首页|李氏一指禅推拿联合Vocastim-Master吞咽言语诊治仪治疗脑卒中吞咽功能障碍的疗效观察

李氏一指禅推拿联合Vocastim-Master吞咽言语诊治仪治疗脑卒中吞咽功能障碍的疗效观察

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目的 观察李氏一指禅推拿联合Vocastim-Master吞咽言语诊治仪治疗脑卒中吞咽功能障碍的疗效.方法 将60例脑卒中吞咽功能障碍患者随机分为对照组和观察组,每组30例,实际对照组完成30例,治疗组29例.两组均予以常规内科治疗及常规吞咽功能康复训练,对照组采用Vocastim-Master吞咽言语诊治仪治疗,观察组在对照组治疗的基础上联合李氏一指禅推拿治疗.治疗前和治疗3周后分别采用吞咽功能评分、改良曼恩吞咽能力评估量表(modified Mann assessment of swallowing ability,MMASA)评价吞咽功能,采用临床肺部感染评分(clinical pulmonary infection score,CPIS)评价肺部感染情况,采用改良 Barthel 指数(modified Barthel index,MBI)评价日常生活活动能力,采用肌骨超声测定舌骨—甲状软骨间距离缩短率(approximation shortening rate,ASR),并根据治疗前后洼田饮水试验分级变化判定临床疗效.结果 与治疗前比较,治疗后两组患者吞咽功能评分、CPIS、舌骨与甲状软骨之间的最短距离(minimum hyoid-larynx approximation,MIHLA)显著降低(P<0.05),MMASA评分、MBI、ASR显著升高(P<0.05);观察组吞咽功能评分、CPIS、MIHLA降低程度和MMASA评分、MBI、ASR升高程度显著大于对照组(P<0.05).观察组基于洼田饮水试验分级的临床疗效明显优于对照组(P<0.05).结论 李氏一指禅推拿联合Vocastim-Master吞咽言语诊治仪治疗能够改善脑卒中的吞咽功能障碍患者吞咽功能,降低肺部感染发生率,提高 日常生活活动能力,修复舌骨与甲状软骨相互靠近的机制.
Clinical Effect of Li's One-thumb Massage Combined with Vocastim-Master Swal-lowing Speech Diagnosis and Treatment Instrument in Treatment of Swallowing Dysfunction in Stroke Patients
Objective To investigate the clinical effect of Li's one-thumb massage combined with Vocastim-Master swallowing speech diagnosis and treatment instrument in the treatment of swallowing dysfunction in stroke patients.Methods A total of 60 stroke patients with swallowing dysfunction were randomly divided into control group and observation group,with 30 patients in each group.The patients in the control group were given conventional medical treatment,swallowing functional rehabilitation training,and Vocastim-Master swallowing speech diagnosis and treatment instrument,and those in the observation group were given Li's one-thumb massage in addition to the treatment in the control group.Before treatment and after 3 weeks of treat-ment,swallowing function score and modified Mann assessment of swallowing ability(MMASA)were used to evaluate swallo-wing function;clinical pulmonary infection score(CPIS)was used to evaluate pulmonary infection;modified Barthel index(MBI)was used to evaluate the activities of daily living;musculoskeletal ultrasound was used to measure the shortening rate of the distance between the hyoid bone and thyroid cartilage;clinical outcome was evaluated based on the change in water swallow test after treatment.Results After treatment,both groups had significant reductions in swallowing function score,CPIS,and minimum hyoid-larynx approximation(MIHLA)(P<0.05)and significant increases in MMASA score,MBI,and approxima-tion shortening rate(ASR)(P<0.05),and compared with the control group,the observation group had significantly greater reductions in swallowing function score,CPIS,and MIHLA and significantly greater increases in MMASA score,MBI,and ASR(P<0.05).Compared with the control group,the observation group had a significantly better clinical outcome based on water swallow test(P<0.05).Conclusion In the treatment of stroke patients with swallowing dysfunction,Li's one-thumb massage combined with Vocastim-Master swallowing speech diagnosis and treatment instrument can improve swallowing function,reduce the incidence rate of pulmonary infection,increase the activities of daily living,and repair the mechanism leading to the reduction in the distance between the hyoid bone and thyroid cartilage.

Li's one-thumb massageSwallowing speech diagnosis and treatment instrumentStrokeSwallowing function

栾国瑞、张宇、占茂林、吕子萌、张燕、刘晓丽、杜鹏、储小芳、孙翔

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安徽中医药大学第三附属医院,安徽合肥 230031

安徽中医药大学第一附属医院,安徽合肥 230031

李氏一指禅推拿 吞咽言语诊治仪 脑卒中 吞咽功能

安徽省卫生健康委员会科研项目国家中医药管理局国医大师工作室建设项目

AHWJ2021b0392018-474

2024

安徽中医药大学学报
安徽中医学院

安徽中医药大学学报

CSTPCD
影响因子:0.796
ISSN:2095-7246
年,卷(期):2024.43(1)
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