摘要
目的评价针刺联合神经肌肉电刺激治疗急性缺血性卒中后吞咽障碍的临床疗效和安全性。方法对2020年8月至2021年8月重庆市中医院南桥寺院区脑病科诊断为急性缺血性卒中后吞咽障碍且发病在72 h内的住院患者100例进行14 d的治疗及随访观察。采用随机数字表法将入组患者分为对照组和观察组,每组各50例。对照组给予西医常规内科治疗和吞咽康复训练,观察组在对照组的基础上加针刺联合神经肌肉电刺激。记录两组患者治疗前后洼田饮水试验(WST)评分、功能性经口摄食量表(FOIS)评分、Barthel生活指数(BI)、临床疗效及不良反应情况。结果治疗后观察组总有效率为89.58%,高于对照组的72.92%,差异有统计学意义(P<0.05)。治疗后两组WST评分均较治疗前降低,且观察组低于对照组,差异有统计学意义(P<0.05)。治疗后两组FOIS、BI评分均较治疗前提高,且观察组高于对照组,差异有统计学意义(P<0.05)。两组患者在治疗过程中,均未出现明显不良反应,治疗前后的生化指标无异常,差异无统计学意义(P>0.05)。结论针刺联合神经肌肉电刺激能有效改善急性缺血性卒中后吞咽障碍患者的吞咽功能和生活质量,效果优于单用吞咽康复训练,且安全性较好,值得深入研究及推广应用。
Objective To evaluate the clinical efficacy and safety of acupuncture combined with neuromuscular electrical stimulation on dysphagia after acute ischemic stroke. Methods A total of 100 inpatients diagnosed as dysphagia after acute ischemic stroke within 72 hours admitted to the Department of Encephalopathy in Nanqiao Temple Branch in Chongqing Traditional Chinese Medicine Hospital from August 2020 to August 2021were treated and followed up for 14 days. The enrolled patients were divided into the control group(n=50) and the observation group(n=50) according to the random number table method. The control group was treated with conventional western medicine treatment and swallowing rehabilitation training, while the observation group was treated with acupuncture combined with neuromuscular electrical stimulation on the treatment basis of the control group. Before and after treatment, the scores of water swallow test(WST), functional oral intake scale(FOIS), Barthel index(BI), clinical efficacy and adverse reactions(ADRs) of patients in the two groups were recorded. Results After treatment, the response rate of the observation group was 89.58%, higher than 72.92%of the control group, with statistically significant differences(P < 0.05). After treatment, the WST scores of the two groups were both lower than those before treatment, and the observation group was lower than that in the control group, with statistically significant differences(P < 0.05). After treatment, the scores of FOIS and BI in both groups were higher than those before treatment, and the observation group was higher than that in the control group, with statistically significant differences(P < 0.05). There were no obvious ADRs of patients in both groups during the treatment, and there was no abnormal in biochemical indices before and after treatment, without statistically significant differences(P > 0.05). Conclusion Acupuncture combined with neuromuscular electrical stimulation can effectively improve the swallowing function and quality of life in patients with dysphagia after acute ischemic stroke. The efficacy is superior to that of swallowing rehabilitation training alone, and the safety is relatively good, which is worthy of in-depth research, promotion and application.
作者
肖云
赵玉华
张旭
罗文斓
叶婷婷
陶文强
舒建中
唐军
XIAO Yun;ZHAO Yuhua;ZHANG Xu;LUO Wenlan;YE Tingting;TAO Wenqiang;SHU Jianzhong;TANG Jun(Guizhou University of Traditional Chinese Medicine,Guizhou,Guiyang 550025,China;Department of Encephalopathy,Chongqing Traditional Chinese Medicine Hospital,Chongqing 400021,China)
出处
《中国医药科学》
2022年第16期65-68,共4页
China Medicine And Pharmacy
基金
重庆市科研院所绩效激励引导专项项目(cstc2018jxjl130071)。
关键词
急性缺血性卒中
吞咽障碍
针刺
神经肌肉电刺激
Acute ischemic stroke
Dysphagia
Acupuncture
Neuromuscular el ectrical stimulation
