[1]杨开洋,时素华,宋 萌.电针联合通督益脑化痰汤治疗脑卒中后口咽期吞咽障碍临床研究[J].陕西中医,2024,(10):1415-1418，1423.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.027]
　YANG Kaiyang,SHI Suhua,SONG Meng.Clinical study of electro-acupuncture combined with Tongdu Yinao Huatan decoction in the treatment of dysphagia in oropharyngeal stage after stroke[J].,2024,(10):1415-1418，1423.[doi:DOI:10.3969/j.issn.1000-7369.2024.10.027]
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电针联合通督益脑化痰汤治疗脑卒中后口咽期吞咽障碍临床研究
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《陕西中医》[ISSN:1000-7369/CN:61-1281/TN]

卷:
期数:
2024年10期
页码:
1415-1418，1423
栏目:
针灸经络
出版日期:
2024-10-05

文章信息/Info

Title:
Clinical study of electro-acupuncture combined with Tongdu Yinao Huatan decoction in the treatment of dysphagia in oropharyngeal stage after stroke
作者:
杨开洋1; 时素华2; 宋 萌3
(1.陕西省中医医院,陕西 西安 710003; 2.北京中医药大学第三附属医院,北京 100029; 3.北京中医药大学,北京 102488)
Author(s):
YANG Kaiyang; SHI Suhua; SONG Meng
(Shaanxi Provincial Hospital of Chinese Medicine,Xi'an 710003,China)
关键词:
脑卒中;  电针;  通督益脑化痰汤;  吞咽障碍;  神经功能;  血管内皮功能
Keywords:
Stroke;  Electric acupuncture;  Tongdu Yinao Huatan decoction;  Dysphagia;  Nerve function;  Vascular endothelial function
分类号:
R 743.3
DOI:
DOI:10.3969/j.issn.1000-7369.2024.10.027
文献标志码:
A
摘要:
目的:探讨电针联合通督益脑化痰汤治疗脑卒中后口咽期吞咽障碍的影响。方法:选择痰瘀阻络型脑卒中后口咽期吞咽障碍患者102例为研究对象,采用随机数字表法将其分为电针组和联合组各51例。电针组采用电针夹廉泉穴、风府穴治疗,联合组在此基础上给予通督益脑化痰汤治疗。观察两组患者的临床疗效、中医证候积分、神经功能缺损评分(NIHSS)、日常生活活动能力(ADL)评分、吞咽功能评价量表(SSA)评分、血管内皮功能、神经功能因子、不良反应发生情况。结果:治疗后,联合组治疗总有效率高于电针组(P<0.05); 治疗后联合组中医证候积分、NIHSS与SSA评分、可溶性血管细胞黏附分子-1(sVCAM-1)、神经元特异性烯醇化酶(NSE)、神经生长相关蛋白-43(GAP-43)水平均低于电针组(P<0.05); 治疗后联合组ADL、内皮源性超极化因子(EDHF)、脑源性神经营养因子(BDNF)水平均高于电针组(P<0.05); 两组不良反应总发生率差异无统计学意义(P>0.05)。结论:电针夹廉泉穴、风府穴联合通督益脑化痰汤治疗脑卒中后口咽期吞咽障碍可改善患者血管内皮功能指标及神经功能因子水平,提高患者神经功能、日常生活能力及吞咽功能,提高临床疗效。
Abstract:
Objective:To investigate the effect of electro-acupuncture combined with Tongdu Yinao Huatan decoction in the treatment of dysphagia in oropharyngeal period after stroke.Methods:A total of 102 patients with oropharyngeal dysphagia after stroke with phlegm and blood stasis were selected as the study objects,and were divided into electro-acupuncture group(n=51)and combined group(n=51)by random number table method.The electro-acupunctur group was treated with Jialianquan point and Fengfu point,and the combined group was treated with Tongdu Yinao Huatan decoction on this basis.Clinical efficacy,TCM syndrome score,Neurological function deficit score(NIHSS),activity of daily living(ADL)score,swallowing function Evaluation Scale(SSA)score,vascular endothelial function,neurological function factors,and adverse reactions were observed in 2 groups.Results:After treatment,the total effective rate of combined group was higher than that of electro-acupunctur group(P<0.05).TCM syndrome score,NIHSS and SSA scores,soluble vascular cell adhesion molecule-1(sVCAM-1),specific enolase(NSE)and nerve growth associated protein-43(GAP-43)levels in combination group were lower than those in electro-acupunctur group(P<0.05).The levels of ADL,endodermal hyperpolarization factor(EDHF)and brain-derived neurotrophic factor(BDNF)in combination group were higher than those in electro-acupunctur group(P<0.05).There was no significant difference in the total incidence of adverse reactions between the two groups(P>0.05).Conclusion:Electro-acupunctur combined with Tongdu Yinao Huatan decoction in the treatment of swallowing disorder in oropharyngeal stage after stroke can improve the level of vascular endothelial function indicators and nerve function factors,improve the nerve function,daily living ability and swallowing function of patients.

参考文献/References:

[1] MARIN S,ORTEGA O,SERRA P M,et al.Economic evaluation of clinical,nutritional and rehabilitation interventions on oropharyngeal dysphagia after stroke:A systematic review[J].Nutrients,2023,15(7):1714.
[2] BOADEN E,BURNELL J,HIVES L,et al.Screening for aspiration risk associated with dysphagia in acute stroke[J].Cochrane Database Syst Rev,2021,10(10):12679.
[3] 王莎莎,詹颖,张中伟.透刺吞咽针法联合呼吸训练治疗风痰瘀阻型脑卒中后吞咽困难的疗效及对血清BDNF、NGF水平影响[J].四川中医,2022,40(6):201-204.
[4] 刘晶晶,张小健,郝春波,等.通督益脑化痰汤对卒中假性球麻痹吞咽困难患者疗效、SSA评分及对TCD血流动力学改变的影响[J].中医药学报,2023,51(3):81-84.
[5] LI S S,HUA X Y,ZHENG M X,et al.Electroacupuncture treatment improves motor function and neurological outcomes after cerebral ischemia/reperfusion injury[J].Neural Regen Res,2022,17(7):1545-1555.
[6] 中华医学会神经病学分会,中华医学会神经病学分会脑血管病学组.中国急性缺血性脑卒中诊治指南2018[J].中华神经科杂志,2018,51(9):666-682.
[7] 中国吞咽障碍康复评估与治疗专家共识组.中国吞咽障碍评估与治疗专家共识(2017年版)第一部分评估篇[J].中华物理医学与康复杂志,2017,39(12):881-892.
[8] 国家中医药管理局.中医病证诊断疗效标准[M].南京:南京大学出版社,2017:139-140.
[9] 王曈,董凌辉,孟萍萍,等.重复经颅磁刺激治疗卒中后吞咽困难的相关临床研究进展[J].中华物理医学与康复杂志,2022,44(10):931-934.
[10] 叶文,蔡雨欣,刘玲玲,等.欧洲卒中后吞咽困难诊断和治疗指南(2021版)解读[J].华西医学,2022,37(5):646-651.
[11] 赵见文,田军彪,张颜伟,等.“活血化浊通窍利咽法”干预缺血性脑卒中吞咽障碍的临床评价研究[J].河北中医药学报,2023,38(3):5-8.
[12] 谢霞,李文娟,黄文琦,等.健脾通络针法联合会厌通络汤治疗脑卒中后假性延髓麻痹吞咽困难疗效观察[J].山西医药杂志,2022,51(9):963-966.
[13] 朱泓宇,任广喜,徐裕彬,等.豆科与木兰科鸡血藤类药材活性成分及药理作用研究进展[J].中国现代中药,2022,24(11):2278-2294.
[14] 高志杰,朱彤彤,牛新茹,等.鸡血藤化学成分及药理活性研究进展[J].辽宁中医药大学学报,2022,24(4):67-74.
[15] 于心洋,张贺齐,刘云平,等.葛根素对缺血性脑卒中模型大鼠神经损伤的防护作用[J].中国药业,2022,31(4):58-63.
[16] 薛强,陈红,周佳丽,等.葛根素对局灶性脑缺血大鼠半暗带微血管内皮细胞的保护作用及其机制[J].中国新药杂志,2019,28(2):151-158.
[17] 杨山景,封安杰,孙越,等.白芍总苷的药理作用及机制研究进展[J].中国现代应用药学,2021,38(13):1627-1633.
[18] 宋苗苗,王颖.舌面散刺联合金津、玉液点刺出血治疗脑卒中后吞咽困难临床疗效观察[J].安徽中医药大学学报,2022,41(4):60-64.
[19] 赵康如,柳雪,范兆鹏,等.针灸联合门德尔松手法对中风后吞咽困难患者吞咽功能的影响[J].陕西中医,2022,43(7):958-962.
[20] 康星宇,郭壮丽,高呈飞,等.电针夹廉泉穴治疗脑卒中后口咽期吞咽障碍的临床研究[J].中华物理医学与康复杂志,2023,45(2):119-124.
[21] 蒋建华,江巧莉,李彩虹,等.咽腔电刺激在脑卒中后吞咽困难患者康复中的应用进展[J].中国医药导报,2022,19(19):61-65.
[22] 马月,曹奕,汪瑛,等.电针夹廉泉联合点刺金津玉液干预脑卒中后吞咽功能障碍临床观察[J].陕西中医,2023,44(9):1302-1304.
[23] 莫亚青.电针夹廉泉穴配合康复训练治疗中风后吞咽障碍的疗效观察[D].南宁:广西中医药大学,2022.
[24] 黄丽贤,姜辉,齐宝云,等.舌七针疗法取穴机理探析[J].中国中医基础医学杂志,2018,24(12):1764-1766.
[25] 李传金,姜波,王德利,等.NLRP3/caspase-1途径在电针联合高频重复经颅刺激改善局灶脑梗死大鼠认知和运动功能中的作用[J].河北医药,2023,45(22):3382-3387.

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备注/Memo

备注/Memo:
基金项目:国家自然科学基金资助面上项目(82374593)
更新日期/Last Update: 2024-10-08