揿针联合康复训练治疗帕金森吞咽障碍临床研究

目的:观察揿针(皮内针)结合康复训练诊治帕金森吞咽障碍的临床疗效。方法:将60例帕金森吞咽障碍患者按随机数字表法分为治疗组与对照组,每组30例。2组在药物治疗的基础上,对照组采用吞咽康复训练,治疗组在吞咽康复训练的同时使用揿针治疗。观察2组在诊疗前以及诊疗2个疗程后藤岛吞咽评分、标准吞咽功能评估量表(SSA)评分。比较2组洼田饮水试验疗效评定结果。结果:治疗组总有效率为86.67%,高于对照组的53.33%(P<0.05)。与同组治疗前比较,2组治疗后藤岛吞咽评分升高(P<0.01),SSA评分降低(P<0.01);与对照组治疗后比较,治疗组的藤岛吞咽评分较高(P<0.05),SSA评分较低(P<0.05)。结论:揿针联合康复训练能有效治疗帕金森吞咽障碍。     

于氏项针联合揿针治疗脑卒中后咽期吞咽障碍的临床研究

摘要：目的：分析于氏项针联合揿针治疗脑卒中后吞咽障碍的临床疗效。方法：将70例符合纳入标准的脑卒中后吞咽障碍患者随机分为治疗组(于氏项针联合揿针组)与对照组(常规针刺组),各35例,其中对照组脱离1例,剩余34例。两组除基础治疗外,对照组给予常规针刺治疗,治疗组给予于氏项针联合揿针治疗。记录并评价两组患者治疗前后的洼田饮水试验评分表、标准吞咽功能评估量表(SSA)、吞咽造影(VFSS)和吞咽障碍特异性生活质量评分(SWAL-QOL)。结果：治疗后,两组患者洼田饮水试验评分、SSA评分降低,VFSS指标及SWAL-QOL评分增高,且治疗组总有效率以及各项指标均优于对照组,差异具有统计学意义(P<0.05)。结论：于氏项针联合揿针可以改善脑卒中后咽期吞咽障碍,且疗效优于常规针刺。     

针刺配合康复训练治疗卒中后吞咽障碍疗效观察

目的 观察针刺配合康复训练改善脑卒中后吞咽障碍的临床疗效。方法 将60例脑卒中后吞咽障碍患者随机分为治疗组和对照组,每组30例,两组均给予内科基础治疗及吞咽康复训练,治疗组患者在内科治疗及康复训练基础上给予针刺治疗。两组治疗前后分别进行标准吞咽功能评价(SSA)、洼田饮水试验评定及吞咽障碍特异性生活质量量表(SWAL-QOL)评定。结果 两组患者治疗后SSA评分较治疗前均明显降低(P0.01),SWAL-QOL评分较治疗前均明显增高(P0.01);治疗组患者治疗后SSA评分明显低于对照组(P0.01),SWAL-QOL评分明显高于对照组(P0.05);治疗组治疗后患者洼田饮水分级明显优于治疗前(P0.01),与对照组比较差异有统计学意义(P0.05)。结论 针刺配合康复训练能明显改善卒中后吞咽障碍患者的吞咽功能,疗效优于单纯康复训练。     

“高氏项针”治疗脑卒中后假性延髓麻痹所致吞咽障碍的临床疗效观察

目的:观察"高氏项针"治疗脑卒中后假性延髓麻痹所致吞咽障碍的短期和长期疗效及其对患者生活质量的影响。方法:将脑卒中后假性延髓麻痹所致吞咽障碍患者随机分为对照组和治疗组,两组均采用相同的现代吞咽康复训练,对照组配合指南推荐的针灸组穴(风府、双侧百劳、双侧人迎、廉泉、双侧夹廉泉),观察组则配合"高氏项针",治疗2周后判断疗效,治疗结束1个月后随访。治疗前后及随访分别采用洼田饮水试验和电视透视吞咽功能检查(VFSS)评估吞咽功能,吞咽障碍特异性生活质量表(SWAL-QOL)评估生活质量。结果:治疗后,两组洼田饮水试验、VFSS及SWAL-QOL评分均优于治疗前(P0.05),两组随访时SWAL-QOL评分均优于治疗前(P0.05),且治疗组改善程度均优于对照组(P0.05);治疗组总有效率为100.00%,优于对照组的96.77%(P0.05)。结论:"高氏项针"较"指南针刺法"配合现代吞咽康复训练可更有效改善脑卒中后假性延髓麻痹患者的吞咽困难及生活质量。     

咽五针联合康复训练对卒中后假性延髓麻痹吞咽障碍患者影响研究

目的:观察咽五针联合康复训练对卒中后假性延髓麻痹吞咽障患者影响。方法:选取2016年6月至2018年6月期间在本院收治的卒中后假性延髓麻痹碍吞咽障碍患者177例,随机分为对照组和观察组,对照组88例,给予康复训练;观察组89例,给予咽五针联合康复训练。连续治疗30天。观察两组患者治疗前后标准吞咽功能评估(SSA)评分、电视透视吞咽功能检查(VFSS)评分及洼田饮水试验结果,比较两组治疗总有效率。结果:治疗前,两组患者SSA评分、VFSS评分及洼田饮水试验等级相比,差异无统计学意义(P0.05);治疗后,两组患者SSA评分、洼田饮水试验等级较治疗前显著降低,VFSS评分较治疗前显著升高,差异有统计学意义(P0.05);两组相比,观察组以上指标较对照组改善更为显著,差异有统计学意义(P0.05);治疗后,观察组治疗总有效率为94.38%,对照组治疗总有效率为80.68%,两组相比,观察组显著优于对照组,差异有统计学意义(P0.05)。结论:咽五针联合康复训练治疗卒中后假性延髓麻痹吞咽障碍疗效显著,能显著提高患者的吞咽困难,值得临床大力推广。     

眼-体针结合康复训练对假性延髓性麻痹吞咽困难的影响

目的观察眼-体针并用配合综合康复训练对脑卒中后假性延髓性麻痹吞咽困难的影响。方法患者87例随机分为两组。两组均给予常规内科治疗与康复训练,对照组再予以体针治疗,观察组在对照组基础上予眼针疗法,均治疗4个疗程。观察并比较两组治疗前、2个、4个疗程后洼田饮水试验、藤岛吞咽评分、X线电视透视法(VFSS)及吞咽障碍特异性生活质量量表(SWAL-QOL)评分的变化情况,并比较两组治疗后有效率。结果观察组患者在2个、4个疗程时,除洼田饮水评分外,藤岛吞咽评分、VFSS及SWAL–QOL评分均优于对照组(P 0.05)。时间效应方面,对照组患者洼田饮水试验、藤岛吞咽评分、VFSS及SWAL-QOL评分均优于前一时间点(P 0.05);而观察组除了2个、4个疗程后洼田饮水试验及VFSS评分差异并不显著外(P 0.05),患者藤岛吞咽评分、SWAL-QOL均优于前一时间点(P 0.05)。此外,观察组治疗有效率为97.50%,高于对照组的90.00%(P 0.05)。结论眼体针并用配合综合康复训练,可改善脑卒中后假性延髓性麻痹吞咽困难患者吞咽功能,并可提高患者假性延髓性麻痹吞咽困难患者生活质量,且其疗效在治疗中前期更为明显。     

经皮穴位电刺激联合吞咽康复训练改善脑卒中后假性球麻痹患者预后的研究

目的 研究经皮穴位电刺激联合吞咽康复训练对脑卒中后假性球麻痹患者预后的改善效果。方法 选取合肥市第二人民医院2020年1月—2021年8月收治的120例脑卒中后假性球麻痹患者作为研究对象。按随机数字表法分为两组。对照组60例,采用吞咽康复训练;干预组60例,采用经皮穴位电刺激联合吞咽康复训练。统计分析两组标准吞咽功能评价(SSA)量表评分、洼田饮水试验分级及吞咽障碍特异性生活质量量表(SWAL-QOL)评分数据。结果 干预组SSA评分显著低于对照组,SWAL-QOL评分显著高于对照组,相比差异有统计意义(t=3.725;4.504,P<0.001);干预组洼田饮水试验分级明显优于对照组,相比差异有统计意义(χ²=4.729,P=0.030);干预组临床总有效率为95.00%(57/60),对照组临床总有效率为81.67%(49/60),相比差异有统计意义(χ²=4.108,P=0.043)。结论 经皮穴位电刺激联合吞咽康复训练治疗脑卒中后假性球麻痹,更有利于改善患者吞咽功能,临床疗效显著,值得临床予以推广应用。     

头项针辅助治疗脑卒中恢复期咽期吞咽障碍：随机对照试验

目的：观察在神经肌肉电刺激及康复训练基础上,联合头项针治疗脑卒中恢复期咽期吞咽障碍的临床疗效。方法：将42例脑卒中恢复期咽期吞咽障碍患者随机分为观察组和对照组,各21例。两组均予内科常规对症治疗,对照组采用神经肌肉电刺激及康复训练治疗,各30 min;观察组在对照组基础上加用头项针治疗,头针穴取顶颞前斜线、顶颞后斜线下2/5,项针穴取风池、翳明、供血、治呛、吞咽等。两组均每日治疗1次,每周5 d,共治疗3周。分别于治疗前后观察两组患者吞咽障碍造影评分量表（VDS）评分、洼田饮水试验评级、功能性经口摄食量表（FOIS）评级和吞咽障碍特异性生活质量（SWAL-QOL）评分。结果：治疗后,两组患者VDS评分较治疗前降低、SWAL-QOL评分较治疗前升高（P<0.05）,洼田饮水试验及FOIS评级均较治疗前改善（P<0.05）;观察组患者VDS、SWAL-QOL评分改善程度及洼田饮水试验、FOIS评级均优于对照组（P<0.05）。结论：在神经肌肉电刺激及康复训练基础上联合头项针可提高脑卒中恢复期咽期吞咽障碍的临床疗效,改善患者吞咽功能及生活质量。     

带针吞咽训练治疗假性球麻痹吞咽障碍临床观察

目的：观察带针吞咽训练治疗假性球麻痹吞咽障碍的临床疗效。方法：选取辽宁中医嘉和医院2020年12月至2021年9月收治的假性球麻痹吞咽障碍患者70例,按照随机数字表法分为吞咽组和带针组,每组35例。吞咽组给予吞咽训练治疗,带针组给予带针吞咽训练治疗。观察两组患者改良版洼田饮水试验(modified water swallow test, MWST)评级、标准吞咽功能评价量表(standardized swallowing assessment, SSA)评分、功能性经口摄食量表(functional oral intake scale, FOIS)等级变化情况。结果：吞咽组有效率为77.14%,带针组有效率为91.42%,带针组有效率高于吞咽组,差异有统计学意义(P<0.05);带针组治疗后MWST评级、FOIS等级优于吞咽组,带针组治疗后SSA评分低于吞咽组,差异有统计学意义(P<0.05)。结论：带针进行吞咽训练治疗假性球麻痹吞咽障碍,能改善患者吞咽功能,恢复正常饮食。     

交叉电项针联合吞咽康复训练治疗缺血性脑卒中后吞咽障碍临床观察

[目的]观察交叉电项针配合吞咽康复训练治疗缺血性脑卒中后吞咽障碍的临床疗效。[方法]选择64例符合纳入标准的缺血性脑卒中后吞咽障碍的患者,采取随机数字表法分为观察组和对照组,每组32例。两组患者均采用基础吞咽康复训练治疗,其中观察组加用交叉电项针治疗（电针交叉连接于翳风穴及风池穴之间）,对照组加予常规电项针治疗。两组均每日治疗1次,每周治疗6次,共治疗4周。观察两组疗效及治疗前后渗透误吸量表（PAS）、吞咽障碍造影评分量表（VDS）、标准吞咽功能评定量表（SSA）、特异性吞咽障碍生活质量量表（SWAL-QOL）评分的变化。[结果]观察组总有效率为87.5%,对照组总有效率为75.0%,观察组疗效优于对照组（P<0.05）;两组治疗后的PAS、VDS、SSA评分均较治疗前降低,SWAL-QOL评分较治疗前升高,且观察组PAS、VDS、SSA评分均低于对照组（P<0.05）,SWAL-QOL评分高于对照组（P<0.05）。[结论]交叉电项针联合吞咽康复训练治疗缺血性脑卒中后吞咽障碍患者疗效确切,且优于普通电项针联合吞咽康复训练,在改善患者吞咽功能方面具有显著疗效,可有效提...     

Effects of nape acupuncture combined with swallowing rehabilitation on dysphagia in pseudobulbar palsy

OBJECTIVE: To evaluate the therapeutic effects of nape acupuncture combined with rehabilitative swallowing training for dysphagia caused by pseudobulbar palsy, and to compare it with rehabilitative swallowing training alone, and to observe the improvement in quality of life after the therapy.METHODS: One hundred patients were randomly divided into two groups: the rehabilitative swallowing training group(control group, n = 50) and the nape acupuncture combined with rehabilitative swallowing training group(experimental group,n = 50). Each group had 8 weeks' therapy, 5 times a week. Patients in the control group received rehabilitative swallowing training, while those in the experimental group received nape acupuncture therapy based on swallowing rehabilitation. The out-comes were assessed by the repetitive saliva-swallowing test(RSST), water swallow test(WST), standardized swallowing assessment(SSA), and a swallow quality-of-life questionnaire(SWAL-QOL). Correlations of onset age, onset frequency and lesion location with the efficacy of the acupuncture treatment were also observed.RESULTS: The scores for RSST, WST, and SSA in both groups were lower than before the therapy(P 0.001), although the changes were more marked in the experimental group than in the control group(RSST and WST, P 0.005; SSA, P 0.001). Both groups recorded changes in SWAL-QOL index after the therapy(P 0.001); and the experimental group scored higher than the control group(P 0.001). The efficacy of acupuncture was not correlated with location(P 0.05), but was related to onset age(P 0.05) and onset frequency(P 0.01).CONCLUSION: Nape acupuncture combined with rehabilitative swallowing training has an effect on dysphagia caused by pseudobulbar palsy and improves quality of life.     

吞咽五穴联合康复训练治疗脑卒中后假性延髓麻痹:随机对照试验

ObjectiveTo compare the clinical effects of needling at “five acupoints for swallow function” combined with rehabilitation training and only rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke.MethodsSeventy-six patients were randomized into rehabilitation group and combination group, with 38 cases in each. Both groups were treated with basic treatment of western medicine. The rehabilitation group was treated with routine rehabilitation training, and the combination group was treated with acupuncture at “five acupoints for swallow function” based on treatment in the rehabilitation group. Patients in the two groups were treated once a day, 6 days a week, 1 day for rest, for 3 weeks in succession. The changes in the grades and scores of water swallow test (WST), video fluoroscopic swallowing study (VFSS), and swallowing quality of life questionnaire (SWAL-QOL) in the two groups were observed before and after treatment, and the clinical effects of the two groups were compared.ResultsAfter treatment, the WST grades of the two groups were statistically different from that of before treatment (both P< 0.05), and the WST grade of the combination group was statistically different from that of the rehabilitation group (P< 0.05). After treatment, the VFSS and SWAL-QOL scores of the two groups were increased in comparing with those of before treatment (all P < 0.05), and the VFSS and SWAL-QOL scores of the combination group were higher than those of the rehabilitation group (both P < 0.05). The total effective rate of the combination group was 92.1% (35/38), higher than 60.1% (23/38) of the rehabilitation group.ConclusionThe acupuncture combined with rehabilitation training for pseudobulbar paralysis after stroke is more effective than rehabilitation training only. The combination of the two can significantly relieve the dysphagia and improve the patients’ quality of life.     

电针联合康复训练治疗脑卒中后吞咽障碍临床研究

目的：观察电针联合康复训练治疗脑卒中后吞咽障碍的疗效。方法：将70例患者随机分为试验组和对照组各35例。试验组接受3周电针联合康复训练,对照组进行单纯康复训练。观察2组治疗前后标准吞咽功能评估（standardjzed Swallowing Assessment,SSA）总分。结果：2组治疗后SSA总分较治疗前均有下降,与治疗前比较,差异均有非常显著性意义（P〈0．01）。2组治疗后比较,差异也有非常显著性意义（P〈0．01）。治疗前含脑干损伤组患者SSA总分较不含脑干损伤患者高,差异有非常显著性意义（P〈0．01）。不含脑干损伤患者中,试验组治疗后SSA总分分值降低较对照组明显,差异有非常显著性意义（P〈0．01）;含脑干损伤患者中,试验组治疗后SSA总分分值降低也较对照组明显,差异有非常显著性意义（P〈0．01）。结论：对于脑卒中后吞咽障碍,电针联合康复训练治疗疗效优于单纯康复训练治疗。     

舌三针配合 Vitalstim 电刺激治疗帕金森病吞咽功能障碍临床研究

目的:观察舌三针配合Vitalstim低频电刺激治疗对帕金森病(PD)吞咽功能障碍患者的临床疗效和对日常生活能力、生活质量的改善作用。方法:将50例PD伴吞咽功能障碍的患者,按照随机数字表法分为治疗组和对照组,每组25例。2组均在接受常规康复治疗基础上,治疗组加用舌三针配合Vitalstim电刺激治疗,对照组加用常规针刺手段治疗。采用洼田吞咽能力评定量表、标准吞咽功能(SSA)评分及吞咽障碍特异性生活质量量表(SWAL-QOL)评分对2组治疗前后的变化情况进行评定,并比较2组临床疗效。结果:治疗后,2组洼田饮水试验效果比较,治疗组效果优于对照组,差异有统计学意义(P<0.05)。治疗组总有效率为88%,对照组为68%,2组比较,差异有统计学意义(P<0.05)。治疗前,2组SSA、SWAL-QOL评分比较,差异无统计学意义(P>0.05)。治疗后,2组SSA、SWAL-QOL评分均较治疗前提高(P<0.05,P<0.01),且组间治疗后比较,差异有统计学意义(P<0.05)。结论:舌三针配合Vitalstim电刺激治疗可提高PD患者的吞咽功能的效果,可降低患者吸入性肺炎发生率和提高生活自理能力,改善生活质量。     

穴位按压治疗缺血性中风假性球麻痹所致吞咽困难疗效观察

目的观察穴位按压治疗缺血性中风假性球麻痹所致吞咽困难的临床疗效。方法将60例缺血性中风假性球麻痹所致吞咽困难患者随机分为治疗组和对照组,每组30例。对照组采用常规药物治疗和康复训练,治疗组在对照组治疗基础上配合穴位按压治疗,比较两组治疗前后吞咽功能及临床疗效。结果两组患者治疗后吞咽功能与同组治疗前比较,差异均具有统计学意义(P<0.05)。治疗组治疗后吞咽功能与对照组比较,差异具有统计学意义(P<0.05)。治疗组总有效率为76.7%,对照组为40.0%,两组比较差异具有统计学意义(P<0.05)。结论穴位按压是一种治疗缺血性中风假性球麻痹所致吞咽困难的有效方法。     

醒脑开窍针刺法治疗中风后假性球麻痹所致吞咽困难

目的探讨醒脑开窍针刺法治疗中风后假性球麻痹所致吞咽困难的临床效果。方法选取我院2015年1月—2016年1月收治的中风后假性球麻痹所致吞咽困难患者112例,随机分为对照组和观察组,对照组实施传统针刺法治疗,观察组实施醒脑开窍针刺法治疗,对比分析两组患者的吞咽功能评分和治疗效果。结果观察组患者的吞咽功能评分和治疗效果均优于对照组,差异具有统计学意义(P0.05),其中观察组治疗总有效率为96.43%,对照组治疗总有效率为82.14%。结论醒脑开窍针刺法能够有效治疗中风后假性球麻痹所致吞咽困难现象,治疗效果十分理想,具有较高的临床应用价值。     

从心脾二经论治假性球麻痹32例

目的:观察从心脾二经论治假性球麻痹的临床疗效.方法:将68例脑梗死后假性球麻痹确诊患者随机均分为2组,对照组36例给予脑血管病常规治疗及康复训练;治疗组给以心脾二经理论为基础采用中药结合针刺及西医常规治疗.两组均以2周为1个疗程.结果:对照组有效率为77.7％,治疗组有效率为93.8％,两组有效率比较,差异有显著性(P＜0.05);治疗组治疗后吞咽障碍积分与治疗前和对照组比较,均有显著性差异(P＜0.05).结论:从心脾二经立论治疗脑梗死后假性球麻痹,取得了理想的临床疗效,值得临床进一步研究推广.     

针刺配合中药冰刺激治疗脑卒中吞咽障碍的疗效观察＊

目的 探究针刺配合中药冰刺激在缺血性脑卒中吞咽障碍患者中的应用效果。方法 选择缺血性脑卒中吞咽障碍患者92例，采用随机数字表法随机分为对照组和观察组各46例，对照组患者给予包括吞咽康复训练、冰刺激、神经肌肉电刺激的常规治疗，在此基础上，观察组患者加以针刺配合中药冰刺激治疗，疗程4周。评估两组患者临床疗效、吞咽功能、脑血流动力学、表面肌电图结果，并进行安全性评价。结果 观察组治疗总有效率为89.13%，显著高于对照组的71.74%（P<0.05）；治疗后，两组患者吞咽功能（洼田饮水试验评级、标准吞咽功能评定量表（SSA）评分）、脑血流动力学（左右两侧椎动脉和基底动脉的平均血流速度（Vm）、搏动指数（PI））、表面肌电图（颏下肌群和舌骨下肌群的吞咽时限、最大波幅均明显改善）均较治疗前明显改善，且观察组治疗后的洼田饮水试验评级、SSA评分、PI水平、吞咽时限水平显著低于对照组（P<0.05），Vm、最大波幅水平显著高于对照组（P<0.05）；治疗期间，观察组吸入性肺炎发生率为6.52%，显著低于对照组的21.74%（P<0.05）。结论 针刺配合中药冰刺激治疗缺血性脑卒中吞咽障碍疗效确切，可改善患者吞咽功能、脑血流动力学，有助于重构吞咽反射，值得临床推广。     

Fire-needle therapy for deglutition disorders in post-stroke pseudobulbar palsy: a randomized controlled trial

Objective

To observe the clinical efficacy of fire-needle therapy in treating deglutition disorders due to pseudobulbar palsy in the remission stage of stroke.

Methods

Sixty-two eligible subjects were divided into a fire-needle group and a rehabilitation group by a simple randomization method at a ratio of 1:1. The two groups received same basic intervention; in addition, the fire-needle group received fire-needle treatment, while the rehabilitation group received rehabilitation training. The two groups of subjects all received a 3-week treatment and were evaluated by the dysphagia severity rating scale (DSRS), modified Mann assessment of swallow ability (MMASA) and Kubota Toshio swallow test (KTST) before and after the intervention. The complications and adverse events occurred during the trial were recorded. The data were statistically analyzed.

Results

At the third week, the DSRS, MMASA and KTST scores changed significantly compared with the baseline in both groups (P<0.05), and the changes in the fire-needle group were more significant than those in the rehabilitation group (P<0.05). The between-group comparison at the third week showed that the therapeutic efficacy in the fireneedle group was superior to that in the rehabilitation group (P<0.05).

Conclusion

Fire-needle therapy can obviously change the DSRS, MMASA and KTST scores in pseudobulbar palsy in the remission stage of stroke, and significantly enhance the therapeutic efficacy of the treatment of deglutition disorders in this stage.