关刺颈前区五穴治疗急性脑卒中后真性延髓麻痹吞咽障碍的临床观察

发布时间：2018-01-06 04:34

本文关键词：关刺颈前区五穴治疗急性脑卒中后真性延髓麻痹吞咽障碍的临床观察　出处：《黑龙江中医药大学》2017年硕士论文　论文类型：学位论文

【摘要】：目的:观察关刺颈前区五穴治疗急性脑卒中后真性延髓麻痹吞咽障碍的临床疗效及安全性,证明"三区三线"学说及颈部五穴对于治疗真性延髓吞咽障碍的治疗作用,为临床治疗提供新的方法与思路。方法:选择符合纳入标准的60例急性脑卒中后真性延髓麻痹吞咽障碍的患者,采用随机数字法分为关刺颈前区五穴治疗组和普通针刺颈部腧穴对照组,每组30例,每天针刺1次,每周针刺6天,休息1天,治疗7天为一个疗程,连续治疗4个疗程后观察对两组患者治疗前后的洼田饮水试验评分以及吞咽造影检查会厌移动时间、舌骨向前移动最大距离(hyoid anterior displacement,HA)、舌骨向上移动最大距离(hyoid vertical displacement,HV)、舌骨最大位移(hyoid excursion maximum,Hm)和吞咽功能分级的前后差异,并且进行安全性指标评估,以上数据运用统计学方法进行分析处理。结果1.关刺颈前区五穴组和普通针刺颈部腧穴组患者在治疗4个疗程后各量表评分均较治疗前有明显改善(P0.05),经过安全性指标评估统计证明两组治疗均安全有效。2.与普通手法针刺颈部腧穴组相比,关刺颈前区五穴组患者洼田饮水试验评分以及吞咽造影检查会厌移动时间、舌骨向前移动最大距离(hyoid anterior displacement,HA)、舌骨向上移动最大距离(hyoid vertical displacement,HV)、舌骨最大位移(hyoid excursion maximum,Hm)和吞咽功能分级均明显改善,安全性评估证明治疗方法安全可行。结论1.关刺颈前区五穴及普通针刺颈部腧穴均有利于急性脑卒中后真性延髓麻痹吞咽障碍患者的吞咽功能恢复。2.关刺颈前区五穴治疗急性脑卒中后真性延髓麻痹吞咽障碍效果优于对照组。3.关刺以"三区三线"定位的颈前区"五穴"对于治疗急性脑卒中后真性延髓麻痹由于舌骨喉提拉无力、咽缩肌群收缩无力及环咽肌失迟缓等原因所导致的吞咽障碍治疗效果优于对照组。
[Abstract]:Objective: to observe the clinical efficacy and safety of five points in the anterior cervical area of Guanacupuncture in treating dysphagia of acute stroke patients with dysphagia of the true medulla oblongata. It is proved that the theory of "three regions and three lines" and the treatment of cervical five points are effective in the treatment of true dysphagia of medulla oblongata. Methods: 60 patients with dysphagia after acute stroke were selected. The method of random number was used to divide the treatment group into five points in the front area of the cervical area and the control group with common acupuncture on the neck. 30 cases in each group were treated with acupuncture once a day, 6 days a week, rest 1 day, and treat 7 days as a course of treatment. After 4 consecutive courses of treatment, the scores of sag water test before and after treatment and the movement time of epiglottis were examined by swallowing angiography. Hyoid anterior displacement (HA). Hyoid vertical displacement (HVV). Hyoid excursion maximum (Hm) and swallowing function grade were compared before and after, and the safety indexes were evaluated. The above data were analyzed and processed by statistical method. 1. The scores of each scale of the patients in the five points group and the common acupuncture acupoint group in the front cervical area of Guan prick were significantly improved after 4 courses of treatment. 2. (2) after 4 courses of treatment, the scores of each scale were significantly improved (2). P0.05). Through the evaluation of safety indicators statistics proved that the two groups are safe and effective. 2. Compared with the common manipulation acupuncture acupoint group neck. In the five acupoints group of the front cervical area of Guan acupuncture patients, the score of drinking water test of depressions and the time of epiglottis movement were examined by swallowing angiography. Hyoid anterior displacement (HA). Hyoid vertical displacement (HVV). Hyoid excursion maximum (Hm) and swallowing function grade were significantly improved. The safety evaluation proves that the treatment method is safe and feasible. 1. The five points in the anterior cervical area of Guanprong and the common acupuncture acupoints in the neck are beneficial to the recovery of swallowing function in the patients with dysphagia due to the true bulbar palsy after acute stroke. 2. The effect of five points in the anterior cervical area on dysphagia after acute stroke was better than that in the control group. The "five points" located in the anterior cervical area of the three regions and three lines are effective in the treatment of the true medulla oblongata after acute stroke due to hyoid laryngotic weakness. The effect of dysphagia caused by contraction weakness of pharyngeal constrictor muscle and tardiness of circular pharynx muscle was better than that of control group.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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