调神益咽针刺对脑梗死后吞咽障碍患者的疗效研究

目的 探究调神益咽针刺对脑梗死后吞咽障碍患者的疗效。方法 选取2011 年1 月-2015 年 1 月于四川省成都市第二中医医院收治的122 例脑梗死后吞咽障碍患者，采用随机数字表法分为对照组和观 察组。两组患者经常规药物和康复治疗，观察组患者加用调神益咽针刺法治疗，对照组患者加用常规针刺治 疗。对比两组患者治疗后的临床疗效，治疗前后的标准吞咽功能评定量表（SSA）评分、微型营养评价（MNA） 评分及洼田饮水试验结果。结果 治疗后观察组和对照组患者的临床总有效率分别为93.43％和80.31％，两 组患者比较有差异（P <0.05）。治疗前两组患者的SSA 评分和MNA 评分比较无差异（P >0.05）。治疗后两 组患者SSA 评分和MNA 评分较治疗前改善（P <0.05），观察组优于对照组。治疗前两组患者的洼田饮水试 验结果比较无差异（P >0.05）。治疗后两组患者的洼田饮水试验结果较治疗前改善（P <0.05）。结论 给予 脑梗死后吞咽障碍患者常规治疗联合调神益咽针刺法治疗能够显著改善患者的吞咽功能，改善营养状态，提 高临床疗效，在临床上值得进一步推广和使用。

Effect of Tiaoshen Yiyan acupuncture on patients with dysphagia after cerebral infarction

Objective To explore the effect of Tiaoshen Yiyan acupuncture in patients with dysphagia after cerebral infarction. Methods Totally 122 cases of cerebral infarction patients with dysphagia in Chengdu Second Hospital of Traditional Chinese Medicine between January 2011 and January 2015 were selected as the objects of study. Using the random number table method they were divided into control group and observation group, with 61 cases in each group. The two groups of patients received conventional drug treatment and rehabilitation, the patients of the observation group were added with Tiaoshen Yiyan acupuncture treatment, the patients of the control group received additional conventional acupuncture. Clinical efficacy after treatment, the scores of Standardized Swallowing Assessment (SSA), Mini-nutritional Assessment (MNA) and Kubota water drinking test before and after treatment were compared between the two groups. Results After treatment, the total effective rate was 93.43% in the observation group and 80.31% in the control group, the difference was statistically significant (P < 0.05). SSA score and MNA score before treatment were not statistically significant between the two groups (P > 0.05). After treatment, SSA score and MNA score were improved in both groups compared with those before treatment (P < 0.05), and the scores in the observation group were better than those in the control group. Kubota water drinking test results of the two groups before treatment were not statistically different (P > 0.05). After treatment Kubota water drinking test results of the two groups were improved compared to those before treatment (P < 0.05), the results in the observation group were better than those in the control group. Conclusions Compared with conventional therapy combined with conventional acupuncture therapy, conventional therapy combined Tiaoshen Yiyan acupuncture can significantly improve the swallowing function, nutritional status and clinical efficacy in the cerebral infarction patients with dysphagia. Therefore it is worth further promotion and use in clinical practice.