交叉电项针配合人迎穴对脑出血后气管切开插管患者吞咽功能的影响

发布时间：2018-01-19 10:23

本文关键词： 交叉电项针脑出血吞咽反射　出处：《黑龙江中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：拟采用交叉电项针配合人迎穴治疗脑出血后气管切开的患者,观察其对患者吞咽功能的重塑,达到促进脑出血后气切插管患者早日封管的目的。方法：按照患者前来就诊的次序纳入符合条件的患者共43例,将收集到的病例使用随机数字表分组的方法随机平均分为两组,一组为治疗组,另一组为对照组。给与这两组患者同样的降颅压、脑保护、改善脑循环、抗炎、化痰等对症支持治疗和头针、微针、电针、康复治疗,其中针灸采用中风病治疗常规取穴,取百会、四神聪、头维、曲池、合谷、外关、手三里、臂膈、肩髑、肩谬、风市、梁丘、血海、阴陵泉、足三里、三阴交、绝谷、太冲等,毫针针刺30min,平补平泻,需要康复治疗的患者给与同样对症的物理疗法和运动疗法。治疗组取穴人迎、翳风、风池给与英迪牌型号KWD 808的针灸治疗仪疏密波交叉通电30min；对照组取穴水沟、廉泉、金津、玉液、风池、翳风,风池、翳风交叉通电,其余穴位施以100转／分的捻转手法刺激各约60秒,留针时间30分钟,期间行针3次。两组患者在年龄和性别、病程、病情等基础信息方面经统计学分析比较后,结果无显著性差异(P0.05)有可比性。在观察指标上,吞咽恢复方面严格按洼田氏饮水试验和藤岛一郎试验量表记录评分,同时还记录两组前后脑卒中临床神经功能缺损评分,并随时记录实验过程中出现的安全意外；经上述治疗4周后,按疗效判定标准判定疗效结果。结果：1.饮水洼田实验治疗组有效率85.00%,对照组有效率55.00%,经过统计两组有明显差异性(X2=10.14,p0.05),两组对比结果显示治疗组疗效优于对照组。2.岛一郎吞咽试验中实验组有效率80.00%对照组有效率45.00%,经统计学统计两组数据具有明显差异性具有统计学意义(X2=1 0.26,P0.05),说明交叉电项针配人迎穴的治疗组疗效明显优于对照组。3.在神经缺损上,经x2检验(X2=10.26,P=0.02),(P0.05)具有统计学意义,说明治疗组疗效明显优于对照组。4.在安全性方面：治疗组安全性一级16例,二级4例,安全率占80.00%；对照组中安全性1级的15例,2级3例安全率75.00%,上表各项数据的比较上(P0.05)无统计学意义,说明交叉电项针配合人迎穴针刺和普通针刺安全性相当,可以推广临床运用。结论：1.交叉电项针配人迎穴能明显改善脑出血后气管切开插管患者疗效确切且优于常规针刺组。2.交叉电项针配人迎对穴对脑出血后气管切开插管患者的吞咽功能障碍有效且优于对照组。3.交叉电项针配人迎穴能明显改善患者神经缺损度。
[Abstract]:Objective: to observe the remodeling of swallowing function of patients with intracerebral hemorrhage after tracheotomy. Methods: 43 eligible patients were included according to the order in which the patients came to visit. The collected cases were randomly divided into two groups: the treatment group and the control group. The two groups were given the same reduction of intracranial pressure, brain protection, improvement of cerebral circulation and anti-inflammation. Expectoration and other symptomatic support treatment and scalp acupuncture, micro-acupuncture, electroacupuncture, rehabilitation treatment, among which acupuncture and moxibustion is used to treat stroke routine points, Baihui, Sishen Cong, Hewei, Quchi, Hegu, Waiguan, three li of the hand, arm diaphragm, shoulder resuscitation. Shoulder error, wind city, Liang Qiu, blood sea, Yin Ling spring, Zusanli, Sanyinjiao, absolute valley, Taichong, needle acupuncture for 30 minutes, Ping Buping diarrhea. Patients in need of rehabilitation were given the same symptomatic physiotherapy and exercise therapy. Wind pond was given Yingdi brand model KWD 808 acupuncture and moxibustion therapy instrument with dense wave intersecting power for 30 mins; In the control group, the points of Shuigou, Lianquan, Jinjin, Yuye, Fengchi, Yifeng, Fengchi and Yifeng were cross-electrified. The remaining acupoints were stimulated by 100 rpm twisting manipulation for about 60 seconds, and the needle retention time was 30 minutes. During the acupuncture 3 times. The two groups of patients in age and gender, course of disease, disease and other basic information after statistical analysis and comparison, the results have no significant difference (P 0.05) comparability. In the aspect of swallowing recovery, the scores were recorded strictly according to Wada's drinking water test and Fujima Ichiro test scale, and the clinical neurological impairment scores of both groups were also recorded before and after stroke. The safety accidents occurred during the experiment are recorded at any time. After the above treatment for 4 weeks, the curative effect was determined according to the criterion of curative effect. Results: 1. The effective rate of drinking water sag experiment treatment group was 85.000.The effective rate of the control group was 55.00%. There was a significant difference between the two groups (P 0.05). The results of comparison between the two groups showed that the curative effect of the treatment group was better than that of the control group .2.The effective rate of the experimental group was 80.00%, the effective rate of the control group was 45.00%. There was significant difference between the two groups by statistical statistics. There was significant difference between the two groups (P 0.05). The results showed that the therapeutic effect of cross electric nape acupuncture combined with Renying acupoint was significantly better than that of control group. In terms of safety, there were 16 cases of safety in the treatment group and 4 cases in the second class, with a safety rate of 80.00g. In the control group, the safety rate was 75.00 in 15 cases of safety grade 1 and 3 cases in grade 2. There was no significant difference in the comparison of the data in the above table (P0.05). It shows that the safety of crossing electric item acupuncture combined with Renying point acupuncture is equivalent to that of common acupuncture. Conclusion:. 1. Cross electric item acupuncture combined with Renying point can obviously improve the curative effect of tracheotomy and intubation after intracerebral hemorrhage and is better than that of routine acupuncture group .2. the swallow work of patients with tracheotomy and intubation after intracerebral hemorrhage treated by cross electric item acupuncture combined with Renying acupoint is better than that of routine acupuncture group. The effect of energy disorder was better than that of control group .3.Combined with Renying point, the nerve defect degree of patients was improved obviously.
【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】：2016
【分类号】：R246.6

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