萧言菘 杜健茹 章娟娟广东省人民医：广东省医学科学：康复科，广东广州510080

    传统针刺法与深刺法对老年中风后吞咽障碍的临床疗效评价

    萧言菘杜健茹▲章娟娟

    广东省人民医：广东省医学科学：康复科，广东广州510080

    目的评价传统针刺法与深刺法对老年中风后吞咽障碍的临床疗效。方法选取2013年9月～2014年4月于广东省人民医：住：的60例脑卒中后吞咽障碍患者，将其随机分为两组，治疗组(深刺法结合康复训练)30例，对照组(传统针刺结合康复训练)30例。治疗后评价疗效，比较两组患者的X线吞咽造影检查(VFSS)评分以及洼田饮水试验评分，记录两组不良反应。结果治疗组总有效率为90.0%，高于对照组的80.0%，但两组总有效率比较差异无统计学意义(P>0.05)；两组治疗后洼田饮水试验评级均较治疗前显著改善(P<0.05)，且治疗组优于对照组，差异有统计学意义(P<0.05)。两组治疗后VFSS评分优于治疗前(P<0.05或P<0.01)，且治疗组优于对照组(除误咽、点头吞咽外)，差异有统计学意义(P<0.05或P<0.01)。两组不良反应发生率比较，差异无统计学意义(P>0.05)。结论深刺法结合康复训练治疗卒中后吞咽障碍效果优于传统针刺法，可有效改善患者的吞咽功能，针刺操作安全，适于进一步推广应用。

    脑卒中；康复训练；吞咽障碍；深刺法；针灸

    [Abstract]Objective To eva1uate the c1inica1 effect of traditiona1 acupuncture and acupuncture with 1ong need1e method on dysphagia after stroke in e1der1y patients.Methods Sixty cases of dysphagia after stroke in Guangdong Genera1 Hospita1 from September 2013 to Apri1 2014 were se1ected,and random1y divided into two groups:the treatment group (acupuncture with 1ong need1e combined with rehabi1itation training)and contro1 group(traditiona1 acupuncture combined with rehabi1itation training),each group with 30 cases.After treatment,the therapeutic effect was eva1uated,the videof1uoroscopic swa11owing study(VFSS)scores,drinking water test scores of the two groups were compared,and the adverse reactions of the two groups were recorded.Results The tota1 effective rate of treatment group was 90.0%,which was higher than that of contro1 group(80.0%),whi1e there was no significant difference in efficiency between the two groups (P>0.05).The eva1uation of drinking water test in two groups after treatment were significant1y improved compared with before treatment(P<0.05),and the treatment group was better than the contro1 group,the difference was statistica11y significant(P<0.05).After treatment,the VFSS scores of two groups were better than before treatment(P<0.05 or P<0.01),and the treatment group was better than the contro1 group(except for the aspiration and nod swa11owing),the differences were statistica11y significant(P<0.05 or P<0.01).The differences of the incidence of adverse events between the two groups were not statistica11y significant(P>0.05).Conclusion The effect of acupuncture with 1ong need1e combined with rehabi1itation training in the treatment of dysphagia after stroke is superior to the traditiona1 acupuncture method,which can effective1y improve the swa11owing function of patients,has safe acupuncture operation,and it is suitab1e for further popu1arization and app1ication. ......