补肾启闭针法联合吞咽康复训练治疗脑梗死后吞咽障碍患者对其吞咽功能改善作用

文章信息/Info

• Title:补肾启闭针法联合吞咽康复训练治疗脑梗死后吞咽障碍患者对其吞咽功能改善作用

• 卷期:2024年22卷11期

• 作者:刘嘉琦 刘丹

• 南昌市第一医院康复科 江西南昌，330000

• Author(s):Liujiaqi liudan

• Department of Rehabilitation, Nanchang First Hospital 330000

• 关键词补肾启闭针法；吞咽康复训练；脑梗死后吞咽障碍；吞咽功能

• Keywords:Tonifying kidney opening and closing acupuncture; Swallowing rehabilitation training; Dysphagia after cerebral infarction; Swallowing function

• 摘要:目的 分析补肾启闭针法联合吞咽康复训练治疗脑梗死后吞咽障碍患者对其吞咽功能改善作用。方法 回顾性分析2020年6月-2022年6月收治的64例脑梗死后吞咽障碍患者临床资料，根据其所选的不同康复方案分为参照组（30例）与研究组（34例），前者实施吞咽康复训练，后者在吞咽康复训练基础上实施补肾启闭针法。比较两组治疗前后标准吞咽功能评价量表（SSA）评分、中医证候积分、吞咽障碍特异性生活质量量表（SWAL-QOL）评分。结果 治疗后，研究组SSA评分、中医证候积分低于参照组，研究组SWAL-QOL评分高于参照组（均P<0.05）。结论 对脑梗死后吞咽障碍患者实施补肾启闭针法联合吞咽康复训练可有效改善患者吞咽障碍和临床症状，促进生活质量的提升。                                                                                                                                                                                

• AbstractTo analyze the effect of Tonifying kidney opening and closing acupuncture combined with swallowing rehabilitation training on the improvement of swallowing function in patients with dysphagia after cerebral infarction. Methods The clinical data of 64 patients with dysphagia after cerebral infarction admitted from June 2020 to June 2022 were retrospectively analyzed, and they were divided into the reference group (30 cases) and the study group (34 cases) according to different rehabilitation programs selected. The former was given swallowing rehabilitation training, and the latter was given toning kidney opening and closing acupuncture on the basis of swallowing rehabilitation training. The scores of Standard Swallowing Function Assessment Scale (SSA), Chinese medicine syndrome score, and dysphagia Specific Quality of Life Scale (SWAL-QOL) before and after treatment were compared between the two groups. Results After treatment, the SSA score and TCM syndrome score of the study group were lower than those of the reference group, and the SWAL-QOL score of the study group was higher than that of the reference group (all P<0.05). Conclusions Tonifying kidney opening and closing acupuncture combined with swallowing rehabilitation training for patients with dysphagia after cerebral infarction can effectively improve dysphagia and clinical symptoms, and promote the improvement of quality of life.                

  脑梗死是临床常见的一种脑血管疾病，复发率、致残率、死亡率较高，其中近80%出现不同程度的后遗症，如言语障碍、肢体偏瘫、吞咽障碍等，其中吞咽障碍较为多见，直接影响患者的康复和生活质量。目前，临床对脑梗死后吞咽障碍尚无统一治疗方案，通常采用吞咽障碍康复训练、物理疗法、鼻饲营养等对症治疗，维持机体代谢和营养摄入，以促进其康复。但吞咽障碍康复训练属于外部操作技术，单纯依靠外部躯体训练，并不能改善机体脏腑功能，治疗效果欠佳。有研究[1]认为，在脑梗死后遗症治疗中实施针灸、熏蒸等中医治疗技术可以发挥协同增效的作用，安全性较高，疗效显著。中医学认为脑梗死后吞咽障碍归于“舌謇”、“中风”等范畴，因情志内伤、外感风寒湿邪，痰瘀阻窍，使脏腑气机逆乱、咽喉开合失司，从而产生饮水呛咳、吞咽困难、舌强语塞等症状。补肾启闭针法是按照特定的手法、深度、方向，针刺具有醒脑调神、滋补填髓、通关利窍功效的穴位，使口舌咽喉恢复生理功能[2]。