摘要
目的观察联合采用高压氧、吞咽训练及针刺风池穴治疗脑卒中后假性延髓麻痹所致吞咽障碍的临床疗效。方法将75例脑卒中后假性延髓麻痹所致吞咽障碍患者随机分为对照组、高压氧组、吞咽训练组、针刺组及联合治疗组，各组患者均给予脑卒中常规处理，高压氧组患者同时辅以高压氧干预，吞咽训练组患者辅以吞咽功能训练，针刺组患者则辅以针刺风池穴治疗，治疗组患者则给予高压氧、吞咽功能训练及针刺风池穴联合治疗。分别于治疗前及治疗后第3，6，9，12，15，18及21天时，采用改良吞咽功能分级标准评价患者吞咽功能改善情况。结果除对照组患者以外，其他各组患者吞咽功能评分均较治疗前显著改善（P〈0．05）；进一步分析后发现，各组患者吞咽功能疗效顺序和起效先后顺序如下：联合治疗组〉针刺组〉吞咽训练组〉高压氧组〉对照组，组间差异均有统计学意义（P〈0．05）。结论高压氧、吞咽功能训练及针刺风池穴联合治疗脑卒中后假性延髓麻痹所致吞咽障碍具有协同效应，可进一步提高临床疗效，促进患者吞咽功能恢复。
Objective To observe the clinical therapeutic effect of hyperbaric oxygen （HBO） therapy and swallowing training combined with Fengchi acupoint acupuncture on dysphagia caused by pseudobulbar paralysis after stroke. Methods Seventy-five patients were randomly divided into control group, HBO therapy group, swallow training group, acupuncture group and combined treatment group（ n = 15 ）. Patients in all groups were given cerebrovascular disease routine treatment. In addition, the patients in HBO therapy group, swallowing training group and acupuncture group were given HBO therapy, swallowing training and Fengchi （GB20） acupoint acupuncture simultaneously, respectively. The patients in combined treatment group were given HBO therapy combined with swallowing training and Fengchi acupoint acupuncture. Modified Kubota-Chiari＇s swallowing functional classification was used to assess swallowing function before and on the 3rd d,6th d,9th d, 12th d, 15th d, 18th d and 21st d after treatment. Results It was shown that the patients in all groups but the control group got significant improvement in swallowing after treatment, as demonstrated by the swallowing function scores （P 〈 0.05 ）. Moreover, the priority order in improvement of swallowing function and recovering rate were： combined treatment group 〉 acupuncture group 〉 swallow training group 〉 HBO therapy group 〉 control group（P 〈 0.05）. Conclusion The combination of HBO therapy, swallowing training and Fengchi acupoint acupuncture could act synergically to ameliorate dysphagia caused by pseudobulbar paralysis after stroke.
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2009年第2期108-111,共4页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
高压氧
吞咽障碍
康复训练
针刺
假性延髓麻痹
Hyperbaric oxygen
Dysphagia
Pseudohulbar paralysis
Rehabilitation training
Acupuncture
