咽三针点按联合摄食-吞咽训练对卒中后吞咽障碍的影响

Effect of Yan San Zhen acupressure combined with feeding-swallowing training on post-stroke dysphagia

摘要:

目的 探究咽三针点按联合摄食-吞咽训练对卒中后吞咽障碍（PSD）的影响。方法 选取2022年1月—2025年1月金华市中心医院98例PSD患者为研究对象，随机分为训练组与咽三针组，每组49例。训练组给予摄食-吞咽训练治疗；咽三针组在训练组的基础上联合咽三针点按治疗。比较两组的临床疗效、证候积分、甲状软骨及舌骨移动距离、吞咽耗时、肌电最大波幅及不良反应。结果 咽三针组的临床疗效总有效率高于训练组（P <0.05）。治疗后，咽三针组吞咽困难、舌强语塞、饮水呛咳证候积分均低于训练组（P <0.05）。咽三针组治疗前后吞咽困难、舌强语塞、饮水呛咳证候积分的差值均大于训练组（P <0.05）。治疗后，咽三针组的甲状软骨及舌骨垂直、水平移动距离均高于训练组（P < 0.05）。咽三针组治疗前后甲状软骨及舌骨垂直、水平移动距离的差值均大于训练组（P <0.05）。治疗后，咽三针组的吞咽耗时低于训练组，肌电最大波幅高于训练组（P <0.05）。咽三针组治疗前后吞咽耗时、肌电最大波幅的差值均大于训练组（P <0.05）。两组均未见不良反应发生。结论 咽三针点按联合摄食-吞咽训练对PSD患者的影响较为显著。

Abstract:

Objective To investigate the effect of Yan San Zhen acupressure combined with feeding-swallowing training on post-stroke dysphagia (PSD).Methods A total of 98 patients with PSD admitted to Jinhua Municipal Central Hospital from January 2022 to January 2025 were selected as the research objects and randomly divided into a training group and a Yan San Zhen group, with 49 cases in each group. The training group was given feeding-swallowing training, while the Yan San Zhen group was treated with Yan San Zhen acupressure on the basis of the training group. Clinical efficacy, syndrome scores, movement distances of the thyroid cartilage and hyoid bone, swallowing time, maximum electromyographic amplitude, and adverse reactions were compared between the two groups.Results The total clinical effective rate of the Yan San Zhen group was higher than that of the training group (P < 0.05). After treatment, the syndrome scores of dysphagia, stiff tongue with slurred speech, and choking on water in the Yan San Zhen group were lower than those in the training group (P < 0.05). The differences in syndrome scores of dysphagia, stiff tongue with slurred speech, and choking on water before and after treatment in the Yan San Zhen group were greater than those in the training group (P < 0.05). After treatment, the vertical and horizontal movement distances of the thyroid cartilage and hyoid bone in the Yan San Zhen group were greater than those in the training group (P < 0.05). The differences in vertical and horizontal movement distances of the thyroid cartilage and hyoid bone before and after treatment in the Yan San Zhen group were greater than those in the training group (P < 0.05). After treatment, the swallowing time in the Yan San Zhen group was shorter than that in the training group, while the maximum electromyographic amplitude was higher (P < 0.05). The differences in swallowing time and maximum electromyographic amplitude before and after treatment in the Yan San Zhen group were greater than those in the training group (P < 0.05). No adverse reactions were observed in either group.Conclusion Yan San Zhen acupressure combined with feeding-swallowing training has a significant effect on patients with PSD.