重庆医学
重慶醫學
중경의학
CHONGQING MEDICAL JOURNAL
2015年
22期
3063-3065,3067
,共4页
卒中%吞咽障碍%电刺激疗法%针灸疗法%病例对照研究
卒中%吞嚥障礙%電刺激療法%針灸療法%病例對照研究
졸중%탄인장애%전자격요법%침구요법%병례대조연구
stroke%deglutition disorders%electric stimulation therapy%acupuncture-moxibustion%case-control studies
目的：比较电刺激和针灸治疗急性脑卒中后吞咽障碍(DD)的临床疗效，为急性脑卒中后球麻痹康复治疗方案的选择提供指导。方法选取急性脑卒中后 DD 患者80例(真、假性球麻痹各40例)，在基本吞咽康复训练基础上，随机分为真性球麻痹-电刺激组(A1组)、真性球麻痹-针灸组(A2组)、假性球麻痹-电刺激组(B1组)和假性球麻痹-针灸组(B2组)。所有患者在基本吞咽康复训练基础上联合电刺激或针灸连续治疗2周；结合“洼田俊夫饮水试验标准”和“藤岛一郎吞咽疗效评价标准”评定疗效。结果A1组显效4例，有效12例，无效4例；A2组显效2例，有效7例，无效11例。A1组治疗好转率为80%(16/20)、A2组为45%(9/20)，两组比较差异有统计学意义(P =0.022)。B1组显效6例，有效12例，无效2例；B2组显效5例，有效12例，无效3例。B1组治疗好转率为90%(18/20)、B2组为85%(17/20)，两组比较差异无统计学意义(P =0.633)。结论吞咽康复训练联合电刺激或针灸治疗急性脑卒中后假性球麻痹可取得较好疗效；而对于真性球麻痹，吞咽康复训练联合电刺激疗效明显优于吞咽康复训练联合针灸治疗。
目的：比較電刺激和針灸治療急性腦卒中後吞嚥障礙(DD)的臨床療效，為急性腦卒中後毬痳痺康複治療方案的選擇提供指導。方法選取急性腦卒中後 DD 患者80例(真、假性毬痳痺各40例)，在基本吞嚥康複訓練基礎上，隨機分為真性毬痳痺-電刺激組(A1組)、真性毬痳痺-針灸組(A2組)、假性毬痳痺-電刺激組(B1組)和假性毬痳痺-針灸組(B2組)。所有患者在基本吞嚥康複訓練基礎上聯閤電刺激或針灸連續治療2週；結閤“窪田俊伕飲水試驗標準”和“籐島一郎吞嚥療效評價標準”評定療效。結果A1組顯效4例，有效12例，無效4例；A2組顯效2例，有效7例，無效11例。A1組治療好轉率為80%(16/20)、A2組為45%(9/20)，兩組比較差異有統計學意義(P =0.022)。B1組顯效6例，有效12例，無效2例；B2組顯效5例，有效12例，無效3例。B1組治療好轉率為90%(18/20)、B2組為85%(17/20)，兩組比較差異無統計學意義(P =0.633)。結論吞嚥康複訓練聯閤電刺激或針灸治療急性腦卒中後假性毬痳痺可取得較好療效；而對于真性毬痳痺，吞嚥康複訓練聯閤電刺激療效明顯優于吞嚥康複訓練聯閤針灸治療。
목적：비교전자격화침구치료급성뇌졸중후탄인장애(DD)적림상료효，위급성뇌졸중후구마비강복치료방안적선택제공지도。방법선취급성뇌졸중후 DD 환자80례(진、가성구마비각40례)，재기본탄인강복훈련기출상，수궤분위진성구마비-전자격조(A1조)、진성구마비-침구조(A2조)、가성구마비-전자격조(B1조)화가성구마비-침구조(B2조)。소유환자재기본탄인강복훈련기출상연합전자격혹침구련속치료2주；결합“와전준부음수시험표준”화“등도일랑탄인료효평개표준”평정료효。결과A1조현효4례，유효12례，무효4례；A2조현효2례，유효7례，무효11례。A1조치료호전솔위80%(16/20)、A2조위45%(9/20)，량조비교차이유통계학의의(P =0.022)。B1조현효6례，유효12례，무효2례；B2조현효5례，유효12례，무효3례。B1조치료호전솔위90%(18/20)、B2조위85%(17/20)，량조비교차이무통계학의의(P =0.633)。결론탄인강복훈련연합전자격혹침구치료급성뇌졸중후가성구마비가취득교호료효；이대우진성구마비，탄인강복훈련연합전자격료효명현우우탄인강복훈련연합침구치료。
Objective To compare the clinical effects between electrical stimulation and acupuncture for dysphagia in acute stroke,and provide effective option for the patients with post-stroke bulbar palsy.Methods A total of 80 patients (40 post-stroke true bulbar paralysis patients and 40 post-stroke pseudo bulbar paralysis patients)were randomly divided into true bulbar paralysis-electrical stimulation group(group A1),true bulbar paralysis-acupuncture group(group A2),pseudo bulbar paralysis-electrical stim-ulation group(group B1),pseudo bulbar paralysis-acupuncture group(group B2).These patients were treated with electrical stimu-lation or acupuncture combined with rehabilitation training for 2 weeks.Results In group A1,4 cases were better effective,12 cases were effective,and 4 cases were no effective.In group A2,2 cases were better effective,7 cases were effective,and 1 1 cases were no effective.The response rate was 80%(1 6/20)in group A1 and 45%(9/20)in group A2.There was statistically significant difference (P =0.022).In group B1,6 cases were better effective,12 cases were effective,and 2 cases were no effective.In group B2,5 cases were better effective,12 cases were effective,and 3 cases were no effective.The response rate was 90%(18/20)in group B1 and 85%(1 7/20)in group B2.There was no statistically significant difference(P =0.633 ).Conclusion Electrical stimulation or acu-puncture combined with early rehabilitation training could provide good effect for post-stroke pseudo bulbar paralysis patients.For post-stroke true bulbar paralysis patients,it was better to choose electrical stimulation combined with early rehabilitation training.
