通督益脑针在缺血性脑卒中伴假性延髓麻痹吞咽障碍患者吞咽功能康复中的应用

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摘要目的探究通督益脑针对缺血性脑卒中伴假性延髓麻痹吞咽障碍患者吞咽功能及脑血流动力学、脑神经营养因子水平的影响。方法采用随机数字表法将2019年5月—2021年8月86例缺血性脑卒中伴假性延髓麻痹吞咽障碍患者分为2组,对照组给予传统康复训练,观察组在对照组基础上给予通督益脑针治疗。采用洼田饮水试验分级评价患者的吞咽功能,比较2组治疗疗效、舌骨下肌群肌电活动持续时间、双侧大脑血流最大峰值流速(Vs)、血管阻力指数(RI)及脑源性神经营养因子(BDNF)、神经生长因子(NGF)水平等。数据采用χ2/Z检验、t检验进行分析。结果观察组治疗总有效率为95.35%,高于对照组的79.07%(χ2=5.108,P＜0.05)。治疗后,观察组洼田饮水试验分级优于对照组(P＜0.05),舌骨下肌群肌电活动持续时间均短于对照组(P＜0.05)。观察组治疗后双侧大脑Vs为(48.13±5.34)cm/s,高于对照组的(45.05±5.96)cm/s(t=2.524,P=0.013),RI(×10-2)值为(69.07±6.19),小于对照组的(72.15±6.34)(t=2.279,P=0.025)。治疗后,观察组、对照组BDNF水平分别为(23.15±4.02)、(22.87±4.13)pg/mL,NGF水平分别为(26.27±5.03)、(25.85±4.56)pg/mL,差异均无统计学意义(P ＞0.05)。结论对缺血性脑卒中伴假性延髓麻痹吞咽障碍患者给予通督益脑针治疗,可改善患者吞咽功能及脑部血液循环。　

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	李欣蕊
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关键词 ：针灸疗法, 缺血性脑卒中, 假性延髓麻痹, 吞咽障碍

Abstract：Objective To explore the effect of Tongdu Yinao acupuncture on swallowing function, cerebral hemodynamics, and brain neurotrophic factor level in patients with pseudobulbar paralysis dysphagia after ischemic stroke. Methods Totally 86 patients with pseudobulbar paralysis dysphagia after an ischemic stroke from May 2019 to August 2021 were divided into two groups by random number table. A control group was given traditional rehabilitation training, and an observation group was given Tongdu Yinao acupuncture treatment on the basis of the control group. The swallowing function of patients was evaluated by the Watian drinking water test, and the therapeutic effect, duration of myoelectric activity of infrahyoid muscles, maximum peak velocity (Vs), vascular resistance index (RI) of bilateral cerebral blood flow, and brain-derived neurotrophic factor (BDNF), and nerve growth factor (NGF) were compared between the two groups. The data were compared with the differences between groups by χ2/Z test and t-test. Results The total effective rate of the observation group was 95.35%, higher than 79.07% of the control group (χ2=5.108, P<0.05). After treatment, Watian drinking water test grading in the observation group was better than that in the control group. The duration of myoelectric activity of the infrahyoid muscles was shorter than that in the control group (P<0.05). After treatment, the bilateral cerebral Vs was (48.13±5.34) cm/s in the observation group, higher than that in the control group: (45.05±5.96) cm/s (t=2.524, P=0.013), and the RI (×10-2) value was (69.07±6.19), lower than that in the control group: (72.15±6.34) (t=2.279, P=0.025). After treatment, there was no significant difference in the levels of BDNF (23.15±4.02; 22.87±4.13) pg/mL and NGF (26.27±5.03; 25.85±4.56) pg/mL between the two groups (P>0.05). Conclusion Tongdu Yinao acupuncture can improve the swallowing function and cerebral blood circulation of patients with dysphagia caused by pseudobulbar paralysis after an ischemic stroke.

Key words： Acupuncture moxibustion therapy Ischemic stroke Pseudobulbar palsy Swallowing disorder

收稿日期: 2022-07-27

ZTFLH:

R245

作者简介: 李欣蕊(1995—),女,河南商丘人,医师,本科学历,研究方向为针灸与康复医学。

引用本文:

李欣蕊,李钊远. 通督益脑针在缺血性脑卒中伴假性延髓麻痹吞咽障碍患者吞咽功能康复中的应用[J]. 中国校医, 2023, 37(7): 546-548,552.
LI Xinrui, LI Zhaoyuan. Application of Tongdu Yinao acupuncture in rehabilitation of swallowing function of patients with dysphagia due to pseudobulbar palsy after ischemic stroke. Chinese Journal of School Doctor, 2023, 37(7): 546-548,552.

链接本文:

https://www.zgxyzz.org.cn/CN/ 或 https://www.zgxyzz.org.cn/CN/Y2023/V37/I7/546

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