李航 李月

摘要：目的  研究针刺配合吞咽康复训练治疗脑卒中后吞咽障碍效果。方法  选取2017年1月～2018年12月在我院治疗的脑卒中后吞咽障碍患者150例，随机分为对照组和观察组，各75例。对照组实施吞咽康复训练，观察组在对照组基础上配合针刺，对比两组治疗总有效率、吞咽功能障碍评分、生存质量评分以及不良事件发生情况。结果  观察组总有效率为97.33%，高于对照组的78.67%，差异有统计学意义（P<0.05）;治疗后两组吞咽功能障碍评分、生存质量评分均较治疗前升高，且观察组改善优于对照组，差异有统计学意义（P<0.05）;观察组不良事件发生率为5.33%，低于对照组的26.67%，差异有统计学意义（P<0.05）。结论针刺配合吞咽康复训练治疗脑卒中后吞咽障碍有效率高，可促进患者吞咽功能恢复，提高其生存质量，并可有效预防呛咳、误吸等不良事件的发生，具有良好的治疗效果。

关键词：针刺;吞咽康复训练;脑卒中;吞咽障碍

中图分类号：R246.6                                 文献标识码：A                                 DOI：10.3969/j.issn.1006-1959.2019.18.056

文章编号：1006-1959（2019）18-0160-03

Abstract：Objective  To study the effect of acupuncture combined with swallowing rehabilitation training on dysphagia after stroke. Methods  A total of 150 patients with dysphagia after stroke from January 2017 to December 2018 were enrolled in our hospital. They were randomly divided into control group and observation group， 75 cases each. The control group was given swallowing rehabilitation training. The observation group was combined with acupuncture on the basis of the control group. The total effective rate， swallowing dysfunction score， quality of life score and adverse events were compared between the two groups.Results  The total effective rate of the observation group was 97.33%， which was higher than that of the control group 78.67%，the difference was statistically significant （P<0.05）. After treatment， the scores of swallowing dysfunction and quality of life were higher than those before treatment. The improvement of the group was better than that of the control group，the difference was statistically significant （P<0.05）. The incidence of adverse events in the observation group was 5.33%， which was lower than that in the control group 26.67%，the difference was statistically significant （P<0.05）.Conclusion  Acupuncture combined with swallowing rehabilitation training is effective in treating dysphagia after stroke. It can promote the recovery of swallowing function， improve the quality of life， and effectively prevent the occurrence of adverse events such as cough and aspiration. It has a good therapeutic effect.

Key words：Acupuncture;Swallowing rehabilitation training;Stroke;Dysphagia

腦卒中（stroke）后吞咽障碍是脑卒中常见的并发症之一，临床患者主要表现为食物经口腔、咽、食管输送至胃的过程中出现障碍，容易发生吸入性肺炎、误吸等不良事件，影响患者的营养摄入，进而严重影响患者的生存质量[1]。为了促进脑卒中患者吞咽功能的康复，临床上通常给予吞咽康复训练。而随着中医学的发展，在吞咽康复训练基础上结合传统针刺，可促进与吞咽相关肌肉运动的协调功能和吞咽反射性，预防吞咽肌群萎缩。同时针刺相关穴位，可调节咽部神经功能，加速吞咽反射的修复和重建，促进吞咽功能的恢复。本研究结合2017年1月～2018年12月在我院治疗的150例脑卒中后吞咽障碍患者临床资料，分析针刺结合康复训练治疗脑卒中后吞咽障碍患者的疗效，以期为临床提供参考，现报告如下。

1资料与方法

1.1一般资料  选取2017年1月～2018年12月在佳木斯市中医院治疗的脑卒中后吞咽障碍患者150例，各75例。……