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首都医科大学附属北京中医医院针灸中心针灸神经调控北京市重点实验室
纸质出版日期:2022
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刘璐, 吕天丽, 聂利敏, 等. 通过表面肌电图技术观察贺氏三通法治疗脑卒中后吞咽障碍的临床疗效[J]. 针刺研究, 2022,47(3):256-261.
LIU Lu, Lü Tian-li, NIE Li-min, et al. Observation on the efficacy of post-stroke dysphagia treated with He’s santong acupuncture therapy through surface electromyography: a randomized controlled trial[J]. Acupuncture research, 2022, 47(3): 256-261.
刘璐, 吕天丽, 聂利敏, 等. 通过表面肌电图技术观察贺氏三通法治疗脑卒中后吞咽障碍的临床疗效[J]. 针刺研究, 2022,47(3):256-261. DOI: 10.13702/j.1000-0607.20210197.
LIU Lu, Lü Tian-li, NIE Li-min, et al. Observation on the efficacy of post-stroke dysphagia treated with He’s santong acupuncture therapy through surface electromyography: a randomized controlled trial[J]. Acupuncture research, 2022, 47(3): 256-261. DOI: 10.13702/j.1000-0607.20210197.
目的:利用表面肌电图(sEMG)观察贺氏三通法治疗脑卒中后吞咽障碍的临床疗效。方法:根据区组随机法将60例脑卒中后吞咽障碍患者分为常规治疗组及贺氏三通法组,每组30例。常规治疗组予脑卒中二级预防治疗及吞咽康复训练,贺氏三通法组在常规治疗组基础上予微通、温通、强通治疗(微通法常规针刺双侧风池、风府、翳风、廉泉、夹廉泉、丰隆和通里,留针30 min
每周5次;温通法:火针点刺双侧风池、廉泉,每周2次;强通法:三棱针点刺放血金津、玉液、咽后壁,每周2次)
均连续治疗4周。记录患者治疗前后纤维内镜吞咽功能检查(FEES)结合Rosenbek渗入-误吸量表(PAS)分级评分、才藤分级法评分、改良曼恩吞咽能力评估量表(MMASA)评分、sEMG最大波幅值。结果:与治疗前比较,两组治疗后FEES结合PAS分级评分均降低(P<0.05)
才藤分级评分、MMASA评分均升高(P<0.05)
贺氏三通法组sEMG最大波幅升高(P<0.05)
常规治疗组sEMG最大波幅降低(P<0.05)。治疗后,与常规治疗组比较,贺氏三通法组FEES结合PAS分级评分降低(P<0.05)
才藤分级评分、sEMG最大波幅均升高(P<0.05)。结论:贺氏三通法治疗脑卒中后吞咽障碍的临床疗效明显,可能与针刺相关穴位可增加吞咽相关肌群收缩能力,提高舌骨肌群最大波幅值有关。
Objective To observe the clinical therapeutic effect on post-stroke dysphagia treated with He's santong(triple promotion) acupuncture therapy through surface electromyography(sEMG). Methods A total of 60 patients with post-stroke dysphagia were divided into a routine treatment group and a He's santong acupuncture therapy group
using blocked randomization
30 cases in each one. In the routine treatment group
the secondary prevention and swallowing rehabilitation training were adopted. In the He's santong acupuncture therapy group
on the base of the treatment as the routine treatment group
weitong(mild promotion
routine acupuncture at bilateral Fengchi [GB20]
Fengfu [GV16]
Yifeng [TE17]
Lianquan [CV23]
Jia-lianquan [Extra]
Fenglong [ST40] and Tongli [HT5]
needle retaining for 30 min
5 treatments a week)
wentong(warm promotion
pricking with fire needle at bilateral GB20 and CV23
twice a week) and qiangtong(strong promotion
blood-letting with three-edge needle at Jinjin [EX-HN12]
Yuye [EX-HN13] and Yanhoubi [Extra]
twice a week) treatment was added. The therapy was given consecutively for 4 weeks in each group. The score of fiberoptic endoscopic examination of swallowing(FEES) and Rosenbek-penetration-aspiration scale(PAS)
the score of swallowing grading scale
the score of the modified Mann assessment of swallowing ability(MMASA) and the peak amplitude of sEMG were recorded before and after treatment in patients. Results Compared with before treatment
the score of FEES and PAS after treatment was decreased(P<0.05)
the scores of swallowing grading scale and MMASA after treatment were increased in both routine treatment group and He's santong acupuncture therapy group(P<0.05)
the peak amplitude of sEMG was increased(P<0.05) in the He's santong acupuncture therapy group and decreased(P<0.05) in the routine treatment group. Compared with the routine treatment group
the score of FEES and PAS was decreased(P<0.05)
the scores of swallowing grading scale and peak amplitude of sEMG were increased in the He's santong acupuncture therapy group(P<0.05). Conclusion He's santong acupuncture therapy is obviously effective on post-stroke dysphagia
which may be related to its effects in increasing the contraction of swallowing-related muscles and improving the peak amplitude of hyoid muscle group.
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