《中国康复理论与实践》

《中国康复理论与实践》 ›› 2011, Vol. 17 ›› Issue (8): 733-736.

• 论文 • 上一篇    下一篇

不同时期介入针刺和康复训练对脑卒中后吞咽障碍疗效的影响

武平1，梁繁荣1，于白莉2，李季2，李安宏3，罗伦4，田卫卫5   

  1. 1.成都中医药大学针灸推拿学院，四川成都市 610075；2.成都中医药大学附属医院，四川成都市 610075；3.绵阳市中医院，四川绵阳市 621000；4.成都市第二人民医院，四川成都市 610033；5.解放军第452 医院，四川成都市 610050。
  • 收稿日期:2011-03-16 修回日期:1900-01-01 出版日期:2011-08-25 发布日期:2011-08-25

Clinical Effect of Acupuncture Combined with Rehabilitation on Dysphagia after Stroke at Different Stage

WU Ping, LIANG Fan-rong, YU Bai-li, et al.   

  1. Chengdu University of TCM, Chengdu 610072, Sichuan, China
  • Received:2011-03-16 Revised:1900-01-01 Published:2011-08-25 Online:2011-08-25

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摘要： 目的观察不同时期介入针刺和康复训练对脑卒中后吞咽障碍临床疗效的影响。方法将155 例患者按照分层随机的方法分为对照组80 例(急性期26 例，恢复期54 例)和观察组75 例(急性期21 例，恢复期54 例)。两组均接受基础治疗和常规康复训练，观察组同时接受针刺治疗。每周治疗5 次，连续治疗4 周。以洼田饮水试验和吞咽障碍中医评价量表分别评价两组的总疗效和不同时期介入治疗的临床疗效。结果根据洼田饮水试验评定，观察组总有效率89.33%，对照组总有效率66.67%，观察组疗效明显优于对照组(P<0.01)；观察组中急性期有效率90.48%，恢复期有效率88.89%，急性期疗效明显优于恢复期(P<0.01)。以吞咽障碍中医评价量表评价，对照组总有效率64.00%，观察组总有效率74.67%，无显著性差异(P<0.05)；观察组中急性期有效率90.48%，恢复期有效率68.52%，急性期疗效显著优于恢复期(P<0.001)。结论针刺配合康复训练的疗效优于单纯的康复训练，且早期介入优于恢复期介入。

关键词: 脑卒中, 吞咽障碍, 针刺, 康复, 分期

Abstract: Objective To observe the therapeutic effect of acupuncture combined with rehabilitation on dysphagia after stroke at differentstage. Methods According to the randomized trial principle, 155 cases were divided into two groups: control group (n=80) and observationgroup (n=75). The control group was treated with rehabilitation training, and the observation group was treated with acupuncture and rehabilitationtraining, 5 times every week for 4 weeks. The two groups were assessed by TCM swallowing assessment scores and Kubota testbefore and after treatment. Results According to Kubota test, the total rate was 66.67% in the control group and 89.33% in the observationgroup with a significant difference between the groups (P<0.001). In the observation group, the total rate was 90.48% at acute stage and88.89% at the convalescence stage with a significant difference (P<0.01). According to TCM swallowing assessment, the total rate was64.00% in the control group and 74.67% in the observation group with no significant difference between the groups (P<0.05). In the observationgroup, the total rate was 90.48% at acute stage and 68.52% at the convalescence stage with a significant difference (P<0.001). ConclusionAcupuncture combined with rehabilitation facilitates to improve the swallowing function in stroke patients following dysphagia especiallyat acute stage.

Key words: stroke, dysphagia, acupuncture, rehabilitation, stage