电针配合康复训练治疗中风恢复期吞咽困难的临床研究

发布时间：2018-05-28 14:21

本文选题：中风 + 吞咽困难　；参考：《湖北中医药大学》2017年硕士论文

【摘要】：目的:探讨电针配合康复治疗中风恢复期吞咽困难的疗效观察,探讨电针翳风、风池等疗效机理,为治疗中风恢复期吞咽障碍提供客观依据。方法:在2016年7月——2017年1月期间于武汉市中医院脑病科病房,收集符合卒中恢复期60例有吞咽困难的病人,按进院秩序归属于治疗组和对照组,两组患者未接受治疗之前一般资料经过统计学比较,没有明显差异,可以进行对比。两组患者同等进行脑病科常规治疗,涵括了降血压、抗血小板聚集、修复脑细胞、防治并发症。对照组在常规治疗的基础上加吞咽康复训练(包括冰刺激、吞咽训练);治疗组在对照组基础上加电针治疗,取穴翳风、风池,金津玉液点刺放血。伴有手足偏瘫者,取头穴运动区加相应局部穴位,患侧极泉穴、尺泽穴、委中穴均进行提插泻法,患侧手足跳动三次为标准。肝阳上亢者加太冲(双);风痰阻络者加丰隆(双);痰热腑实者加曲池(双);气虚血瘀配足三里(双);阴虚风动配太溪。记录未治疗前及其后2个疗程两组患者洼田饮水试验分级、SSA及SWAL-QOL评分等评价标准,将用于统计分析及临床疗效评价。结果:显示治疗组的总有效率是90.00%,对照组的总有效率是73.34.%,治疗组有效率超过照组。经过秩和检验p0.05,两组比较具有明显差异性,表明治疗组临床效果好于对照组。电针配合康复训练对脑卒中后恢复期吞咽困难的治疗,治疗组治疗前后吞咽功能通过统计学分析p均0.05,表明电针配合康复训练对脑卒中恢复期吞咽困难患者吞咽功能的恢复显著的效果。两组进行组间比较,通过对两组洼田饮水试验分级、SSA评分,两组评价指标通过统计学分析p0.05,差异明显有意义,治疗组临床效果好于对照组。SWAL-QOL通过统计分析,组间差异p0.05,考虑研究的误差与样本量较小等问题,SWAL-QOL认为差异不明显。从研究结果分析,电针配合康复训练治疗吞咽困难在一定程度上存在指向性。结论:电针颈项部穴位配合康复训练项目用于卒中吞咽困难临床效果好于纯粹康复训练。且能更好的为改善患者的生活质量。
[Abstract]:Objective: to observe the curative effect of electroacupuncture combined with rehabilitation in the treatment of dysphagia in convalescent stage of apoplexy, and to explore the mechanism of curative effect of electroacupuncture in Yifeng and Fengchi, so as to provide objective basis for the treatment of dysphagia in convalescent stage of apoplexy. Methods: from July 2016 to January 2017, 60 patients with dysphagia were collected from the Department of Encephalopathy, Wuhan traditional Chinese Medicine Hospital. According to the order of admission, 60 patients with dysphagia were assigned to the treatment group and the control group. There was no significant difference in general data before treatment between the two groups. The two groups were treated with routine encephalopathy, including lowering blood pressure, antiplatelet aggregation, repairing brain cells and preventing and treating complications. The control group received rehabilitation training on the basis of routine treatment (including ice stimulation and swallowing training), while the treatment group was treated with electroacupuncture on the basis of control group, and points Yifeng, Fengchi and Jinjin Jade were punctured and bloodletting. In the patients with hemiplegia of hand and foot, the motor area of the head point and the corresponding local acupoints, the acupoints of Zhiquan, Ze and Beizhong of the affected side were all carried out the method of lifting and reducing, and the beat of the affected side of the hand and foot was taken as the standard three times. Hyperactivity of liver yang plus Taichong; wind phlegm blocking collaterals plus Fenglong (Shuangli; phlegm heat and fu-fu solid plus qu Chi (Shuangli; Qi deficiency and blood stasis combined with Zusanli); Yin deficiency wind moving with Taixi. The evaluation criteria of SWAL-QOL and SSA were recorded before and after two courses of treatment in two groups of patients, which will be used for statistical analysis and evaluation of clinical curative effect. Results: the total effective rate of the treatment group was 90.00g, the total effective rate of the control group was 73.34.The effective rate of the treatment group was higher than that of the radiation group. After the rank sum test p0.05, the two groups had obvious difference, which indicated that the clinical effect of the treatment group was better than that of the control group. Electroacupuncture combined with rehabilitation training for the treatment of dysphagia in convalescent stage after stroke, In the treatment group, the swallowing function before and after treatment was 0.05, which indicated that electroacupuncture combined with rehabilitation training had a significant effect on the recovery of swallowing function of patients with dysphagia in convalescent stage of stroke. The two groups were compared between the two groups. By grading SSA score of the two groups of depressions, the two groups were evaluated by statistical analysis (p0.05), the difference was significant. The clinical effect of the treatment group was better than that of the control group by statistical analysis of SWAL-QOL. The difference between groups was p0.05, considering the error and sample size were small, SWAL-QOL thought that the difference was not obvious. Electroacupuncture combined with rehabilitation training in the treatment of dysphagia has a certain degree of directionality. Conclusion: the clinical effect of electroacupuncture combined with rehabilitation training for dysphagia in stroke is better than that in pure rehabilitation training. And can better improve the quality of life of patients.
【学位授予单位】：湖北中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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