针刺咽部腧穴治疗脑梗死后真性延髓麻痹:随机对照研究

目的:比较针刺患侧与针刺双侧咽部腧穴治疗脑梗死后真性延髓麻痹的临床疗效。方法:将66例脑梗死后真性延髓麻痹患者随机分为单侧组和双侧组,每组33例,最后每组各有1例脱落。两组患者在常规药物和电项针治疗的基础上,单侧组针刺患侧的吞咽、发音和治反流穴,双侧组针刺双侧吞咽、发音和治反流穴。每天1次,每周连续针刺6 d,休息1 d,治疗21 d后评定临床疗效。采用吞咽困难分级量表、洼田饮水试验和GRBAS分级评价两组患者治疗前后的吞咽和构音情况。结果:治疗21 d后,两组患者吞咽困难分级量表评分均提高(均P<0.01),且单侧组改善程度大于双侧组(P<0.01);两组患者GRBAS分级、洼田饮水试验情况均改善(均P<0.01),且单侧组改善程度大于双侧组(P<0.05,P<0.01)。结论:针刺患侧咽部腧穴治疗脑梗死后真性延髓麻痹较针刺双侧咽部腧穴疗效更优。

Acupuncture at pharyngeal acupoints for true bulbar paralysis after cerebral infarction: a randomized controlled trial

Objective To compare the clinical effect of acupuncture at the affected side and both sides of the pharyngeal acupoints for true bulbar paralysis after cerebral infarction. Methods A total of 66 patients with true bulbar paralysis after cerebral infarction were randomly divided into an unilateral group and a bilateral group, 33 cases in each group, 1 case dropped off in each group at last. On the basis of conventional drugs and electro-nape-acupuncture treatment, the patients in the unilateral group were treated with acupuncture at the affected side’s Tunyan, Fayin and Zhifanliu(Extra), while patients in the bilateral group were treated with acupuncture at the both sides’ Tunyan, Fayin and Zhifanliu. The treatment was performed once a day, 6 days a week, and the clinical effect was assessed after 21-day therapy. The swallowing and vocalization of the two groups were evaluated by dysphagia grading scale, Kubota water swallowing test and GRBAS grading scale before and after treatment. Results After 21 days of treatment, the scores of the dysphagia grading scale in the two groups were both improved(P<0.01), and the unilateral group was superior to the bilateral group(P<0.01). The GRBAS grading scale and Kubota water swallowing test grading after treatment were improved in both groups(P<0.01), and the unilateral group was superior to the bilateral group(P<0.05, P<0.01). Conclusion Acupuncture at the pharyngeal acupoints of the affected side achieves much better therapeutic effect on true bulbar paralysis as compared with the acupoints of the bilateral sides.