摘要
目的观察针灸、常规治疗联合高压氧(hyperbaric oxygen,HBO)、吞咽训练对急性脑卒中吞咽功能障碍的康复效果。方法经患者知情同意,并经医院伦理委员会批准后,将2018年1月—2020年12月收治的106例患者分为A组34例:常规治疗、吞咽训练早期联合高压氧;B组34例:常规治疗、吞咽训练;C组38例:常规治疗、吞咽训练联合高压氧及针灸治疗。三组治疗前、治疗1个月进行洼田氏饮水评分、藤岛一郎吞咽障碍(video fluoroscopic swallowing study,VFSS)造影评分,并用经颅多普勒(transcranial doppler,TCD)检测治疗前后脑血流。结果洼田氏饮水评分、VFSS评分显示,三组患者的吞咽障碍治疗后均较治疗前明显改善(F=24.45,P=0.00;F=17.70,P=0.00),差异有统计学意义(P<0.05);TCD检查结果显示,三组病变血管治疗后较治疗前血流速度明显增加,阻力指数降低,大脑中动脉(middle cerebral artery,MCA)、大脑前动脉(anterior cerebral artery,ACA)、大脑后动脉(posterior cerebral artery,PCA)血流速度比较分别(F=112.23,P=0.00;F=110.30,P=0.00;F=90.24,P=0.00),血管阻力指数(resistance index,RI)I比较分别为(F=23.22,P=0.03;F=15.46,P=0.00;F=30.32,P=0.00)差异有统计学意义(P<0.05)。结论中西医结合治疗对急性脑卒中吞咽功能障碍患者康复效果显著,并能改善脑血流量。
Objective To observe the effect of acupuncture,conventional treatment combined with hyperbaric oxygen(HBO)swallowing training on the rehabilitation of swallowing dysfunction in acute stroke.Methods After the informed consent of the patients and the approval of the hospital ethics committee,Will be admitted from January 2018 to December 2020,106 patients were divided into 34 cases of group A:routine treatment combined with hyperbaric oxygen;34 cases in group B:routine treatment;38 patients in group C received conventional treatment combined with hyperbaric oxygen and acupuncture before and 1 month after treatment,water swallow test,viddeofluorograpric swal-low stduy(VFSS)score were applied to the three groups,and transcranial Doppler(TCD)was used to detect the cerebral blood flow before and after treatment.Results The Wada drinking water score and VFSS score showed that the swallowing disorder of the three groups was significantly improved after treatment compared with before treatment(F=24.45,P=0.00;F=17.70,P=0.00),the difference was statistically significant(P<0.05).The results of TCD showed that the blood flow velocity and resistance index of the three groups were significantly increased after treatment compared with before treatment.The comparison of MCA,ACA,PCA blood flow velocity was(F=112.23,P=0.00;F=110.30,P=0.00;F=90.24,P=0.00),and RI comparison were respectively(F=23.22,P=0.03;F=15.46,P=0.00;F=30.32,P=0.00)The difference was statistically significant(P<0.05).Conclusion Combined traditional Chinese and western medicine has a significant effect on the rehabilitation of patients with dysphagia after acute stroke,and can improve cerebral blood flow.
作者
陈云
都婧
黄学英
杨永萍
吴艳芳
柳尧花
王丽华
CHEN Yun;DU Jing;HUANG Xueying;YANG Yongping;WU Yanfang;LIU Yaohua;WANG Lihua(Department of Neurology,Yantai Yantai Mountain Hospital,Yantai Shandong 264003,China;Department of Rehabilitation Nursing,Shandong College of Traditional Chinese Medicine,Yantai Shandong 264100,China)
出处
《中国继续医学教育》
2022年第19期191-195,共5页
China Continuing Medical Education
基金
山东省中医药科技发展计划项目(2017-148)。
关键词
针灸
药物
高压氧
脑卒中
吞咽障碍
脑血流量
acupuncture
drugs
hyperbaric oxygen
stroke
dysphagia
cerebral blood flow
