卒中单元模式下联合针刺治疗脑卒中吞咽障碍疗效观察

目的 观察卒中单元联合针刺治疗脑卒中后吞咽障碍的疗效.方法 脑卒中后吞咽障碍患者244例随机分为对照组、卒中单元组、卒中单元联合针刺组,均采用常规药物治疗,卒中单元组给予规范的综合治疗,卒中单元联合针刺组在卒中单元的基础上联合针刺治疗.治疗4周后采用洼田咽水试验量表评价吞咽障碍疗效,美国国立卫生院卒中量表(national Institutes of health stroke scale,NIHSS)和日常生活活动能力Barthel 指数(Barthel Index,BI)评分进行神经康复的评价.结果 治疗后卒中单元组、卒中单元联合针刺组洼田咽水试验量表总有效率显著高于对照组(P<0.01);卒中单元联合针刺组总有效率高于卒中单元组(P<0.05).与对照组比较,卒中单元组、卒中单元联合针刺组NIHSS评分明显降低,BI指数明显增高(P<0.01),卒中单元联合针刺组NIHSS评分及BI指数与卒中单元组比较有统计学差异(P<0.05 ).结论 卒中单元治疗能明显改善脑卒中后吞咽障碍,联合针刺治疗能进一步提高疗效.

Efficacy of stroke unit combined with acupuncture therapy on dysphagia in stroke patients

Objective To study the therapeutic effect of stroke unit combined with acupuncture on dysphygia in stroke patients.Methods A total of 244 patients were randomized into three groups： the stroke unit（SU） group（82 cases）,the SU combined with acupunture group（82 cases）,and the control group（80 cases）.All the three groups were treated with routine medication as a basic treatment.Patients in the SU group received standard combined therapy of stroke unit.Those in the SU combined with acupunture group were given the stroke unit therapy and a standardized comprehensive acupuncture treatment at the same time.After four weeks of treatment,the effect was evaluated according to the swallowing test in the three groups.National Institutes of Health Stroke Scale（NIHSS） and Barthel Index（BI） were used after treatment.Results The total effective rate of swallowing test was 74.39% in the SU group and 87.80% in the SU combined with acupunture group,significantly higher than 62.5% in the control group（P0.01）.The total effective rate in the SU combined with acupunture was significantly higher than that in the SU group（P0.05）.NIHSS score in the in the SU combined with acupunture group and the SU group was significantly lower than that in the control group（P0.01）,but BI score was significantly higher（P0.01）.The scores in the SU combined with acupunture were significantly higher than those in the SU group（P0.05）.Conclusions Stroke unit treatment can significantly improve dysphagia in stroke patients.Stroke unit combined with acupuncture treatment can further improve the theapeutic effect.