江西省新余市人民医院,江西省新余市新欣北大道369号,338000
xudongM6226@163.com
收稿:2025-01-18,
修回:2025-05-18,
纸质出版:2025-08-02
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邓小渝,徐冬梅,樊琼等.舌三针联合穴位贴敷廉泉穴对缺血性脑卒中后吞咽障碍患者吞咽功能及表面肌电信号的影响[J].中医杂志,2025,66(15):1559-1565.
DENG Xiaoyu,XU Dongmei,FAN Qiong,et al.Effects of Combined Tongue Three-Needle Acupuncture and Acupoint Application on Lianquan (CV 23) on Swallowing Function and Surface Electromyography Signals in Patients with Dysphagia after Ischemic Stroke[J].Journal of Traditional Chinese Medicine,2025,66(15):1559-1565.
邓小渝,徐冬梅,樊琼等.舌三针联合穴位贴敷廉泉穴对缺血性脑卒中后吞咽障碍患者吞咽功能及表面肌电信号的影响[J].中医杂志,2025,66(15):1559-1565. DOI: 10.13288/j.11-2166/r.2025.15.009.
DENG Xiaoyu,XU Dongmei,FAN Qiong,et al.Effects of Combined Tongue Three-Needle Acupuncture and Acupoint Application on Lianquan (CV 23) on Swallowing Function and Surface Electromyography Signals in Patients with Dysphagia after Ischemic Stroke[J].Journal of Traditional Chinese Medicine,2025,66(15):1559-1565. DOI: 10.13288/j.11-2166/r.2025.15.009.
目的
2
观察舌三针联合穴位贴敷廉泉穴治疗缺血性脑卒中后吞咽障碍患者的临床疗效及可能机制。
方法
2
将160例缺血性脑卒中后吞咽障碍患者随机分为治疗组和对照组各80例。对照组患者接受常规康复训练治疗,治疗组在常规康复训练基础上加用舌三针联合穴位贴敷廉泉穴进行治疗,两组均治疗4周。治疗后比较两组临床疗效,分别于治疗前、治疗2周、治疗4周时对两组患者进行吞咽功能评估[包括电视X线透视吞咽功能检查(VFSS)、标准吞咽功能评价量表(SSA)、功能性经口摄食量表(FIOS)]、吞咽造影检测[包括舌骨最大位移距离(HmaxD)、咽期通过时间(PTT)、食管上括约肌(UES)开放程度]、表面肌电(sEMG)检测(包括最大波幅、吞咽时程)及吞咽生活质量量表(SWAL-QOL)评分。
结果
2
治疗组总有效率(82.50%,66/80)高于对照组(66.25%,53/80)(
P
<0.05)。治疗2周、4周时,两组患者VFSS及FOIS评分、UES开放率及HmaxD、sEMG最大波幅、SWAL-QOL评分均较本组治疗前升高(
P
<0.05),SSA评分、PTT、吞咽时程均较治疗前降低(
P
<0.05)。治疗组治疗2周、4周时VFSS及FOIS评分、UES开放率及HmaxD、sEMG最大波幅、SWAL-QOL评分均较对照组同期升高(
P
<0.05),SSA评分、PTT、吞咽时程均较对照组同期降低(
P
<0.05)。
结论
2
舌三针联合穴位贴敷廉泉穴对缺血性脑卒中后吞咽障碍患者吞咽功能改善明显,其作用机制可能与改善吞咽相关肌群的收缩能力及协调性有关。
Objective
2
To observe the clinical effectiveness and potential mechanism of combined tongue three-needle acupuncture and acupoint application on Lianquan (CV 23) for patients with dysphagia after ischemic stroke.
Methods
2
A prospective study was conducted on 160 patients with post-stroke dysphagia, who were randomly divided into a treatment group and a control group, with 80 cases in each group. The control group received conventional rehabilitation training, while the treatment group received tongue three-needle acupuncture combined with acupoint application on Lianquan (CV 23) on the basis of conventional rehabilitation training, for 4 weeks in both groups. We compared the clinical effectivenss of both groups after treatment, and assessed the swallowing function including videofluoroscopic swallowing study (VFSS), standardized swallowing assessment (SSA) and functional oral intake scale (FIOS), swallowing contrast test including hyoid maximum displacement (HmaxD), pharyngeal transit time (PTT), and upper esophageal sphincter (UES) opening, surface electromyography (sEMG) test including maximum amplitude and swallowing duration as well as swallowing quality of life questionnaire (SWAL-QOL) score of the patients in both groups before treatment, after 2 weeks and 4 weeks of treatment, respectively.
Results
2
The total effective rate in treatment group was 82.50% (66/80), significantly higher than 66.25% (53/80) in control group (
P
<0.05). The VFSS, and FOIS scores, UES opening rate and HmaxD, sEMG maximal amplitude values, and SWAL-QOL scores were increased in both groups after 2 weeks and 4 weeks of treatment compared with the values before treatment (
P
<0.05), while SSA scores, PTT, and swallowing duration were decreased compared within group before treatment (
P
<0.05). VFSS and FOIS scores, UES opening rate and HmaxD, sEMG maximal amplitude values, and SWAL-QOL scores after 2 and 4 weeks of treatment in the treatment group were higher (
P
<0.05), while SSA scores, PTT, and swallowing duration were lower (
P
<0.05) than those in the control group at the same time.
Conclusion
2
Combined tongue three-needle acupuncture and acupoint application on Lianquan (CV 23) for patients with dysphagia after ischemic stroke can significantly improve swallowing activities, and its mechanism of action may be related to the improvement of the contraction ability and coordination of swallowing-related muscle groups.
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