穴位贴敷联合吞咽功能训练治疗老年脑卒中后吞咽障碍临床研究
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R246.6

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浙江省中医药科技计划项目(2021ZB310)


Clinical Study on Point Application Combined with Swallowing Function Training for Elderly Post-Stroke Dysphagia
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    摘要:

    目的:观察穴位贴敷联合吞咽功能训练治疗老年脑卒中后吞咽障碍的疗效。方法:选取2021年 1月—2023年12月绍兴文理学院附属医院老年内科收治的92例脑卒中后吞咽障碍患者,按随机数字表法分为 治疗组与对照组各46例。治疗组剔除2例,对照组剔除4例,最终治疗组完成研究44例,对照组完成研究 42例。2组均给予常规基础治疗,在此基础上,对照组实施吞咽功能训练,治疗组在对照组基础上给予穴位贴 敷治疗。治疗4周后比较2组临床疗效,比较2组治疗前、治疗4周后中医证候评分、吞咽功能[洼田饮水试 验(WST) 分级、标准吞咽功能评价量表(SSA)、电视透视吞咽功能检查(VFSS)] 及生活质量[吞咽生命 质量量表(SWAL-QOL) 评分] 的变化。结果:治疗组与对照组临床疗效总有效率分别为90.91% (40/44)、 73.81%(31/42),2组比较,差异有统计学意义(P<0.05)。治疗后,2组痰瘀阻络型中医证候主症、次症及总 分均较治疗前下降(P<0.05),治疗组中医证候主症、次症及总分均低于对照组(P<0.05)。治疗后,2组 WST分级均有改善(P<0.05),治疗组WST分级优于对照组(P<0.05)。治疗后,2组SSA评分均较治疗前下 降(P<0.05),VFSS评分均较治疗前升高(P<0.05);治疗组SSA评分低于对照组(P<0.05),VFSS评分高 于对照组(P<0.05)。治疗后,2组SWAL-QOL各评分及总分均较治疗前上升(P<0.05),治疗组SWAL-QOL 各评分及总分均高于对照组(P<0.05)。结论:穴位贴敷联合吞咽功能训练治疗老年脑卒中后吞咽障碍疗效较 好,有助于缓解临床症状,改善吞咽功能,提升生活质量。

    Abstract:

    Abstract: Objective: To observe the curative effect of point application combined with swallowing function training in treating elderly post-stroke dysphagia. Methods:A total of 92 elderly patients with post-stroke dysphagia admitted to the Department of Geriatrics of Affiliated Hospital of Shaoxing University from January 2021 to December 2023 were selected and divided into the treatment group and the control group (46 cases each) according to the random number table method. After excluding 2 cases from the treatment group and 4 cases from the control group,44 cases in the treatment group and 42 cases in the control group finally completed the study. Both groups received conventional basic treatment. On this basis, the control group underwent swallowing function training, while the treatment group received additional point application therapy. After four weeks of treatment,the clinical efficacy was compared between the two groups. The changes in traditional Chinese medicine syndrome scores, swallowing function [Kubota Water Swallowing Test (WST) grading, Standardized Swallowing Assessment (SSA), Videofluoroscopic Swallowing Study (VFSS)], and quality of life [Swallowing Quality of Life Questionnaire (SWAL-QOL) scores] were compared between the two groups before treatment and after four weeks of treatment. Results:The total effective rates of clinical efficacy in the treatment group and the control group were 90.91% (40/44)and 73.81%(31/42), respectively, the difference being significant (P<0.05). After treatment,the scores of main symptoms,secondary symptoms,and total scores of traditional Chinese medicine syndromes (phlegm-stasis obstructing collaterals type) in both groups decreased compared with those before treatment (P<0.05), and the treatment group had lower scores of main symptoms, secondary symptoms, and total scores of traditional Chinese medicine syndromes than the control group (P<0.05). After treatment, the WST grading improved in both groups (P<0.05), and the treatment group showed better WST grading than the control group (P<0.05). After treatment, the SSA scores in both groups decreased compared with those before treatment (P<0.05),while the VFSS scores increased compared with those before treatment (P<0.05). The treatment group had lower SSA scores (P<0.05) and higher VFSS scores (P<0.05) than the control group. After treatment, all domain scores and total scores of SWAL-QOL in both groups increased compared with those before treatment (P<0.05), and the treatment group had higher domain scores and total scores of SWAL-QOL than the control group (P<0.05). Conclusion: Point application combined with swallowing function training shows good efficacy in treating elderly post-stroke dysphagia, which helps alleviate clinical symptoms, improve swallowing function,and enhance quality of life.

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任一理,王钧,张磊,李莉,卢珊珊,张贝贝,徐晨凯.穴位贴敷联合吞咽功能训练治疗老年脑卒中后吞咽障碍临床研究[J].新中医,2025,57(13):108-113

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  • 在线发布日期: 2025-07-14
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