目的:观察皮内针埋针对脑卒中后吞咽障碍患者的吞咽功能和表面肌电图的影响,评价其临床疗效.方法:将脑卒中后吞咽障碍患者80例,按随机数字表法分为治疗组和对照组,每组40例.对照组除神经内科常规药物治疗外,给予神经肌肉电刺激(NMES)和吞咽功能训练,治疗组在对照组的基础上给予皮内针埋针治疗.10d为1个疗程,治疗2个疗程.治疗前、后对两组患者进行吞咽功能评分评定和表面肌电图(sEMG)检测.结果:治疗后,两组患者吞咽功能评分较治疗前均升高(P＜0.05),且治疗组评分高于对照组(P＜0.05);两组患者在3种状态下(放松、干吞咽、咽水)舌骨肌群的sEMG最大波幅较治疗前均明显升高(P＜0.05),且治疗组波幅高于对照组(P＜0.05).结论:皮内针埋针配合NMES、吞咽功能训练治疗脑卒中后吞咽障碍,可显著提高其吞咽功能.%Objective To observe the clinical efficacy of intradermal needle-embedding therapy in the treatment of dysphagia in stroke patients.Methods A total of 80 stroke patients with dysphagia were randomly divided into treatment group and control group (n =40 in each).The control group was treated with conventional medicines,neuromuscular electrical stimulation of the bilateral midlines of the neck and swallowing function training,and the treatment group treated by intradermal needleembedding at Lianquan (CV 23),Jialianquan-point,Yifeng (TE 17),Ashi-point,etc.(once every other day for 20 days) on the basis of the treatments used in the control group.Swallowing function (0-10 points scaling,the bigger the better)and surface electromyography (sEMG) of the bilateral suprahyoid muscles and infrahyoid muscles in the relaxing,nothing swallowing and water-swallowing conditions were tested before and after the treatment.Results After treatment,the swallowing scores were significantly increased in both groups compared with those of their individual pre-treatment (P＜0.05),suggesting an improvement of swallowing function.During relaxing,nothing swallowing and water-swallowing conditions,the peak amplitudes of sEMG were considerably increased in both groups relevant to those of their individual pre-treatment (P ＜ 0.05).The swallowing function score,and maximum amplitudes of sEMG during relaxing,nothing swallowing and water-swallowing conditions were significantly higher in the treatment group than in the control group (P＜0.05),suggesting a better efficacy of intradermal needle-embedding treatment.Conclusion Intradermal needle-embedding can significantly improve the swallowing function of stroke patients with dysphagia.
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