中医冰火疗法理论指导下的吞咽康复护理干预中风后吞咽障碍临床研究
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R473.74

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河南省中医药科学研究专项课题(2018ZY2138)


Clinical Study on Swallowing Rehabilitation Nursing Guided by Chinese Medicine Theory on Ice-Fire Therapy for Dysphagia After Stroke
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    摘要:

    目的:观察中医冰火疗法理论指导下的吞咽康复护理联合常规疗法与吞咽康复训练对中风后吞咽障碍患者吞咽功能的影响。方法:将纳入的60 例中风后吞咽障碍患者随机分为中医组与对照组各30 例。2 组均给予神经内科基础治疗,实施常规护理与吞咽康复训练,中医组实施中医冰火疗法理论指导下的吞咽康复护理。2 组疗程均为1 个月。治疗前、治疗1 个月后,应用洼田氏饮水试验、标准吞咽功能评定量表(SSA) 测评2 组患者的吞咽功能,应用吞咽障碍特异性生活质量量表(SWAL-QOL)测评生活质量,应用肌电诱发电位仪行肌电图检查,记录患者吞咽肌群的吞咽时程及最大振幅。结果:治疗1 个月,中医组临床疗效总有效率为96.67%,高于对照组的73.33%,差异有统计学意义(P<0.05)。2 组吞咽能力均较治疗前改善,差异均有统计学意义(P<0.05),中医组吞咽能力的改善程度优于对照组,差异有统计学意义(P<0.05)。2 组咬肌、口轮匝肌、颏下肌群、舌骨下肌群的吞咽时程均较治疗前缩短、吞咽最大振幅均大于治疗前,差异均有统计学意义(P<0.01),中医组4 个肌群的吞咽时程均短于对照组、吞咽最大振幅均大于对照组,差异均有统计学意义(P<0.01)。2 组SSA 评分均低于治疗前,SWAL-QOL 评分均高于治疗前,差异均有统计学意义(P<0.01)。中医组SSA 评分低于对照组,SWAL-QOL 评分高于对照组,差异均有统计学意义(P<0.01)。结论:在中医冰火疗法理论指导下的吞咽康复护理联合常规疗法与吞咽康复训练可增强中风后吞咽障碍患者吞咽肌群的协调性,改善吞咽障碍,进而恢复吞咽功能,有效防止肌群萎缩不用。

    Abstract:

    Abstract:Objective:To observe the effect of swallowing rehabilitation nursing guided by Chinese medicine theory on ice-fire therapy combined with routine therapy and swallowing rehabilitation training on swallowing function of patients with dysphagia after stroke. Methods: A total of 60 cases of patients with dysphagia after stroke were enrolled and randomly divided into the Chinese medicine group and the control group, 30 cases in each group. Both groups were given basic treatment of neurological internal medicine and routine nursing combined with swallowing rehabilitation training. The Chinese medicine group was given swallowing rehabilitation nursing guided by Chinese medicine theory on ice- fire therapy. Both groups were treated for one month. Before treatment and after one- month treatment, Kubota's water swallow test and Standardized Swallowing Assessment(SSA) were used to evaluate swallowing function, and Swallowing- Quality of Life (SWAL- QOL) Scale was used to evaluate quality of life. Electromyograph was carried out through myoelectric evoked potential instrument. Swallowing duration and maximal amplitude of swallowing muscle groups were recorded. Results:After one month,the total effective rate of clinical effect was 96.67% in the Chinese medicine group,higher than that of 73.33% in the control group, the difference being significant(P<0.05). Swallowing function in the two groups was improved when compared with that before treatment,differences being significant(P<0.05),and the improvement in the Chinese medicine group was better than that in the control group,the difference being significant(P<0.05). Swallowing duration of masseter, orbicularis oris, submental muscles, and sublingual muscles in the two groups was shortened when compared with that before treatment,and maximal amplitude of swallowing was larger than that before treatment,differences being significant (P<0.01). Swallowing duration of masseter, orbicularis oris, submental muscles, and sublingual muscles in the Chinese medicine group was shorter than that in the control group,and maximal amplitude of swallowing was larger,differences being significant(P<0.01). SSA scores in the two groups were lower than those before treatment,and SWAL-QOL scores were higher, differences being significant(P<0.01). SSA score in the Chinese medicine group was lower than that in the control group, and SWAL- QOL score was higher, differences being significant(P<0.01). Conclusion: The therapy of swallowing rehabilitation nursing guided by Chinese medicine theory on ice- fire therapy combined with routine therapy and swallowing rehabilitation training can enhance coordination of swallowing muscle groups in patients with dysphagia after stroke and improve dysphagia,thus recovering swallowing function and effectively preventing atrophy of muscle groups.

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杜娟,李海松,田果.中医冰火疗法理论指导下的吞咽康复护理干预中风后吞咽障碍临床研究[J].新中医,2021,53(20):165-170

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  • 在线发布日期: 2021-10-22
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