采用动态荧光透视技术评估头体针结合治疗中风后吞咽障碍的临床疗效研究.docVIP

  采用动态荧光透视技术评估头体针结合治 疗中风后吞咽障碍的临床疗效研究# 周震，方京龙，宋宛珊，张玉莲** 5 10 15 20 25 30 35 40 （天津中医药大学第二附属医院，天津 300150） 摘要：[目的]通过动态荧光透视技术（VFSS）研究头体针结合治疗中风后吞咽障碍患者的临 床疗效。[方法]将符合纳入标准的 41 例患者随机分为针刺组与康复组。其中针刺组 20 例， 采用头体针结合治疗；康复组 21 例，采用现代康复治疗。患者治疗前后均采用洼田饮水试 验及 VFSS 进行临床评估（VFSS 评估包括时间参数、口咽部滞留及误吸、渗透情况），以 比较两组临床疗效。[结果]（1）治疗 3 月后，两组患者经洼田饮水试验评估，针刺组（有 效率 85.0%）临床疗效明显高于康复组（有效率 66.7%）；（2）治疗 2 周后，两组患者经 VFSS 检测，在口期、咽期滞留及误吸、渗透方面均明显减低（P0.05），两组间比较无明 显差异（P0.05）；（3）治疗 2 周后，经 VFSS 检测时间参数，两组在口腔传递时间、咽 传递时间、腭咽部关闭时间均明显减少（P0.05），且针刺组较康复组改善更为明显（P0.05）。 [结论]头体针结合治疗可明显缓解中风后吞咽障碍，具有较好的临床疗效，适于广泛应用于 临床治疗。 关键词：吞咽障碍；中风；头体针结合；动态荧光透视技术（VFSS） Clinical Research on the Effect of Combined Scalp and Body Acupuncture Treatment for Dysphagia after Stroke Evaluated by videofluoroseopic Zhou Zhen, Fang Jinglong, Song Wanshan, Zhang Yulian (The Second Hospital Attach to Tianjin of TCM, TianJin 300150) Abstract: Objective: To study the clinical effect of combined scalp and body acupuncture treatment for dysphagia after stroke by VFSS..Methods: Forty-one cases were randomized into the acupuncture and rehabilitation groups. The acupuncture group, which had twenty cases, was received with combined scalp and body acupuncture treatment. The control group, which had twenty-one cases, was received with modern rehabilitative treatment. Compare the clinical effect evaluated by bedside water-swallowing test and VFSS(including time parameter、oropharyngeal retention 、aspiration and permeability )between two groups pre and post treatment.Results:(1) At three months after the treatment, the clinical effect of acupuncture group which effective rate was 85% was better than rehabilitation groups which was 66.7%;(2) At two weeks after the treatment, the value of two groups were decreased in aspect of oropharyngeal retention、aspiration and permeability evaluated by VFSS（P0.05）.There was no significant difference between two groups（P0.05）.(3) At two weeks after the treatment, the time of oral cavity transmission、 pharynx transmission and pal