胞磷胆碱钠联合针刺治疗脑梗死后吞咽障碍的疗效观察

Curative effect of citicoline and sodium acupuncture in treating swallowing disorder after cerebral infarction

关键词:  脑梗死  吞咽障碍  胞磷胆碱钠  针刺疗法

Key words:  cerebral infarction  swallowing disorders  citicoline sodium  acupuncture

摘要:

[目的]评价在常规治疗基础上加用胞磷胆碱钠并联合针刺疗法对脑梗死后吞咽功能障碍的临床疗效。[方法]将100例脑梗死伴吞咽功能障碍的患者按随机数字表法随机分为试验组50例和对照组50例，两组患者均给予相同的常规治疗，试验组在此基础上予口服胞磷胆碱钠胶囊，并配合针刺廉泉、左右夹廉泉、人迎、金津、玉液、翳风、风池等穴位治疗。治疗14 d后运用洼田饮水试验进行疗效评估，对比两组疗法对改善吞咽功能障碍的疗效差异，比较两组的肺炎发生率，并运用美国国立卫生研究院卒中量表（NIHSS）评分、Barthel（BI）指数评估两组患者在改善神经功能缺损症状，提高日常生活自理能力方面的疗效水平。[结果]经治疗后两组吞咽功能均较前有改善，试验组总有效率为96%，优于对照组总有效率82%，差异具有统计学意义（P<0.05）；试验组肺炎发生率为6%，显著低于对照组的24%，差异具有统计学意义（P<0.05）；在改善患者神经功能缺损症状方面，试验组治疗后NIHSS评分（10.5±5.2）分，低于对照组（11.4±5.0）分；两组患者BI指数均较治疗前有所提高，且试验组治疗后BI指数（55.6±10.9）高于对照组（51.04±10.6），差异均具有统计学意义（P<0.05）。[结论]胞磷胆碱钠联合针刺疗法在脑梗死后吞咽功能障碍的治疗中具有较好的临床疗效，能显著降低患者肺炎发生率，同时能够改善患者神经功能缺损，提高患者生活自理能力。

Abstract:

[Objective] To evaluate the clinical curative effect of adding citicoline and acupuncture on swallowing dysfunction after cerebral infarction on the basis of routine treatment.[Methods] One hundred patients with cerebral infarction and swallowing dysfunction were randomized into two groups according to random number table 50 cases in the control group and 50 cases in the control group. The patients in both groups were given the same routine treatment. On the basis of this group, the patients in the experimental group were treated with oral citicoline sodium capsules and acupuncture at Lianquan, Yu liquid, wind, wind pool and other points of treatment. After 14 days of treatment, the Kubota drinking water test was used to evaluate the curative effect. The difference of curative effect between the two groups in improving swallowing dysfunction was compared. The incidence of pneumonia was compared between the two groups. NIHSS score and Barthe I index were used to evaluate the neurological deficits Symptoms, improve self-care ability of everyday life level of efficacy.[Results] After treatment, the swallowing function of both groups improved compared with the former. The total effective rate in the experimental group was 96%, which was better than that in the control group (82%), the difference was statistically significant (P<0.05). The incidence of pneumonia in the experimental group was (P<0.05). The NIHSS score (10.5±5.2) in the experimental group was significantly lower than that in the control group (11.4±5.0). The BI index in both groups was higher than that before treatment, and the BI index (55.6±10.9) in the experimental group was significantly higher than that in the control group (51.04±10.6) (P<0.05).[Conclusion] Citicoline combined with acupuncture has good clinical curative effect in the treatment of swallowing dysfunction after cerebral infarction, can significantly reduce the incidence of pneumonia in patients, at the same time can improve neurological deficits and improve patients' self-care ability.