针刺研究2025，Vol.50Issue(11)：1308-1316,9.DOI:10.13702/j.1000-0607.20250421
基于视频吞咽造影检查观察头针结合针刺颈前五穴对脑卒中后吞咽障碍患者的影响
Effects of scalp acupuncture combined with five points in the anterior cervical region on patients with post-stroke dysphagia based on videofluoroscopic swallow study
摘要
Abstract
Objective To observe the effects on swallowing reflex latency(SRL),the distances of hyoid bone forward and upward movements in the patients with post-stroke dysphagia(PSD)based on videofluoroscopic swallow study(VFSS)after treated with scalp acupuncture combined with five points in the anterior cervical region.Methods Sixty-six patients with PSD were randomly divided into a trial group(33 cases,1 case dropped out)and a control group(33 cases,1 case dropped out).The basic treatment with neurological medicine and with acupuncture for stroke(Neiguan[PC6],Sanyinjiao[SP6],Chize[LU5]and Weizhong[BL40]on the affected side)were provided in the two groups.Besides,in the trial group,scalp acupuncture was delivered and combined with five points in the anterior cervical region;and in the control group,acupuncture was applied to Shuigou(GV26),Lianquan(CV23),Tongli(HT5)and Zhaohai(KI6).The treatment was administered once daily,for 30 min each time;and 2 weeks of treatment were required,with the interval of 1 d after 6 interventions.Using VFSS,SRL and the distances of hyoid bone forward and upward movements were assessed before and after treatment in the 2 groups;and the changes in the scores of standardized swallowing assessment(SSA),water swallowing test(WST),and swallowing quality of life questionnaire(SWAL-QOL)were observed.The correlation was analyzed between VFSS indicators and scale assessment results.Results Compared with those before treatment,SRL was shortened(P<0.01),the distances of hyoid bone forward and upward movements increased(P<0.01)in both groups.When compared with the control group after treatment,SRL was shorter(P<0.01),the distances of hyoid bone forward and upward movements were longer(P<0.01)in the trial group.SSA score was reduced in comparison with that before treatment in either group(P<0.01),and the score in the trial group was lower than that of the control group(P<0.01).The WST grade was better after treatment in both groups(P<0.01),and the grade in the trial group was superior to that in the control group(P<0.05).SWAL-QOL score was increased after treatment in both groups(P<0.01),and the score in the trial group was higher than that of the control group(P<0.01).The clinical effective rate was 93.75%(30/32)in the trial group,which was higher than that(81.25%,26/32)in the control group(P<0.05).The correlation analysis showed that the SSA score and WST grade were positively correlated with SRL before and after treatment(P<0.01),and were negatively correlated with the distances of hyoid bone forward and upward movements(P<0.01).During trial,no obvious adverse reactions occurred.Conclusion Acupuncture at head points,combined with the five points in the anterior cervical region significantly shortens SRL,increases the distances of hyoid bone forward and upward movements and effectively improves swallowing function and quality of life in the patients.SRL and the distances of hyoid bone forward and upward movements can be taken as the objective indicators to assess dysphagia in clinic.Scalp acupuncture combined with the five points in the anterior cervical region is effective and safe on PSD.关键词
卒中后吞咽障碍/头针/颈前五穴/视频吞咽造影Key words
Post-stroke dysphagia/Scalp acupuncture/Five points in the anterior cervical region/Videofluoroscopic swallow study引用本文复制引用
李诺,李晓宁,赵永烈,周晓卿..基于视频吞咽造影检查观察头针结合针刺颈前五穴对脑卒中后吞咽障碍患者的影响[J].针刺研究,2025,50(11):1308-1316,9.基金项目
黑龙江省头雁团队项目基金(No.2019-9) （No.2019-9）
