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舌咽局部深刺治疗中风后吞咽障碍85例
MENG Ying-chun (孟迎春), WANG Hai-quan (王海泉)
Acupuncture and Rehabilitation Department of Shandong Provincial Hospital Affiliated to Shandong University, Jinan 250021, Shandong Province, China（山东大学附属省立医院针灸理疗康复科，济南 250021，中国）
ARTICLE INFO
MENG Ying-chun (1977-), female, attending physician, medical doctor (MD).
Research field: acupuncture and moxibustion therapy on nervous system diseases and sub-health status.
E-mail:myc9866@163.com
Accepted on May 4, 2015
ABSTRACT
Objective To observe the clinical efficacy of deep needling at local glossopharyngeum in treatment of dysphagia after stroke. Methods Deep needling at local glossopharyngeum was applied in 85 patients with dysphagia after stroke. Firstly, quick prick was conducted on lingual surface (mainly at the side of paralysis lingualis), Jīnjīn (金津 EX-HN 12) and Yùyè (玉液 EX-HN 13) under the tongue; secondly, filiform needle with the length of 75 mm was used to perform quick prick at posterior wall of pharynx at the affected side about three or four times, and then the needle was removed rapidly. Filiform needle with the length of 75 mm was inserted perpendicularly at Liánquán (廉泉 CV 23) towards root of tongue; after deqi, the needle was pushed towards root of tongue in the depth of 60–70 mm, and the needle was retained for 30 min. Meanwhile, the patient was asked to swallow, and the feeling of abnormal deglutition without pain was considered as most appropriate. During needle retention, twirling for reinforcement was applied for two times. The manipulation was conducted once daily, and six days was considered as one course of treatment. Between two courses, one day was free of treatment; and there were four courses in total. Kubota’s drinking water test evaluation scale was applied to assess the efficacy after the treatment for two weeks and four weeks. Results The score of Kubota’s drinking water test at the early stage of treatment was 5.08?±?2.28, the score of evaluation of treatment with deep needling at local glossopharyngeum after treatment for two weeks was 4.56?±?2.32, and the total effective rate was 89.4%; the score of evaluation after treatment for four weeks was 2.80?±?2.12, and the total effective rate was 95.3%. Compare before the treatment, the score of Kubota’s drinking water test was reduced after treatment for two and four weeks (P<>P<>Conclusion Deep needling at local glossopharyngeum in treatment of dysphagia after stroke has good effect.
KEY WORDS: dysphagia; stroke; acupuncture therapy; the depth of acupuncture
ABSTRACT IN CHINESE
[摘 要] 目的：观察舌咽局部深刺治疗中风后吞咽障碍临床疗效。方法：对85例中风后吞咽障碍患者，采用舌咽局部深刺法，先快速点刺舌面（以舌瘫侧为主）、舌下金津、玉液，次取75 mm长度毫针点刺患侧咽后壁约3-4次后快速出针。再取廉泉穴，以75 mm长度毫针向舌根方向直刺，针刺得气后，向舌根方向推进留针，深度约60-70 mm，此时可令患者做吞咽动作，有障碍感但不疼痛为度，留针30 min，期间施捻转补法2次。以上操作每日1次，6天为一疗程，休息1天后进入第2疗程，共治疗4个疗程。以洼田氏饮水试验评价量表进行疗效评定，第2周及第4周结束后各评价１次。结果：治疗初期洼田氏饮水试验评分为5.08±2.28分，采用舌咽局部深刺法治疗第2周后评分为4.56±2.32分，总有效率为89.4%，第4周后评分为2.80±2.12分，总有效率为95.3%，治疗2周、4周后，洼田氏饮水试验评分均较治疗前明显降低（P<>，P<>）。结论：舌咽局部深刺治疗中风后吞咽障碍有较好的临床疗效。
[关键词]吞咽障碍?中风 针刺疗法?针刺深度
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