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  本文關(guān)鍵詞： 交叉電項針 腦出血 吞咽反射　出處：《黑龍江中醫(yī)藥大學(xué)》2016年碩士論文　論文類型：學(xué)位論文

【摘要】：目的：擬采用交叉電項針配合人迎穴治療腦出血后氣管切開的患者,觀察其對患者吞咽功能的重塑,達到促進腦出血后氣切插管患者早日封管的目的。方法：按照患者前來就診的次序納入符合條件的患者共43例,將收集到的病例使用隨機數(shù)字表分組的方法隨機平均分為兩組,一組為治療組,另一組為對照組。給與這兩組患者同樣的降顱壓、腦保護、改善腦循環(huán)、抗炎、化痰等對癥支持治療和頭針、微針、電針、康復(fù)治療,其中針灸采用中風(fēng)病治療常規(guī)取穴,取百會、四神聰、頭維、曲池、合谷、外關(guān)、手三里、臂膈、肩髑、肩謬、 風(fēng)市、梁丘、血海、陰陵泉、足三里、三陰交、絕谷、太沖等,毫針針刺30min,平補平瀉,需要康復(fù)治療的患者給與同樣對癥的物理療法和運動療法。治療組取穴人迎、翳風(fēng)、風(fēng)池給與英迪牌型號KWD 808的針灸治療儀疏密波交叉通電30min；對照組取穴水溝、廉泉、金津、玉液、風(fēng)池、翳風(fēng),風(fēng)池、翳風(fēng)交叉通電,其余穴位施以100轉(zhuǎn)／分的捻轉(zhuǎn)手法刺激各約60秒,留針時間30分鐘,期間行針3次。兩組患者在年齡和性別、病程、病情等基礎(chǔ)信息方面經(jīng)統(tǒng)計學(xué)分析比較后,結(jié)果無顯著性差異(P0.05)有可比性。在觀察指標(biāo)上,吞咽恢復(fù)方面嚴(yán)格按洼田氏飲水試驗和藤島一郎試驗量表記錄評分,同時還記錄兩組前后腦卒中臨床神經(jīng)功能缺損評分,并隨時記錄實驗過程中出現(xiàn)的安全意外；經(jīng)上述治療4周后,按療效判定標(biāo)準(zhǔn)判定療效結(jié)果。結(jié)果：1.飲水洼田實驗治療組有效率85.00%,對照組有效率55.00%,經(jīng)過統(tǒng)計兩組有明顯差異性(X2=10.14,p0.05),兩組對比結(jié)果顯示治療組療效優(yōu)于對照組。2.島一郎吞咽試驗中實驗組有效率80.00%對照組有效率45.00%,經(jīng)統(tǒng)計學(xué)統(tǒng)計兩組數(shù)據(jù)具有明顯差異性具有統(tǒng)計學(xué)意義(X2=1 0.26,P0.05),說明交叉電項針配人迎穴的治療組療效明顯優(yōu)于對照組。3.在神經(jīng)缺損上,經(jīng)x2檢驗(X2=10.26,P=0.02),(P0.05)具有統(tǒng)計學(xué)意義,說明治療組療效明顯優(yōu)于對照組。4.在安全性方面：治療組安全性一級16例,二級4例,安全率占80.00%；對照組中安全性1級的15例,2級3例安全率75.00%,上表各項數(shù)據(jù)的比較上(P0.05)無統(tǒng)計學(xué)意義,說明交叉電項針配合人迎穴針刺和普通針刺安全性相當(dāng),可以推廣臨床運用。結(jié)論：1.交叉電項針配人迎穴能明顯改善腦出血后氣管切開插管患者療效確切且優(yōu)于常規(guī)針刺組。2.交叉電項針配人迎對穴對腦出血后氣管切開插管患者的吞咽功能障礙有效且優(yōu)于對照組。3.交叉電項針配人迎穴能明顯改善患者神經(jīng)缺損度。
[Abstract]:Objective: to observe the remodeling of swallowing function of patients with intracerebral hemorrhage after tracheotomy. Methods: 43 eligible patients were included according to the order in which the patients came to visit. The collected cases were randomly divided into two groups: the treatment group and the control group. The two groups were given the same reduction of intracranial pressure, brain protection, improvement of cerebral circulation and anti-inflammation. Expectoration and other symptomatic support treatment and scalp acupuncture, micro-acupuncture, electroacupuncture, rehabilitation treatment, among which acupuncture and moxibustion is used to treat stroke routine points, Baihui, Sishen Cong, Hewei, Quchi, Hegu, Waiguan, three li of the hand, arm diaphragm, shoulder resuscitation. Shoulder error, wind city, Liang Qiu, blood sea, Yin Ling spring, Zusanli, Sanyinjiao, absolute valley, Taichong, needle acupuncture for 30 minutes, Ping Buping diarrhea. Patients in need of rehabilitation were given the same symptomatic physiotherapy and exercise therapy. Wind pond was given Yingdi brand model KWD 808 acupuncture and moxibustion therapy instrument with dense wave intersecting power for 30 mins; In the control group, the points of Shuigou, Lianquan, Jinjin, Yuye, Fengchi, Yifeng, Fengchi and Yifeng were cross-electrified. The remaining acupoints were stimulated by 100 rpm twisting manipulation for about 60 seconds, and the needle retention time was 30 minutes. During the acupuncture 3 times. The two groups of patients in age and gender, course of disease, disease and other basic information after statistical analysis and comparison, the results have no significant difference (P 0.05) comparability. In the aspect of swallowing recovery, the scores were recorded strictly according to Wada's drinking water test and Fujima Ichiro test scale, and the clinical neurological impairment scores of both groups were also recorded before and after stroke. The safety accidents occurred during the experiment are recorded at any time. After the above treatment for 4 weeks, the curative effect was determined according to the criterion of curative effect. Results: 1. The effective rate of drinking water sag experiment treatment group was 85.000.The effective rate of the control group was 55.00%. There was a significant difference between the two groups (P 0.05). The results of comparison between the two groups showed that the curative effect of the treatment group was better than that of the control group .2.The effective rate of the experimental group was 80.00%, the effective rate of the control group was 45.00%. There was significant difference between the two groups by statistical statistics. There was significant difference between the two groups (P 0.05). The results showed that the therapeutic effect of cross electric nape acupuncture combined with Renying acupoint was significantly better than that of control group. In terms of safety, there were 16 cases of safety in the treatment group and 4 cases in the second class, with a safety rate of 80.00g. In the control group, the safety rate was 75.00 in 15 cases of safety grade 1 and 3 cases in grade 2. There was no significant difference in the comparison of the data in the above table (P0.05). It shows that the safety of crossing electric item acupuncture combined with Renying point acupuncture is equivalent to that of common acupuncture. Conclusion:. 1. Cross electric item acupuncture combined with Renying point can obviously improve the curative effect of tracheotomy and intubation after intracerebral hemorrhage and is better than that of routine acupuncture group .2. the swallow work of patients with tracheotomy and intubation after intracerebral hemorrhage treated by cross electric item acupuncture combined with Renying acupoint is better than that of routine acupuncture group. The effect of energy disorder was better than that of control group .3.Combined with Renying point, the nerve defect degree of patients was improved obviously.
【學(xué)位授予單位】：黑龍江中醫(yī)藥大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2016
【分類號】：R246.6

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