摘要
目的 观察头项针联合补阳还五汤中药棒冰治疗脑出血后吞咽障碍的临床疗效。方法 共纳入80例脑出血后吞咽障碍患者,按随机数字表法分为对照组和治疗组,每组40例。对照组予内科常规治疗和吞咽功能训练,治疗组在对照组治疗基础上另予头项针联合补阳还五汤中药棒冰治疗。观察两组治疗前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale, NIHSS)、标准吞咽功能评价量表(standardized swallowing assessment, SSA)、改良曼恩吞咽能力评估量表(modified Mann assessment of swallowing ability, MASA)和吞咽障碍特异性生活质量问卷(swallowing quality of life, SWAL-QOL)的评分以及舌骨与喉部活动度、吞咽肌群的表面肌电图指标和脑血流动力学指标的变化。比较两组临床疗效和不良反应发生率。结果 治疗组的总有效率为95.0%,高于对照组的75.0%(P<0.05)。治疗后,两组NIHSS、SSA、MASA和SWAL-QOL评分均较治疗前改善(P<0.05),且治疗组均优于对照组(P<0.05)。治疗组治疗后舌骨和喉部活动度指标均较治疗前改善(P<0.05),且治疗组治疗后舌骨上移距离和前移距离均优于对照组(P<0.05)。两组治疗后吞咽肌群表面肌电指标和脑血流动力学指标均优于同组治疗前(P<0.05),且治疗组治疗后吞咽肌群表面肌电指标和脑血流动力学指标均优于对照组(P<0.05)。治疗组不良反应发生率低于对照组(P<0.05)。结论 在内科常规治疗和吞咽功能训练基础上,头项针联合补阳还五汤中药棒冰治疗可提高脑出血后吞咽障碍的临床疗效,进一步改善患者的吞咽功能,提高生活质量,且不良反应发生率较低。
Objective To observe the clinical efficacy of scalp-nape acupuncture plus Bu Yang Huan Wu decoction medicated popsicle in treating dysphasia following cerebral hemorrhage.Method Eighty cases with dysphasia after cerebral hemorrhage were recruited and divided into a control group or a treatment group using the random number table method,with 40 cases in each group.The control group was given conventional internal medicine treatment and swallowing function training,and the treatment group additionally received scalp-nape acupuncture plus Bu Yang Huan Wu decoction medicated popsicle based on the control group’s treatment.Changes in the scores of the National Institute of Health stroke scale(NIHSS),standardized swallowing assessment(SSA),modified Mann assessment of swallowing ability(MASA),and swallowing quality of life questionnaire(SWAL-QOL)before and after the treatment,as well as changes in hyoid and laryngeal mobility,surface electromyography(sEMG)parameters of swallowing muscle groups,and cerebral hemodynamic indicators were observed in both groups.The clinical efficacy and incidence of adverse reactions were compared between the two groups.Result The total effective rate was 95.0%in the treatment group,higher than 75.0%in the control group(P<0.05).After the intervention,both groups achieved improvements in the NIHSS,SSA,MASA,and SWAL-QOL scores(P<0.05),and the treatment group outperformed the control group(P<0.05).Hyoid and laryngeal mobility indices improved after the intervention in the treatment group(P<0.05),and the upward displacement and forward displacement of the hyoid bone were greater in the treatment group than in the control group(P<0.05).The swallowing muscle sEMG parameters and cerebral hemodynamic indicators all improved after the intervention in both groups(P<0.05),and the treatment group achieved superior improvements compared to the control group(P<0.05).The treatment group had a lower incidence of adverse reactions than the control group(P<0.05).Conclusion Based on conventional internal medicine treatment and swallowing function training,incorporating scalp-nape acupuncture and Bu Yang Huan Wu decoction medicated popsicle can enhance the clinical efficacy in treating dysphasia following cerebral hemorrhage,further improving the patients’swallowing function and quality of life while inducing a lower incidence of adverse reactions.
作者
曹晓锋
王俊义
史立洋
晋景超
王静
刘鹏
CAO Xiaofeng;WANG Junyi;SHI Liyang;JIN Jingchao;WANG Jing;LIU Peng(Handan Mingren Hospital of Hebei Province,Handan 056006,China;Shenzhen Hospital of Beijing University of Chinese Medicine,Shenzhen 518116,China)
出处
《上海针灸杂志》
2025年第8期904-910,共7页
Shanghai Journal of Acupuncture and Moxibustion
基金
深圳市龙岗区科技创新专项资金医疗卫生科技计划项目(LGWJ2022-75)。
关键词
针刺疗法
中药棒冰
穴
头颈部
脑出血
吞咽障碍
Acupuncture therapy
Chinese medicated popsicle
Points,Head and neck
Cerebral hemorrhage
Deglutition disorders
