針刺聯合康復訓練對于中風后吞咽障礙的療效分析

[摘要] 目的 探討針刺聯合康復訓練治療中風后吞咽障礙的療效。 方法 方便選取2011年1月—2015年12月在該院針灸康復科病房住院的假性球麻痹患者50例，隨機分為針刺組和治療組，每組25例。兩組均給予神經內科腦卒中常規藥物治療。針刺組采用以項針和舌咽穴為主針刺治療。治療組選穴、操作、療程均同治療組，同時加康復治療。兩組治療前后均進行吞咽功能分級及療效評分，并進行比較。 結果 兩組治療后的吞咽功能評分與治療前相比較，差異均有統計學意義（P<0.05）。治療組有效率為96%，針刺組有效率為68%，治療組的吞咽功能評分及有效性與針刺組比較，差異均有統計學意義（P<0.05）。 結論 針刺聯合康復治療對于改善中風后吞咽障礙療效更佳。

[關鍵詞] 假性球麻痹；針刺；康復治療

[中圖分類號] R246.6 [文獻標識碼] A [文章編號] 1674-0742（2016）11（c）-0185-03

[Abstract] Objective To observe the acupuncture combined rehabilitation treatment the curative effect of swallowing disorder after stroke. Methods Convenient selection will be between January 2011 and December 2015 in acupuncture and rehabilitation wards in the hospital of 50 patients with pseudo bulbar paralysis were randomly divided into acupuncture group and treatment group，25 patients in each group.In the two groups were given neurology stroke routine drug treatment and nursing. The acupuncture group is given priority to with a needle and tongue pharynx point acupuncture treatment.Treatment group selected point， operations， a course with treatment group，The treatment group plus rehabilitation therapy at the same time.The swallowing function in the two groups before and after treatment grading and curative effect evaluation， and comparison. Results After treatment， there were significant differences between the two groups before and after treatment（P < 0.05）.The treatment group effective rate was 96%， effective rate was 68%， the acupuncture group. In the treatment group， there were significant differences between the scores of swallowing function and acupuncture group（P < 0.05）. Conclusion Acupuncture with rehabilitation therapy to improve swallowing disorder after stroke curative effect is better.

[Key words] Pseudobulbar palsy；Acupuncture；Rehabilitation treatment

假性球麻痹是腦梗死最常見的并發癥之一，臨床表現為吞咽障礙，飲水嗆咳，構音障礙，強哭強笑，聲音嘶啞等，查體可發現咽反射存在或減弱，并出現原始反射、錐體束征等。其中吞咽障礙如不能及時有效治療，可造成患者營養不良、電解質紊亂、吸入性肺炎、窒息等嚴重并發癥，甚至危及患者的生命，嚴重影響患者的系統康復治療[1]。針灸對于腦梗死后吞咽障礙的治療以及促進其臨床癥狀的改善已得到廣大臨床醫師的認可[2]。該院自2011年1月—2015年12月期間應用針刺及針刺聯合康復治療假性球麻痹的患者50例，現報道如下。

1 資料與方法

1.1 一般資料

該研究方便選取的50例患者均為該院針灸康復科住院治療的腦梗死后出現吞咽障礙的患者。……