摘要
Abstract
Objective To evaluate the preventive effect of head and neck acupuncture combined with a meridian-guided pulmo-nary function training device on aspiration pneumonia in patients with post-stroke dysphagia.Methods A total of 90 patients with post-stroke dysphagia admitted to our hospital from January 2022 to January 2024 were enrolled in this randomized controlled tri-al.They were randomly divided into three groups in a 1∶1∶1 ratio:the combined group(swallowing function training+head and neck acupuncture+meridian-guided pulmonary function training device,n=30),the acupuncture group(swallowing function train-ing+head and neck acupuncture,n=30),and the pulmonary function training device group(swallowing function training+me-ridian-guided pulmonary function training device,n=30).The intervention lasted for 8 weeks.The incidence of aspiration pneumoni-a,improvements in swallowing function,pulmonary function indices,nutritional status,and safety were observed in all three groups.Results During the observation period,the incidence of aspiration pneumonia was 1 case(3.33％)in the combined group,which was significantly lower than 6 cases(20.00％)in the acupuncture group and 5 cases(16.67％)in the pulmonary function training device group(x2=4.038,P=0.133).After 8 weeks of intervention:① Swallowing function:All three groups showed improved Functional Oral Intake Scale(FOIS)grades,decreased Standardized Swallowing Assessment(SSA)scores,shortened swallowing time,and increased average and maximum electromyographic values compared with pre-intervention.All indices in the combined group were significantly superior to those in the acupuncture group and the pulmonary function training device group(all P＜0.05).②Pulmonary function:Forced expiratory volume in one second(FEV1),forced vital capacity(FVC),and maximal voluntary ventila-tion(MVV)were improved in all three groups compared with pre-intervention.Indices in the combined group were significantly higher than those in the pulmonary function training device group,and indices in the pulmonary function training device group were higher than those in the acupuncture group(all P＜0.05).③Nutritional indices:Serum albumin(ALB),prealbumin(PAB),and retinol-binding protein(RBP)levels increased in all three groups compared with pre-intervention.All indices in the combined group were significantly higher than those in the acupuncture group and the pulmonary function training device group(all P＜0.05).④Safety:During the intervention,1 case(3.33％)in the combined group and 2 cases(6.67％)in the acupuncture group experi-enced mild bleeding at acupuncture sites,which stopped after compression and did not affect treatment.No adverse reactions occurred in the pulmonary function training device group(x2=2.069,P=0.355).Conclusion Head and neck acupuncture combined with a meridian-guided pulmonary function training device can more effectively reduce the risk of aspiration pneumonia in patients with post-stroke dysphagia.The mechanism involves synergistic effects of neural regulation,enhanced respiratory function,improved swal-lowing muscle function,and optimized nutritional status,which significantly improve swallowing safety,pulmonary function,and nutri-tional indices.Its clinical application is safe.关键词
吸入性肺炎/吞咽障碍/头项针/经络导引肺功能训练器/预防Key words
aspiration pneumonia/dysphagia/head and neck acupuncture/meridian-guided pulmonary function training device/preventive
