头针对脑性瘫痪吞咽障碍儿童吞咽功能的影响

许金波; 韩辉; 童光磊

doi:10.16766/j.cnki.issn.1674-4152.002783

头针对脑性瘫痪吞咽障碍儿童吞咽功能的影响

doi: 10.16766/j.cnki.issn.1674-4152.002783

1.
复旦大学附属儿科医院安徽医院康复科，安徽合肥 230051
2.
安徽省中医院脑病科，安徽合肥 230031

基金项目:

国家自然科学基金面上项目 8167141718

安徽省重点研究与开发计划项目 1804h08020254

安徽医科大学校科研基金项目 2020xkj076

详细信息

通讯作者:
童光磊, E-mail: tong704@sina.com

中图分类号: R245.321 R742.3
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- 文章访问数: 241
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- 被引次数: 0
出版历程
- 收稿日期: 2022-08-05
- 网络出版日期: 2023-02-07

Effect of scalp acupuncture on swallowing function in children with pharyngeal dysphagia of cerebral palsy

1.
Department of Rehabilitation, Anhui Hospital Affiliated to the Pediatric Hospital of Fudan University, Hefei, Anhui 230051, China

摘要

摘要: 目的观察在神经肌肉电刺激和吞咽康复训练的基础上，联合头针治疗脑性瘫痪吞咽障碍的临床疗效。方法选取2020年6月—2022年6月于复旦大学附属儿科医院安徽医院就诊的脑性瘫痪吞咽障碍患者40例。采用随机数字表法分成头针组与康复组，每组20例。2组患者均给予常规康复治疗，康复组采用神经肌肉电刺激和吞咽康复训练，头针组在康复组基础上加用头针治疗，头针穴取顶颞前斜线、顶颞后斜线下2/5，2组均每日治疗1次，每周治疗6 d，共治疗4周。分别于治疗前后观察2组患者吞咽障碍造影评分量表(VDS)评分、洼田饮水试验评级、进食能力分级系统(EDACS)评级、吞咽障碍调查表(DDS)评分。结果治疗后，2组患者VDS评分、DDS评分较治疗前降低，洼田饮水试验评级、EDACS评级较治疗前改善(均P＜0.05)。头针组VDS评分[(29.20±1.99)分]、DDS评分[(10.55±1.63)分]低于康复组[(31.30±3.92)分、(11.80±1.58)分，均P＜0.05]。头针组洼田饮水试验评级、EDACS评级改善程度优于康复组(均P＜0.05)。结论在神经肌肉电刺激及吞咽康复训练基础上联合头针能提高脑性瘫痪吞咽障碍的临床疗效，改善患者吞咽功能及生活质量。
- 脑性瘫痪 /
- 头针 /
- 吞咽障碍 /
- 神经肌肉电刺激
Abstract: Objective To observe the therapeutic effect of scalp acupuncture for pharyngeal dysphagia of cerebral palsy on the basis of neuromuscular electrical stimulation (NMES) and swallowing rehabilitation training. Methods A total of 40 patients with pharyngeal dysphagia who were admitted to Anhui Hospital Affiliated to the Pediatric Hospital of Fudan University from June 2020 to June 2022 were selected and randomized into a scalp acupuncture group and a rehabilitation group, 20 cases in each group. Routine rehabilitation training was given in both groups. NMES and swallowing rehabilitation training were adopted in the rehabilitation group. On the basis of the treatment in the rehabilitation group, scalp acupuncture was given in the scalp acupuncture group. Scalp acupuncture was applied at lower 2/5 of anterior and posterior oblique lines of parietal and temporal. The treatment was given once a day, 6 days a week for 4 weeks. Before and after treatment, the videofluoroscopic dysphagia scale (VDS) score, Kubota water swallowing test grade, eating and drinking ability classification system (EDACS) grade, and dysphagia disorder survey (DDS) score were observed in both groups. Results After treatment, the VDS score and the DDS score were decreased compared before treatment (all P < 0.05), and the Kubota water swallowing test grade and EDACS grade were improved compared before treatment (all P < 0.05) in both groups. The VDS score and DDS score of the scalp acupuncture group were lower than those of the rehabilitation group [(29.20±1.99) points vs. (31.30±3.92) points, (10.55±1.63) points vs. (11.80±1.58) points, all P < 0.05]. The improvement degree of Kubota water swallowing test grade and EDACS grade in the scalp acupuncture group were better than those in the rehabilitation group (all P < 0.05). Conclusion Based on NMES and swallowing rehabilitation training, scalp acupuncture can enhance the therapeutic effect on pharyngeal dysphagia of cerebral palsy, and improve the patients' swallowing function and quality of life.
- Cerebral palsy /
- Scalp acupuncture /
- Pharyngeal dysphagia /
- Neuromuscular electrical stimulation

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表 1 2组脑性瘫痪吞咽障碍患者一般资料比较

Table 1. Comparison of general data of patients with pharyngeal dysphagia of cerebral palsy in two groups

组别	例数	性别(例)		年龄(x±s，岁)	病因[例(%)]
组别	例数	男	女	年龄(x±s，岁)	早产	缺氧	黄疸	其他
头针组	20	12	8	5.30±1.76	5	10	4	1
康复组	20	11	9	5.05±1.43	6	12	2	0
统计量		0.102^a		0.480^b	1.906^a
P值		0.749		0.634	0.748
注：^a为χ²值，^b为t值。

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表 2 2组脑性瘫痪吞咽障碍患者治疗前后VDS评分比较(x±s，分)

Table 2. Comparison of VDS scores before and after treatment in patients with pharyngeal dysphagia of cerebral palsy in two groups(x±s, points)

组别	例数	治疗前	治疗后
头针组	20	38.55±2.04	29.20±1.99^a
康复组	20	37.35±3.08	31.30±3.92^a
t值		-1.452	2.136
P值		0.155	0.042
注：与同组治疗前比较，^aP＜0.05。

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表 3 2组脑性瘫痪吞咽障碍患者治疗前后洼田饮水试验评级比较(例)

Table 3. Comparison of Watian drinking water test grade before and after treatment in patients with pharyngeal dysphagia of cerebral palsy in two groups (cases)

组别	例数	治疗前					治疗后
组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级
头针组	20	0	0	2	11	7	6	9	3	2	0
康复组	20	0	0	1	11	8	2	7	6	5	0
Z值		-0.474					-2.082
P值		0.635					0.037
注：2组治疗前后比较，均P＜0.05。

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表 4 2组脑性瘫痪吞咽障碍患者治疗前后EDACS评级比较(例)

Table 4. Comparison of EDACS grade before and after treatment in patients with pharyngeal dysphagia of cerebral palsy in two groups (cases)

组别	例数	治疗前					治疗后
组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级
头针组	20	0	2	4	11	3	12	5	1	1	0
康复组	20	0	3	3	12	2	6	8	2	4	0
Z值		-0.302					-2.148
P值		0.762					0.032
注：2组治疗前后比较，均P＜0.05。

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表 5 2组脑性瘫痪吞咽障碍患者治疗前后DDS评分比较(x±s，分)

Table 5. Comparison of DDS scores before and after treatment in patients with pharyngeal dysphagia of cerebral palsy in two groups (x±s, points)

组别	例数	治疗前	治疗后
头针组	20	14.65±2.64	10.55±1.63^a
康复组	20	14.30±1.87	11.80±1.58^a
t值		-4.484	2.460
P值		0.632	0.019
注：与同组治疗前比较，^aP＜0.05。

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