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河南中医药大学附属驻马店市中医院康复医学科,河南驻马店 463000
陈清云,E-mail:chenlil2007@163.com
收稿:2025-07-11,
修回:2025-09-23,
网络首发:2026-02-27,
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刘怡,焦琪,白云杰,等.门德尔松手法联合廉泉热敏灸对脑卒中后吞咽障碍患者吞咽功能及并发症的干预效果[J].针刺研究,XXXX,XX(XX):1-8.
LIU Yi,JIAO Qi,BAI Yun-jie,et al.Effect of Mendelsohn maneuver combined with heat-sensitive moxibustion at Lianquan (CV23) on swallowing function and complications in patients with post-stroke dysphagia[J].Acupuncture Research,
刘怡,焦琪,白云杰,等.门德尔松手法联合廉泉热敏灸对脑卒中后吞咽障碍患者吞咽功能及并发症的干预效果[J].针刺研究,XXXX,XX(XX):1-8. DOI: 10.13702/j.1000-0607.20250739.
LIU Yi,JIAO Qi,BAI Yun-jie,et al.Effect of Mendelsohn maneuver combined with heat-sensitive moxibustion at Lianquan (CV23) on swallowing function and complications in patients with post-stroke dysphagia[J].Acupuncture Research, DOI:10.13702/j.1000⁃0607.20250739.
目的
2
探究廉泉热敏灸、门德尔松手法联合治疗脑卒中后吞咽障碍的效果。
方法
2
选取105例脑卒中后吞咽障碍患者,采用随机数字表法分成3组,每组35例。对照1组采用门德尔松手法,对照2组采用廉泉热敏灸,观察组采用门德尔松手法联合廉泉热敏灸,均连续治疗4周。比较3组患者的临床疗效、咽侧壁活动度、舌骨喉复合体动度、表面肌电信号(sEMG)、吞咽功能[洼田俊夫饮水试验(WST)、标准吞咽功能评价量表(SSA)、吞咽X线电视透视检查(VFSS)]、吞咽障碍特异性生活质量量表(SWAL-QOL)、营养状态[血清前白蛋白(PA)、白蛋白(ALB)、转铁蛋白(TRF)水平]及并发症、不良反应情况。
结果
2
观察组总有效率94.29%,高于对照1组(71.43%)和对照2组(68.57%,
P
<
0.05)。治疗4周后,观察组、对照1组和对照2组咽侧壁活动度、舌骨上移及前移、甲状软骨上移及前移距离、最大波幅值、VFSS评分、生活质量评分、血清ALB、TRF、PA水平均较治疗前升高(
P
<
0.05),且观察组高于对照1组和对照2组(
P
<
0.05);吞咽时程、WST、SSA评分均较治疗前降低(
P
<
0.05),且观察组低于对照1组和对照2组(
P
<
0.05)。在干预过程中仅对照2组有1例患者施灸部位出现小水泡,且干预前后3组患者一般生命体征和常规检查未见明显异常;随访3个月时观察组并发症发生率(2.86%)低于对照1组(25.71%)和对照2组(31.43%,
P
<
0.05)。
结论
2
门德尔松手法联合廉泉热敏灸可有效强化脑卒中后吞咽障碍患者咽缩肌,改善sEMG,促进吞咽功能恢复,并在降低相关并发症、提升机体营养和生活质量方面具有积极作用。
Objective To investigate the effect of heat-sensitive moxibustion at Lianquan (CV23) combined with the Mendelsohn maneuver in the treatment of post-stroke dysphagia.
Methods
2
A total of 105 patients with post-stroke dysphagia from January 2024 to February 2025 were selected and divided into three groups by random number table method, with 35 cases in each group. Control group 1 received the Mendelsohn maneuver, control group 2 received heat-sensitive moxibustion at Lianquan (CV23), and the observation group received the Mendelsohn maneuver combined with heat-sensitive moxibustion at CV23. All groups were treated continuously for 4 weeks. The clinical efficacy, lateral pharyngeal wall movement, mobility of the hyolaryngeal complex, surface electromyography (sEMG) signals, swallowing function including Water Swallowing Test (WST), Standardized Swallowing Assessment (SSA), and Videofluoroscopic Swallowing Study (VFSS), Swallowing Quality of Life Questionnaire (SWAL-QOL), nutritional status including serum levels of prealbumin (PA), albumin (ALB), transferrin (TRF), as well as complications and adverse reactions were compared among the three groups.
Results
2
The total effective rate of the observation group was 94.29%, which was higher than 71.43% in control group 1 and 68.57% in control group 2 (
P
<
0.05). After 4 weeks of treatment, the lateral pharyngeal wall movement, superior and anterior displacement of the hyoid bone, superior and anterior displacement of the thyroid cartilage, maximum amplitude of sEMG, VFSS score, quality of life score, and serum levels of ALB, TRF, and PA in the observation group, control group 1, and control group 2 were all increased compared with before treatment (
P
<
0.05), and those in the observation group were higher than those in control group 1 and control group 2 (
P
<
0.05). The swallowing duration, WST grade, and SSA score were decreased compared with before treatment (
P
<
0.05), and those in the observation group were lower than those in control group 1 and control group 2 (
P
<
0.05). During intervention, only 1 patient in control group 2 had small blisters at the moxibustion site, and no significant abnormalities were found in general vital signs and routine examinations among the three groups before and after intervention. At 3-month follow-up, the complication rate in the observation group (2.86%) was lower than that in control group 1 (25.71%) and control group 2 (31.43%,
P
<
0.05).
Conclusion
2
The Mendelsohn maneuver combined with heat-sensitive moxibustion at CV23 can effectively activate the pharyngeal constrictor muscles, improve sEMG signals, promote the recovery of swallowing function in patients with post-stroke dysphagia, and exert positive effects in reducing related complications, improving nutritional status and quality of life.
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