针刺治疗卒中后吞咽困难的疗效观察

发布时间：2018-08-20 16:07

【摘要】：目的:吞咽困难是脑卒中的常见并发症之一,可导致营养不良、吸入性肺炎、电解质紊乱及心理障碍等问题,严重影响脑卒中患者的生活质量及生存周期,因而必须积极寻求有效的治疗措施以恢复患者的吞咽功能。现代医学通过多种治疗措施对于吞咽困难虽有一定疗效,但总体临床效果欠佳,且其治疗过程存在康复慢、经济负担重及过程复杂等缺点,难以满足现代的临床治疗需求。中医治疗卒中后吞咽困难有一定优势,尤其是针刺疗法,其临床疗效已经获得一定的临床认可,而本文的研究目的即是证实针刺在治疗本病方面的临床有效性及安全性。方法:将我院针灸科及中风科科自2015年6月至2016年6月间收治的60例脑卒中后吞咽困难的患者,按照其入院先后顺序并结合其自身意愿,半随机的平均分为观察组及对照组两组,每组各30例,其中对照组给予西医常规治疗,观察组则在对照组基础上联合中医针刺治疗。每次针刺留针20min,每日一次,每针灸10天休息3天,共治疗两个疗程。治疗结束后分析两组患者的吞咽能力、临床效果、生活质量、神经功能缺损情况及中医症候评分情况。结果:治疗前,两组患者的基本资料大致相同,无明显差异性。治疗结束后,两组患者吞咽功能以洼田饮水试验进行评价,总体评价结果显示,观察组吞咽功能优于对照组,其差异具有统计学意义。在临床治疗效果方面,观察组临床有效率达83.3%,明显优于对照组的53.3%,临床差异明显,具有统计学意义。在生活质量评分方面,观察组治疗结束后评分为(75.24±3.67),明显优于对照组的(63.25±4.19),差异亦具有统计学意义。在神经功能缺损方面,观察组治疗后评分为(3.36±0.71),明显优于照组(5.25±1.19),两者差异明显。在中医症候积分方面,观察组治疗结束后的评分为(11.64±2.71),明显低于对照组(15.46±3.27),差异亦具有统计学意义(P0.05)。结论:针刺治疗卒中后吞咽困难临床疗效确切,可有效改善患者的吞咽功能,提高临床治疗效果,纠正神经功能缺损情况,降低并发症的发生率,有利于改善患者的生活质量,延长患者的生存周期。
[Abstract]:Objective: dysphagia is one of the common complications of stroke, which can lead to malnutrition, aspiration pneumonia, electrolyte disorders and psychological disorders, which seriously affect the quality of life and life cycle of stroke patients. Therefore, effective treatment must be actively sought to restore the patient's swallowing function. Although modern medicine has certain curative effect on dysphagia through various treatment measures, the overall clinical effect is not good, and its treatment process has the shortcomings of slow rehabilitation, heavy economic burden and complicated process, so it is difficult to meet the needs of modern clinical treatment. There are some advantages in the treatment of dysphagia after stroke, especially acupuncture. The clinical efficacy of acupuncture has been recognized. The purpose of this study is to prove the clinical efficacy and safety of acupuncture in the treatment of this disease. Methods: from June 2015 to June 2016, 60 patients with dysphagia after stroke were treated in our department of acupuncture and moxibustion and apoplexy from June 2015 to June 2016. Half random group was divided into observation group and control group with 30 cases in each group. The control group was treated with routine western medicine and the observation group was treated with traditional Chinese medicine acupuncture on the basis of the control group. Acupuncture for 20 minutes, once a day, every 10 days rest for 3 days, a total of two courses of treatment. After the treatment, the swallowing ability, clinical effect, quality of life, neurological deficit and TCM symptom score were analyzed. Results: before treatment, the basic data of the two groups were approximately the same, no significant difference. After the treatment, the swallowing function of the two groups was evaluated by the depression-drinking water test. The overall evaluation results showed that the swallowing function of the observation group was better than that of the control group, and the difference was statistically significant. The clinical effective rate of the observation group was 83.3, which was significantly better than that of the control group (53.3%). In terms of quality of life score, the score of the observation group was (75.24 卤3.67) after treatment, which was significantly better than that of the control group (63.25 卤4.19), and the difference was also statistically significant. In the aspect of nerve function defect, the score of the observation group after treatment was (3.36 卤0.71), which was significantly better than that of the radiation group (5.25 卤1.19), and the difference between the two groups was obvious. In TCM symptom score, the observation group after treatment was (11.64 卤2.71), significantly lower than the control group (15.46 卤3.27), the difference was also statistically significant (P0.05). Conclusion: acupuncture is effective in treating dysphagia after stroke. It can effectively improve the swallowing function of patients, improve the clinical therapeutic effect, correct the situation of nerve function defect, reduce the incidence of complications, and improve the quality of life of patients. Prolong the patient's life cycle.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6

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