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1、頭體針結(jié)合治療中風(fēng)后吞咽障礙60例臨床觀察研究周震,張玉蓮,袁河,郭家奎(天津中醫(yī)藥人學(xué)第二附屬醫(yī)院)摘要:[目的]通過(guò)吞咽功能評(píng)價(jià)最表及相關(guān)營(yíng)養(yǎng)指標(biāo)研究頭體針結(jié)合治療屮風(fēng)后吞咽障礙患者的臨床療效。[方法]將符介納入標(biāo)準(zhǔn)的60例患者隨機(jī)分為針刺組與康復(fù)組。其中針刺組30例,采用頭體針結(jié)合治療;康復(fù)組30例,采用現(xiàn)代康復(fù)治療。每名患者治療前后均采用洼田飲水試驗(yàn)、BI指數(shù)及營(yíng)養(yǎng)學(xué)指標(biāo)(MNA、MAMC、TSF)進(jìn)行臨床評(píng)估,以比較兩組臨床療效。[結(jié)果](1)頭體針結(jié)介治療2周后有效率達(dá)56.7%,治療
2、3月后育效率達(dá)83.3%,明顯高于康復(fù)治療(PC0.05);(2)洼□□飲水試驗(yàn)分級(jí)顯示,兩種治療方法均能明顯提高患者的飲水試驗(yàn)等級(jí)(P<0.05),且治療3月后效果更明顯(P<0.05),同時(shí)治療3月后針刺組療效明顯髙于康復(fù)組(PV0.05);(3)BI指數(shù)顯示,治療后3個(gè)月針刺組明顯髙于康復(fù)組(PV0.05);(4)營(yíng)養(yǎng)學(xué)指標(biāo)(MNA、MAMC、TSF)顯示,治療三月后針刺組與康復(fù)組均有改善趨勢(shì),但二者間無(wú)明顯差界。[結(jié)論]頭體針結(jié)合治療可明顯減輕中風(fēng)后吞咽障礙,具有較好的臨床療效,適于廣泛應(yīng)
3、用于臨床治療。關(guān)鍵詞:吞咽障礙;中風(fēng);頭體針結(jié)合;吞咽評(píng)估;營(yíng)養(yǎng)學(xué)評(píng)估中圖分類(lèi)號(hào):TheStudyofClinicalObservationon60casesaboutDysphagiaafterStrokeTreatedbyCombinedScalpandBodyAcupunctureZhouZhen,ZhangYulian,YuanHe,GuoJiakui(TheSecondHospitalAttachtoTianjinofTCM)Abstract:Objective:Tostudythecl
4、inicaleffectofcombinedscalpandbodyacupuncturetreatmentfordysphagiaafterstrokebyevaluationscaleofswallowingfunctionandcorrelatednutriologyindex.Methods:Sixtycasesaccordancewiththeinclusioncriteriawererandomizedintotheacupunctureandrehabilitationgroups.
5、Theacupuncturegroup,whichhadthirtycases,wasreceivedwithcombinedscalpandbodyacupuncturetreatment.Therehabilitationgroup,whichhadthirtycases,wasreceivedwithmodemrehabilitativetreatment.Comparetheclinicaleffectbetweentwogroupspreandposttreatmentbybedside
6、water-swallowingtest、BIindexandnutriologyindex(includingMNA、MAMC^TSF).Rcsults:(l)Inacupuncturegroup,thccuredratewas56.7%attwoweeksafterthetreatment,theeffectiveratewas83.3%atthreemonthsafterthetreatment,whichwassignificantlysuperiortotherehabilitation
7、group(P<0.05);(2)Bedsidewater-swallowingtestrevealedthattwomethodsbothcouldimproveobviouslythegradeofbedsidewater-swallowingtcst(P<0.05),andtheeffectwasbetteratthreemonthsaftertreatment(P<0.05).(3)Atthreemonthsafterthetreatment,BIindexoftheacupuncture
8、groupwassignificantlybetterthanthatinrehabilitationgroup(P<0.05).(4)TheresultofnutriologyindexshowedthatthesignificantgrowthimprovementofMNA>MAMCandTSFwasobservedbothintwogroupsatthreemonthsafterthetreatment,buttherewasnodifferencebetweentwogr