不同刺法调整卒中后吞咽障碍的作用观察

目的:观察以廉泉为主要穴位进行不同的针刺方法在改善脑卒中后吞咽困难之咽阶段障碍中的作用。方法:将111例入选患者随机分为3组,分别采用廉泉单针浅刺法(A1组)、廉泉单针深刺法(A2组)和廉泉加旁廉泉多针深刺法(B组),连续治疗14天后观察疗效。结果:在总有效率方面,B组为95·0%,A1组为65·7%,A2组为83·3%,B组与A1、A2组比较分别为P<0·01和P<0·05,差异有非常显著性意义和显著性意义;在愈显率方面,B组为82·5%,A1组为20·0%,A2组为52·8%,B组与A1、A2组比较均为P<0·01,差异有非常显著性意义;在治疗7天后,吞咽功能评分B组与A1、A2组比较均为P<0·01,说明改善吞咽障碍敏感性方面B组优于A1、A2组。结论:以颈部腧穴解剖为基础的多针深刺法不但可以明显改善卒中后吞咽困难的咽阶段障碍,而且安全性高、见效快,值得临床推广。

The role of different needling manipulation in adjusting swallow-period obstacle of dysphagia after stroke

Objective To observe the effect of different needling manipulation in improvement of swallow-period obstacle of dysphagia after stroke. Methods One hundred and eleven cases were randomly divided into a single Lianquan RN 23 shallow needling group (group A_ 1 ), single Lianquan (RN 23) deep needling group (group A_ 2 ) and Lianquan (RN 23) and para-Lianquan deep multi-needling group (group B). The therapeutic effect was investigated after continuous treatment for 14 days. Results The total effective rate was 95.0% in the group B, 65.7% in the group A_ 1 and 83.3% in the group A_ 2 , with significant difference or very significant difference when the group B compared with the group A_ 1 and the group A_ 2 ( P<0.01 or P<0.05 ); the cured and markedly effective rate was 82.5% in the group B, 20.0% in the group A_ 1 and 52.8% in the group A_ 2 , with a very significant difference as the group B compared with the group A_1 and A_ 2 (both P<0.01 ). After treatment for 7 days, there were very significant differences in scores of swallow function as the group B compared with the group A_ 1 and A_ 2 (both P<0.01 ), indicating that the group B was better than the group A_1 and A_ 2 in improvement of sensitivity of swallow dysphagia. Conclusion Deep needling with multi-needles can significantly improve swallow-period obstacle of dysphagia after stroke with higher safety and rapid effect.