针刺联合康复训练对于中风后吞咽障碍的疗效分析(1)
[摘要] 目的 探讨针刺联合康复训练治疗中风后吞咽障碍的疗效。 方法 方便选取2011年1月—2015年12月在该院针灸康复科病房住院的假性球麻痹患者50例，随机分为针刺组和治疗组，每组25例。两组均给予神经内科脑卒中常规药物治疗。针刺组采用以项针和舌咽穴为主针刺治疗。治疗组选穴、操作、疗程均同治疗组，同时加康复治疗。两组治疗前后均进行吞咽功能分级及疗效评分，并进行比较。 结果 两组治疗后的吞咽功能评分与治疗前相比较，差异均有统计学意义(P<0.05)。治疗组有效率为96%，针刺组有效率为68%，治疗组的吞咽功能评分及有效性与针刺组比较，差异均有统计学意义(P<0.05)。 结论 针刺联合康复治疗对于改善中风后吞咽障碍疗效更佳。
[关键词] 假性球麻痹；针刺；康复治疗
[中图分类号] R246.6 [文献标识码] A [文章编号] 1674-0742(2016)11(c)-0185-03
[Abstract] Objective To observe the acupuncture combined rehabilitation treatment the curative effect of swallowing disorder after stroke. Methods Convenient selection will be between January 2011 and December 2015 in acupuncture and rehabilitation wards in the hospital of 50 patients with pseudo bulbar paralysis were randomly divided into acupuncture group and treatment group，25 patients in each group.In the two groups were given neurology stroke routine drug treatment and nursing. The acupuncture group is given priority to with a needle and tongue pharynx point acupuncture treatment.Treatment group selected point， operations， a course with treatment group，The treatment group plus rehabilitation therapy at the same time.The swallowing function in the two groups before and after treatment grading and curative effect evaluation， and comparison. Results After treatment， there were significant differences between the two groups before and after treatment(P < 0.05).The treatment group effective rate was 96%， effective rate was 68%， the acupuncture group. In the treatment group， there were significant differences between the scores of swallowing function and acupuncture group(P < 0.05). Conclusion Acupuncture with rehabilitation therapy to improve swallowing disorder after stroke curative effect is better.
[Key words] Pseudobulbar palsy；Acupuncture；Rehabilitation treatment
假性球麻痹是腦梗死最常见的并发症之一，临床表现为吞咽障碍，饮水呛咳，构音障碍，强哭强笑，声音嘶哑等，查体可发现咽反射存在或减弱，并出现原始反射、锥体束征等。其中吞咽障碍如不能及时有效治疗，可造成患者营养不良、电解质紊乱、吸入性肺炎、窒息等严重并发症，甚至危及患者的生命，严重影响患者的系统康复治疗[1]。针灸对于脑梗死后吞咽障碍的治疗以及促进其临床症状的改善已得到广大临床医师的认可[2]。该院自2011年1月—2015年12月期间应用针刺及针刺联合康复治疗假性球麻痹的患者50例，现报道如下。
1 资料与方法
1.1 一般资料
该研究方便选取的50例患者均为该院针灸康复科住院治疗的脑梗死后出现吞咽障碍的患者。根据住院顺序的先后简单随机分为针刺组和治疗组(针刺康复组)，两组患者在年龄、性别、平均病程等方面的差异无统计学意义(P>0.05)。
1.2 诊断标准
(1)符合1997年中华医学会第四次修定的《各类脑血管疾病诊断要点》中有关“动脉粥样硬化性血栓性脑梗死”诊断标准，且经头颅CT或MRI检查证实；(2)①吞咽困难，饮水呛咳，或语言含糊，声音障碍；②情感障碍，强哭强笑或表情呆滞；③软腭反射消失，咽反射减弱；④病理性脑干反射阳性；⑤无舌肌萎缩及纤颤。符合①项及②～⑤项中任意2项者，可诊断为假性球麻痹[3]。
1.3 治疗方法
两组均连续治疗1个月，然后观察疗效。
1.3.1 基础治疗 两组均给予神经内科脑梗死常规的药物治疗及对症治疗。 (李巧云 邢海辉)
[关键词] 假性球麻痹；针刺；康复治疗
[中图分类号] R246.6 [文献标识码] A [文章编号] 1674-0742(2016)11(c)-0185-03
[Abstract] Objective To observe the acupuncture combined rehabilitation treatment the curative effect of swallowing disorder after stroke. Methods Convenient selection will be between January 2011 and December 2015 in acupuncture and rehabilitation wards in the hospital of 50 patients with pseudo bulbar paralysis were randomly divided into acupuncture group and treatment group，25 patients in each group.In the two groups were given neurology stroke routine drug treatment and nursing. The acupuncture group is given priority to with a needle and tongue pharynx point acupuncture treatment.Treatment group selected point， operations， a course with treatment group，The treatment group plus rehabilitation therapy at the same time.The swallowing function in the two groups before and after treatment grading and curative effect evaluation， and comparison. Results After treatment， there were significant differences between the two groups before and after treatment(P < 0.05).The treatment group effective rate was 96%， effective rate was 68%， the acupuncture group. In the treatment group， there were significant differences between the scores of swallowing function and acupuncture group(P < 0.05). Conclusion Acupuncture with rehabilitation therapy to improve swallowing disorder after stroke curative effect is better.
[Key words] Pseudobulbar palsy；Acupuncture；Rehabilitation treatment
假性球麻痹是腦梗死最常见的并发症之一，临床表现为吞咽障碍，饮水呛咳，构音障碍，强哭强笑，声音嘶哑等，查体可发现咽反射存在或减弱，并出现原始反射、锥体束征等。其中吞咽障碍如不能及时有效治疗，可造成患者营养不良、电解质紊乱、吸入性肺炎、窒息等严重并发症，甚至危及患者的生命，严重影响患者的系统康复治疗[1]。针灸对于脑梗死后吞咽障碍的治疗以及促进其临床症状的改善已得到广大临床医师的认可[2]。该院自2011年1月—2015年12月期间应用针刺及针刺联合康复治疗假性球麻痹的患者50例，现报道如下。
1 资料与方法
1.1 一般资料
该研究方便选取的50例患者均为该院针灸康复科住院治疗的脑梗死后出现吞咽障碍的患者。根据住院顺序的先后简单随机分为针刺组和治疗组(针刺康复组)，两组患者在年龄、性别、平均病程等方面的差异无统计学意义(P>0.05)。
1.2 诊断标准
(1)符合1997年中华医学会第四次修定的《各类脑血管疾病诊断要点》中有关“动脉粥样硬化性血栓性脑梗死”诊断标准，且经头颅CT或MRI检查证实；(2)①吞咽困难，饮水呛咳，或语言含糊，声音障碍；②情感障碍，强哭强笑或表情呆滞；③软腭反射消失，咽反射减弱；④病理性脑干反射阳性；⑤无舌肌萎缩及纤颤。符合①项及②～⑤项中任意2项者，可诊断为假性球麻痹[3]。
1.3 治疗方法
两组均连续治疗1个月，然后观察疗效。
1.3.1 基础治疗 两组均给予神经内科脑梗死常规的药物治疗及对症治疗。 (李巧云 邢海辉)