本文選題：中風(fēng) + 吞咽困難�。� 參考：《湖北中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:探討電針配合康復(fù)治療中風(fēng)恢復(fù)期吞咽困難的療效觀察,探討電針翳風(fēng)、風(fēng)池等療效機(jī)理,為治療中風(fēng)恢復(fù)期吞咽障礙提供客觀依據(jù)。方法:在2016年7月——2017年1月期間于武漢市中醫(yī)院腦病科病房,收集符合卒中恢復(fù)期60例有吞咽困難的病人,按進(jìn)院秩序歸屬于治療組和對(duì)照組,兩組患者未接受治療之前一般資料經(jīng)過統(tǒng)計(jì)學(xué)比較,沒有明顯差異,可以進(jìn)行對(duì)比。兩組患者同等進(jìn)行腦病科常規(guī)治療,涵括了降血壓、抗血小板聚集、修復(fù)腦細(xì)胞、防治并發(fā)癥。對(duì)照組在常規(guī)治療的基礎(chǔ)上加吞咽康復(fù)訓(xùn)練(包括冰刺激、吞咽訓(xùn)練);治療組在對(duì)照組基礎(chǔ)上加電針治療,取穴翳風(fēng)、風(fēng)池,金津玉液點(diǎn)刺放血。伴有手足偏癱者,取頭穴運(yùn)動(dòng)區(qū)加相應(yīng)局部穴位,患側(cè)極泉穴、尺澤穴、委中穴均進(jìn)行提插瀉法,患側(cè)手足跳動(dòng)三次為標(biāo)準(zhǔn)。肝陽上亢者加太沖(雙);風(fēng)痰阻絡(luò)者加豐隆(雙);痰熱腑實(shí)者加曲池(雙);氣虛血瘀配足三里(雙);陰虛風(fēng)動(dòng)配太溪。記錄未治療前及其后2個(gè)療程兩組患者洼田飲水試驗(yàn)分級(jí)、SSA及SWAL-QOL評(píng)分等評(píng)價(jià)標(biāo)準(zhǔn),將用于統(tǒng)計(jì)分析及臨床療效評(píng)價(jià)。結(jié)果:顯示治療組的總有效率是90.00%,對(duì)照組的總有效率是73.34.%,治療組有效率超過照組。經(jīng)過秩和檢驗(yàn)p0.05,兩組比較具有明顯差異性,表明治療組臨床效果好于對(duì)照組。電針配合康復(fù)訓(xùn)練對(duì)腦卒中后恢復(fù)期吞咽困難的治療,治療組治療前后吞咽功能通過統(tǒng)計(jì)學(xué)分析p均0.05,表明電針配合康復(fù)訓(xùn)練對(duì)腦卒中恢復(fù)期吞咽困難患者吞咽功能的恢復(fù)顯著的效果。兩組進(jìn)行組間比較,通過對(duì)兩組洼田飲水試驗(yàn)分級(jí)、SSA評(píng)分,兩組評(píng)價(jià)指標(biāo)通過統(tǒng)計(jì)學(xué)分析p0.05,差異明顯有意義,治療組臨床效果好于對(duì)照組。SWAL-QOL通過統(tǒng)計(jì)分析,組間差異p0.05,考慮研究的誤差與樣本量較小等問題,SWAL-QOL認(rèn)為差異不明顯。從研究結(jié)果分析,電針配合康復(fù)訓(xùn)練治療吞咽困難在一定程度上存在指向性。結(jié)論:電針頸項(xiàng)部穴位配合康復(fù)訓(xùn)練項(xiàng)目用于卒中吞咽困難臨床效果好于純粹康復(fù)訓(xùn)練。且能更好的為改善患者的生活質(zhì)量。
[Abstract]:Objective: to observe the curative effect of electroacupuncture combined with rehabilitation in the treatment of dysphagia in convalescent stage of apoplexy, and to explore the mechanism of curative effect of electroacupuncture in Yifeng and Fengchi, so as to provide objective basis for the treatment of dysphagia in convalescent stage of apoplexy. Methods: from July 2016 to January 2017, 60 patients with dysphagia were collected from the Department of Encephalopathy, Wuhan traditional Chinese Medicine Hospital. According to the order of admission, 60 patients with dysphagia were assigned to the treatment group and the control group. There was no significant difference in general data before treatment between the two groups. The two groups were treated with routine encephalopathy, including lowering blood pressure, antiplatelet aggregation, repairing brain cells and preventing and treating complications. The control group received rehabilitation training on the basis of routine treatment (including ice stimulation and swallowing training), while the treatment group was treated with electroacupuncture on the basis of control group, and points Yifeng, Fengchi and Jinjin Jade were punctured and bloodletting. In the patients with hemiplegia of hand and foot, the motor area of the head point and the corresponding local acupoints, the acupoints of Zhiquan, Ze and Beizhong of the affected side were all carried out the method of lifting and reducing, and the beat of the affected side of the hand and foot was taken as the standard three times. Hyperactivity of liver yang plus Taichong; wind phlegm blocking collaterals plus Fenglong (Shuangli; phlegm heat and fu-fu solid plus qu Chi (Shuangli; Qi deficiency and blood stasis combined with Zusanli); Yin deficiency wind moving with Taixi. The evaluation criteria of SWAL-QOL and SSA were recorded before and after two courses of treatment in two groups of patients, which will be used for statistical analysis and evaluation of clinical curative effect. Results: the total effective rate of the treatment group was 90.00g, the total effective rate of the control group was 73.34.The effective rate of the treatment group was higher than that of the radiation group. After the rank sum test p0.05, the two groups had obvious difference, which indicated that the clinical effect of the treatment group was better than that of the control group. Electroacupuncture combined with rehabilitation training for the treatment of dysphagia in convalescent stage after stroke, In the treatment group, the swallowing function before and after treatment was 0.05, which indicated that electroacupuncture combined with rehabilitation training had a significant effect on the recovery of swallowing function of patients with dysphagia in convalescent stage of stroke. The two groups were compared between the two groups. By grading SSA score of the two groups of depressions, the two groups were evaluated by statistical analysis (p0.05), the difference was significant. The clinical effect of the treatment group was better than that of the control group by statistical analysis of SWAL-QOL. The difference between groups was p0.05, considering the error and sample size were small, SWAL-QOL thought that the difference was not obvious. Electroacupuncture combined with rehabilitation training in the treatment of dysphagia has a certain degree of directionality. Conclusion: the clinical effect of electroacupuncture combined with rehabilitation training for dysphagia in stroke is better than that in pure rehabilitation training. And can better improve the quality of life of patients.
【學(xué)位授予單位】：湖北中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R246.6

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