标题：通督调神针刺疗法联合吞咽治疗仪对脑卒中后吞咽障碍患者吞咽功能及肌电图的影响

      作者：吴霞 1，王寅 2，李英 1，蔡英剑 1    安康市中医医院治未病中心 1、针灸康复一科 2，陕西 安康 725000

      卷次： 2022年33卷14期

      【摘要】 目的 观察通督调神针刺疗法联合吞咽治疗仪对脑卒中后吞咽障碍患者吞咽功能及肌电图的影响。方法 选取2019年6月至 2021年1月安康市中医医院接受治疗的 133例脑卒中后吞咽障碍患者作为研究对象，依据随机数表法将患者分为观察组(n=67)和对照组(n=66)，对照组患者在常规治疗的基础上使用吞咽治疗仪治疗，观察组在对照组治疗的基础上联合通督调神针刺疗法治疗。比较两组患者治疗前后的标准吞咽功能评价量表(SSA)和电视X线透视进行吞咽功能检查量表(VFSS)评分、表面肌电图(sEMG)最大波幅值和吞咽时程，以及两组患者的临床疗效和不良反应发生情况。结果 治疗后，观察组患者的SSA评分为(23.16±4.05)分，明显低于对照组的(27.30±5.11)分，VFSS评分为(6.27±1.29)分，明显高于对照组的(5.13±1.17)分，差异均有统计学意义(P<0.05)；治疗后，观察组患者的 sEMG最大波幅值为(721.36±40.59) μV，明显大于对照组的(676.56±39.97) μV，吞咽时程为(1.06±0.24) s，明显短于对照组的 (1.35±0.31) s，差异均有统计学意义(P<0.05)；观察组患者的临床治疗总有效率为95.52%，明显高于对照组的84.85%，差异有统计学意义(P<0.05)；观察组和对照组患者的不良反应总发生率分别为4.48%、3.03%，差异无统计学意义(P>0.05)。结论 通督调神针刺疗法联合吞咽治疗仪治疗脑卒中后吞咽障碍可有效改善患者的吞咽功能，促进 sEMG波幅提升，临床疗效显著且安全性好，值得临床推广。
      【关键词】 通督调神针刺疗法；脑卒中；吞咽障碍；吞咽功能；肌电图；疗效
      【中图分类号】 R743.3 【文献标识码】 A 【文章编号】 1003—6350（2022）14—1781—04

Effect of Tongdu Tiaoshen acupuncture combined with deglutition therapy instrument on swallowing functionand electromyography of patients with dysphagia after stroke.
WU Xia 1, WANG Yin 2, LI Ying 1, CAI Ying-jian 1.Pre-treatment Center 1, First Department of Acupuncture and Moxibustion Rehabilitation 2, Ankang Hospital of TraditionalChinese Medicine, Ankang 725000, Shaanxi, CHINA
【Abstract】 Objective To observe the effect of Tongdu Tiaoshen acupuncture combined with deglutition thera-py instrument on swallowing function and electromyography of patients with dysphagia after stroke. Methods A totalof 133 patients with dysphagia after stroke who received treatment in Ankang Hospital of Traditional Chinese Medicinefrom June 2019 to January 2021 were selected as the research objects. According to the random number table method,the patients were divided into an observation group (n=67) and a control group (n=66). The patients in the control groupwere treated with deglutition therapy instrument on the basis of conventional treatment, and the patients in the observa-tion group were treated with Tongdu Tiaoshen acupuncture on the basis of the treatment of the control group. The twogroups were compared before and after treatment in Standardized Swallowing Assessment (SSA) Scale and Video Fluo-roscopic Swallowing Study (VFSS) Scale, maximum amplitude of surface electromyography (sEMG) and swallowingduration, clinical efficacy, and occurrence of adverse reactions. Results After treatment, the SSA score of the observa-tion group was (23.16±4.05) points, significantly lower than (27.30±5.11) points of the control group; VFSS score was(6.27±1.29) points, significantly higher than (5.13±1.17) points in the control group; the differences were statistically sig-nificant (all P<0.05). After treatment, the maximum amplitude of sEMG in the observation group was (721.36±40.59) μV,significantly higher than (676.56±39.97) μV in the control group, and the swallowing duration was (1.06±0.24) s,which was significantly shorter than (1.35±0.31) s in the control group; the differences were all statistically significant(P<0.05). The total effective rate of the observation group was 95.52%, significantly higher than 84.85% of controlgroup; the differences were statistically significant (P<0.05). The total incidence of adverse reactions was 4.48% in theobservation group and 3.03% in the control group, respectively, with no statistically significant differences (P>0.05).Conclusion Tongdu Tiaoshen acupuncture combined with deglutition therapy instrument can effectively improve theswallowing function of patients with dysphagia after stroke, promote the enhancement of sEMG amplitude, and has sig-nificant clinical efficacy and good safety, which is worthy of clinical promotion.
      【Key words】 Tongdu Tiaoshen acupuncture therapy; Stroke; Dysphagia; Swallowing function; Electromyogra-phy; Curative effect