口咽同步刺激配合针刺治疗改善卒中后吞咽障碍的临床效果分析

Clinical Analysis of Synchronous Stimulation of Oropharynx Combined with Acupuncture in the Treatment of Dysphagia after Stroke

摘要: 目的：观察通过吞咽障碍患者进行口腔冰、酸刺激和咽反射、咳嗽反射刺激为主的康复训练联合针刺治疗改善脑卒中后吞咽功能障碍的疗效。方法：将64例脑卒中后经过洼田饮水试验和吞咽造影检查，确定确实存在吞咽障碍，将患者随机分为治疗组与对照组，每组各32人，治疗组在对患者进行反复口腔冰酸刺激、咽反射、咳嗽反射刺激和基础吞咽训练联合针刺治疗进行治疗，治疗每日两次，每次30分钟；对照组只给予针刺治疗和基础吞咽训练，4周后通过洼田饮水试验分级和吞咽造影后Rosenbek分级法进行疗效评定。结果：两组共64名患者经过4周的临床治疗，2组治疗后洼田饮水试验评级均好于治疗前(P < 0.05)，且治疗组好于对照组(P < 0.05)。2组治疗后吞咽造影检查Rosenbek不同性状食物进食后分级均好于治疗前(P < 0.05)，治疗组好于对照组(P < 0.05)，2组吞咽障碍均有不同程度改善和恢复。结论：口咽同步刺激配合针刺治疗改善卒中后吞咽功能障碍疗效显著。

Abstract: Objective: To observe the combination of oral ice, acid stimulation, pharyngeal reflex and cough reflex stimulation in patients with dysphagia, combined with acupuncture on dysphagia after stroke. Methods: Sixty-four patients with dysphagia were examined by swallowing radiography after stroke. The patients were randomly divided into the treatment group (n = 32) and the control group (n = 32). In the treatment group, patients were treated with repeated oral ice-acid stimulation, pharyngeal reflex, cough reflex stimulation and basic swallowing training combined with acupuncture therapy. The treatment was conducted twice a day for 30 minutes each time. The control group received acupuncture therapy and basic swallowing training. The curative effect was evaluated by Watian drinking water test and VFSS. Results: After 4 weeks of clinical treatment, dysphagia was improved and recovered in both groups. A total of 64 patients in the two groups underwent 4 weeks of clinical treatment. After treatment, the rating of drinking water test in the depression was better than that before treatment in both groups (P < 0.05), and the treatment group was better than the control group (P < 0.05). After treatment, Rosenbek was better than before treatment (P < 0.05), and the treatment group was better than the control group (P < 0.05). The swallowing disorders in both groups were improved to different degrees. Conclusion: Synchronous stimulation of oropharynx combined with acupuncture is effective in treating dysphagia after stroke.