椎针通络循经疗法结合康复训练及神经肌肉电刺激对脑卒中后吞咽障碍患者的影响

目的:观察椎针通络循经疗法结合康复训练及神经肌肉电刺激对脑卒中后吞咽障碍患者的影响。方法:选取本院神经内科2015年6月—2016年6月收治的脑卒中后吞咽障碍患者120例,随机分为试验组和对照组,每组60例。两组患者均给予控制血压、血糖、抗血小板聚集等对症治疗,对照组患者给予康复训练配合神经肌肉电刺激治疗,试验组患者在对照组治疗的基础上给予椎针通络循经疗法治疗。观察并比较两组患者治疗前后患者吞咽功能量表(standardized swallowing assessment,SSA)水平、功能性经口摄食量表(functional oral Intake scale,FOIS)水平、洼田饮水试验以及患者临床治疗有效率。结果:两组患者吞咽功能评分比较,对照组治疗前(32.98±4.11)分,治疗后(26.26±3.04)分,试验组治疗前(32.38±3.19)分,治疗后(22.55±2.73)分,两组治疗后均优于治疗前(P0.05),且试验组治疗后优于对照组(P0.05);两组患者治疗前后经口摄食量表分级比较,对照组治疗前(2.42±0.58)级,治疗后(3.41±0.31)级,试验组治疗前(2.45±0.66)级,治疗后(4.62±0.44)级,两组治疗后均优于治疗前(P0.05),且试验组治疗后优于对照组(P0.05);两组患者治疗前后洼田饮水试验分级比较,对照组治疗前(2.22±0.65)级,治疗后(3.11±0.49)级,试验组治疗前(2.17±0.73)级,治疗后(4.12±0.58)级,两组治疗后均优于治疗前,且试验组治疗后优于对照组(P0.05);试验组有效率85.0%,对照组有效率65.0%,试验组疗效优于对照组(P0.05)。结论:椎针通络循经疗法结合康复训练及神经肌肉电刺激能够明显改善脑卒中后吞咽障碍患者的吞咽功能,临床疗效较好。

Effects of Acupuncture Combined with Rehabilitation Training and Neuromuscular Electrical Stimulation on Patients with Post-Stroke Dysphagia

Objective:To observe the effect of acupuncture therapy combined with rehabilitation training and neuromuscular electrical stimulation on patients with post-stroke dysphagia.Methods:A total of 120 patients with post-stroke dysphagia were enrolled in our hospital from June 2015 to June 2016,and were randomly divided into experimental group and control group (n =60).Two groups of patients were treated with regular methods including the control of blood pressure,blood glucose,anti-platelet aggregation and other symptomatic treatment.The control group of patients was treated with rehabilitation therapy of training with neuromuscular electrical stimulation in addition to that of the experimental group.The levels of Standardized Swallowing Assessment (SSA),Functional Oral Intake Scale (FOIS),Wuda Drinking Water Test and Clinical Treatment of Patients in both groups before and after treatment were observed and compared.Results:The scores of swallowing function in the two groups were compared:the control group:before treatment (32.98 ± 4.11),after treatment (26.26 ± 3.04);the experimental group:before treatment (32.38 ± 3.19),after treatment (22.55 ±2.73).The treatment group was significantly better than that of the control group (P ＜ 0.05).Before and after treatment,the two groups of patients before and after treatment of oral food intake grading comparison:the control group:before treatment (2.42 ±0.58),(3.41 ±0.31);the experimental group:before treatment (2.45 ±0.66);after treatment (4.62 ± 0.44).Both groups were significantly better than that before treatment (P ＜ 0.05).Comparison of drinking water test scores between two groups of patients before and after treatment:the experimental group:before treatment (2.22 ± 0.65),after treatment (3.11 ± 0.49),the treatnent group:before treatment (2.17 ± 0.65),after treatment (4.12 ± 0.58).After treatment,the drinking water test scores of the two groups were significantly better than before treatment,and that of the test group was significantly better than that of the control group after treatment (P ＜ 0.05).The effective rate in the experimental group was 85.0％ and the effective rate of the control group was 65.0％.The effective rate of the control group was significantly higher than that of the control group(P ＜ 0.05).Conclusion:The treatment of accupuncture combined with rehabilitation training and neuromuscular electrical stimulation can significantly improve the swallowing function of patients with dysphagia after stroke,and the clinical curative effect is significantly better.