占大权+赵贝贝+刘晓铭+邹利云+叶宇璇

【摘要】 目的 观察微针针刺治疗脑梗死后吞咽障碍的临床疗效。方法 60例脑梗死后出现吞咽障碍的患者， 随机分为治疗组和对照组， 每组30例。对照组给予改善脑循环、营养脑神经、脑卒中二级预防及康复理疗等治疗， 治疗组在对照组治疗的基础上采用微针针刺治疗。采用洼田饮水试验评定两组治疗前后吞咽功能， 并比较两组治疗前后洼田饮水试验评分。结果 治疗组治疗后洼田饮水试验评分与对照组比较差异无统计学意义（P>0.05）。治疗组总有效率为86.6%， 对照组为53.3%， 两组比较差异具有统计学意义（P<0.05）。结论 微针针刺是一种治疗脑梗死后吞咽障碍的有效方法， 值得临床推广应用。

【关键词】 微针针刺；脑梗死；吞咽障碍

DOI：10.14163/j.cnki.11-5547/r.2017.16.097

Observation of clinical effect by microneedle acupuncture in the treatment of post-cerebral infarction dysphagia ZHAN Da-quan， ZHAO Bei-bei， LIU Xiao-ming， et al. Shenzhen City Baoan Hospital of Traditional Chinese Medicine （Group）， Shenzhen 518101， China

【Abstract】 Objective To observe clinical effect by microneedle acupuncture in the treatment of post-cerebral infarction dysphagia. Methods A total of 60 patients with post-cerebral infarction dysphagia were randomly divided into treatment group and control group， with 30 cases in each group. The control group received therapy by cerebral circulation improvement， cranial nerve nourishment， secondary prevention of stroke， and rehabilitation physiotherapy. The treatment group received additional microneedle acupuncture to treatment in the control group. Kubotas water swallow test was applied to evaluate swallowing function in the two groups before and after treatment. Comparison was made on Kubotas water swallow test scores between the two groups before and after treatment. Results There was no statistically significant difference of Kubotas water swallow test score after treatment between the treatment group and the control group （P>0.05）. The treatment group had total effective rate as 86.6%， which was 53.3% in the control group， and the difference had statistical significance （P<0.05）. Conclusion As an effective method for treating post-cerebral infarction dysphagia， microneedle acupuncture is worth clinical promotion and application.

【Key words】 Microneedle acupuncture； Cerebral infarction； Dysphagia

腦梗死是神经系统常见病、多发病， 致残率高， 严重者易导致死亡， 严重影响患者的生活和生存质量。球麻痹则是脑梗死患者最为常见的临床表现之一， 多由双侧大脑半球梗死、脑干梗死所致， 其主要表现为饮水呛咳、言语含糊、构音障碍、吞咽困难等， 球麻痹按其损害部位可分为两种：真性球麻痹和假性球麻痹， 真性球麻痹是指由于舌咽、迷走和舌下神经及核的下运动神经元病变所致， 可出现咽反射减弱或消失， 可不伴有病理反射；假性球麻痹是由于双侧皮质延髓束损害所致， 可出现咽反射亢进、双侧Hoffman 征（+）， 下颌反射亢进等[1]。不管是何种形式的球麻痹， 均可引起吞咽障碍， 吞咽障碍在脑卒中患者中的发生率为51%， 可引起吸入性肺炎、水电解质平衡紊乱、气道梗阻、窒息甚至死亡等多种严重的并发症。有……