中西医结合治疗脑卒中患者的吞咽障碍

目的：探讨中西医结合治疗脑卒中吞咽障碍的临床疗效。方法：将病情稳定的300例脑卒中伴吞咽障碍患者分成常规药物组、训练组、电针组、中药组和综合组各60例,分别给予相应治疗,于治疗前及治疗第3、14及28天时采用吞咽X线透视检查法（VFSS）评分评定患者的吞咽障障碍程度。结果：与治疗前比较,治疗第28天时药物组、训练组、电针组、中药组和综合组VFSS评分均显著提高;总有效率分别为40%、73.3%、70%、63.3%及100%（P〈0.05或0.01）。综合组治疗第14及28天时与其他4组比较,VFSS评分提高更显著（P〈0.05）。结论：在常规药物治疗的基础上,辅以中西结合的综合治疗是改善脑卒中伴吞咽障碍患者的最佳方案。

Treatment of Dysphagia in Stroke Patients by Combination of TCM with Western Medicine

Objective:To study the clinical effectiveness of combination of TCM with Western medicine in the treatment of dysphagia in stroke patients.Methods:300 stroke patients with dysphagia were averagely divided into common drugs group,function training group,electric acupuncture group,Chinese herbal medicine group and combination group,and were treated respectively.Assessment score of dysphagia by videofluoroscopic swallowing study(VFSS)was compared among 5 groups before treatment and at the 3rd,14th,28th day after treatment.Results:Compared with that before treatment,at 28th day of the course,the VFSS score in common drugs group,function training group,electric acupuncture group,Chinese herbal medicine group and combination group were markedly increased(P<0.05 or 0.01),and the total effective rate was 40%,73.3%,70%,63.3% and 100% respectively.At the 14th and 28th day,the increase of VFSS score in combination group was more significant(P<0.05)than the other 5 groups.Conclusion:The combined treatment of using swallowing function training,electric acupuncturing,Chinese herbal medicine on the basis of common drugs is the best strategy to stroke patients with dysphagia.