针刺联合吞咽训练对脑卒中后假性球麻痹吞咽障碍患者吞咽功能的影响
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R246.6

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国家自然科学基金青年项目(81904268);福建省康复产业研究院技术创新平台项目(2015Y2001-13)


Influence of Acupuncture Combined with Swallowing Training on Swallowing Function in Patients with Post-Stroke Pseudobulbar Palsy Swallowing Disorder
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    摘要:

    目的:观察针刺联合吞咽训练对脑卒中后假性球麻痹吞咽障碍患者咽部运动功能及咽部食物残留 情况的影响。方法:纳入脑卒中后假性球麻痹吞咽障碍患者80例,按随机数字表法分为联合组和吞咽训练组 各40例。联合组剔除1例,吞咽训练组剔除2例,最终纳入研究联合组39例、吞咽训练组38例。2组均给予脑 卒中常规治疗,吞咽训练组进行吞咽功能训练,联合组在吞咽功能训练基础上针刺廉泉、风府、风池、翳风、 吞咽穴,治疗4周。治疗前后应用纤维喉镜吞咽功能检查(FEES) 观察患者咽部运动(咽内缩、舌根后缩能 力) 能力、残留(会厌谷、梨状窦残留) 情况,同时采用洼田饮水试验评分评估吞咽功能。结果:治疗后, 2 组咽内缩、舌根后缩能力均较治疗前提高(P<0.05),联合组咽内缩、舌根后缩能力均高于吞咽训练 组(P<0.05)。2组会厌谷、梨状窦残留情况均较治疗前减少(P<0.05),联合组会厌谷、梨状窦残留情况均 少于吞咽训练组(P<0.05)。2组洼田饮水试验评分均较治疗前降低(P<0.05),联合组洼田饮水试验评分低 于吞咽训练组(P<0.05)。结论:针刺联合吞咽训练可提高脑卒中后假性球麻痹吞咽障碍患者的咽内缩、舌根 后缩能力,减少会厌谷、梨状窦食物残留,改善其吞咽功能。

    Abstract:

    Abstract: Objective: To observe the influence of acupuncture combined with swallowing training on pharyngeal motor function and pharyngeal food residue in patients with post-stroke pseudobulbar palsy swallowing disorder. Methods: A total of 80 cases of patients with post-stroke pseudobulbar palsy swallowing disorder were included and divided into the combination group and the swallowing training group according to random number table method,with 40 cases in each group. One case was excluded from the combination group and two cases were excluded from the swallowing training group. Finally, 39 cases in the combination group and 38 cases in the swallowing training group were included. The two groups were given routine treatment for stroke; the swallowing training group received swallowing function training, and the combination group was additionally treated with acupuncture at Lianquan (RN23) point, Fengfu (DU16) point, Fengchi (GB20) point, Yifeng (SJ17) point and Tunyan point for four weeks based on swallowing function training. The Flexibl Endoscopic Evaluation Swallowing (FEES) was applied to observe the pharyngeal movement ability (endopharyngeal contraction,retraction of tongue root) and residue state (epiglotic valley,piriform sinus residue) in patients before and after treatment,and the swallowing function was evaluated by kubota Water Swallowing Test. Results:After treatment,the ability of endopharyngeal contraction and posterior lingual contraction in both groups was improved when compared with that before treatment (P<0.05),and the above ability in the combination group was greater than that in the swallowing training group (P<0.05). The incidence of residue in epiglottic valley and piriform sinus in both groups was reduced when compared with that before treatment (P<0.05), and the incidence of residue in the combination group was less than that in the swallowing training group (P<0.05). The scores of kubota Water Swallowing Test in the two groups were decreased when compared with those before treatment (P<0.05), and the scores in the combination group were lower than those in the swallowing training group (P<0.05). Conclusion: Acupuncture combined with swallowing training can improve the ability of pharyngeal retraction and tongue root retraction, reduce the food residue in epiglotic valley and piriform sinus, and improve the swallowing function of patients with post-stroke pseudobulbar palsy swallowing disorder.

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徐颖,林淑芳,江一静,林茜,杨珊莉.针刺联合吞咽训练对脑卒中后假性球麻痹吞咽障碍患者吞咽功能的影响[J].新中医,2024,56(22):124-129

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  • 在线发布日期: 2024-11-28
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