度联合冰刺激治疗中风后吞咽障碍患者临床疗效。方法:80例脑卒中后伴吞咽障碍患者随机分为浅刺组和深刺组各40例,2组患者给与常规药物治疗和冰刺激,浅刺组针刺廉泉穴30~40mm,深刺组针刺廉泉穴60~70 mm。治疗前后运用电视X线透视吞咽功能(VFSS)、标准吞咽功能评定量表(SSA)对2组患者进行评定,并统计临床疗效及不良反应情况。结果:治疗12周和治疗后第8周随访时,2组口腔期通过时间、咽期延迟时间、咽期通过时间与组内治疗前比较均明显减少(均P<0.05),SSA评分均明显降低(均P<0.05);治疗后第8周随访时与治疗12周比较,2组口腔期通过时间、咽期延迟时间、咽期通过时间均明显减少(均P<0.05),SSA评分均明显降低(均P<0.05);治疗12周和治疗后第8周随访时,深刺组口腔期通过时间、咽期延迟时间、咽期通过时间较浅刺组同时间点比较均明显减少(均P<0.05),SSA评分均明显降低(均P<0.05)。深刺组临床疗效的总有效率明显高于浅刺组(P<0.05),2组不良反应比较差异无统计学意义。结论:廉泉穴深刺联合冰刺激可有效改善中风后吞咽障碍患者吞咽功能,远期效果稳定。

Clinical efficacy of different acupuncture depths of Lianquan point combined with ice stimulation on dysphagia after stroke

Objective: To observe the clinical efficacy of Lianquan point acupuncture at different depths combined with ice stimulation in the treatment of dysphagia after stroke. Methods: Totally, 80 patients with dysphagia after stroke were randomly divided into shallow needling group and deep needling group, 40 cases in each group. The patients in both groups were given conventional drug treatment and ice stimulation. The shallow needling group was subjected to acupuncture at Lianquan (30-40 mm) and the deep needling group to acupuncture at Lianquan (60-70 mm). Before and after treatment, the visual fluoroscopy swallowing function (VFSS) and standard swallowing function assessment scale (SSA) were used to evaluate the two groups, and the clinical efficacy and adverse reactions were recorded. Results: At 12th week of treatment and 8th week of follow-up after the end of treatment, the oral passage time, pharyngeal delay time and pharyngeal passage time in the two groups were significantly shortened as compared with those before treatment (all P<0.05), and SSA scores were significantly reduced (all P<0.05). At 12th week of treatment and 8th week of follow-up after the end of treatment, the oral passage time, pharyngeal delay time and pharyngeal passage time in the deep needling group were significantly shorter than those in the shallow needling group (all P<0.05), and SSA scores were significantly lower (all P<0.05). The total effective rate in the deep needling group was significantly higher than that in the shallow needling group (P<0.05). There was no significant difference in adverse reactions between the two groups. Conclusion: Deep needling of Lianquan point combined with ice stimulation can effectively improve the swallowing function of patients with dysphagia after stroke, and the long-term effect is stable.