[1]张雯,金海涛,王非,等.不同频率电针廉泉穴联合吞咽康复训练对脑卒中吞咽障碍患者疗效及血清BDNF、SP水平的影响[J].西部中医药,2023,36(07):125-129.[doi:10.12174/j.issn.2096-9600.2023.07.31]
　ZHANG Wen,JIN Haitao,WANG Fei,et al.Clinical Effects of Different Frequency Electroacupuncture at Lianquan Points and Swallowing Rehabilitation Training in the Treatment of Dysphagia after Stroke and the Influence on the Levels of Serum BDNF and SP[J].Western Journal of Traditional Chinese Medicine,2023,36(07):125-129.[doi:10.12174/j.issn.2096-9600.2023.07.31]
点击复制

不同频率电针廉泉穴联合吞咽康复训练对脑卒中吞咽障碍患者疗效及血清BDNF、SP水平的影响
分享到：

《西部中医药》[ISSN:2096-9600/CN:62-1204/R]

卷:
36
期数:
2023年07期
页码:
125-129
栏目:
出版日期:
2023-07-15

文章信息/Info

Title:
Clinical Effects of Different Frequency Electroacupuncture at Lianquan Points and Swallowing Rehabilitation Training in the Treatment of Dysphagia after Stroke and the Influence on the Levels of Serum BDNF and SP
作者:
张雯, 金海涛, 王非, 刘麒麟, 靳晶
武汉市中医医院脑病科，湖北 武汉 430061
Author(s):
ZHANG Wen, JIN Haitao, WANG Fei, LIU Qilin, JIN Jing
Department of Encephalopathy, Wuhan Hospital of Traditional Chinese Medicine, Wuhan 430061, China
关键词:
吞咽障碍; 脑卒中; 脑源性神经营养因子; P物质; 脑血流不同频率电针; 吞咽康复训练
Keywords:
dysphagia;  stroke; BDNF; P substance; cerebral blood flow; different frequencies electroacupunc-tureswallowing rehabilitation training
分类号:
R245.31+9
DOI:
10.12174/j.issn.2096-9600.2023.07.31
文献标志码:
B
摘要:
目的探讨不同频率电针廉泉穴联合吞咽康复训练对脑卒中吞咽障碍患者疗效及血清脑源性神经营养因子（brain-derived neurotrophic factor，BDNF）、P物质（substance P，SP）水平的影响。 方法将144例脑卒中吞咽障碍患者采用随机数字表法分为参照组、低频组、高频组各48例，参照组患者给予吞咽康复训练，低频组在参照组基础上给予1 Hz电针廉泉穴，高频组在参照组基础上给予5 Hz电针廉泉穴。观察3组患者临床疗效、吞咽功能、脑血流、血清BDNF与SP水平及不良反应发生率。 结果总有效率低频组为95.83%（46/48），高频组为81.25%（39/48），均高于参照组的68.75%（33/48）（P＜0.05），低频组高于高频组（P＜0.05）。治疗后低、高频组患者大脑动脉收缩期峰值流速（spectral atlas systolic peak velocity，Vs）、平均流速（mean velocity，Vm）高于参照组，搏动指数（pulsatility index，PI）、标准吞咽功能评价量表评分（standardized swallowing assessment，SSA）评分低于参照组（P＜0.05）；低频组Vs、Vm高于高频组，PI、SSA低于高频组（P＜0.05）。治疗后低、高频组BDNF、胰岛素样生长因子1（insulin-like growth factor-1，IGF-1）及SP水平高于参照组（P＜0.05），低频组高于高频组（P＜0.05）。3组患者治疗期间不良反应发生率比较差异无统计学意义（χ2=0.447，P=0.800）。 结论低频率电针廉泉穴联合吞咽康复训练可提高脑卒中吞咽障碍患者BDNF、SP水平，改善其吞咽功能，疗效优于单纯吞咽康复训练及高频率电针廉泉穴联合吞咽康复训练。
Abstract:
ObjectiveTo explore clinical effects of different frequency electroacupuncture at Lianquan (RN23) points and swallowing rehabilitation training in the treatment of dysphagia after stroke, and the influence of BDNF and SP. MethodsAll 144 patients were allocated to reference group, low frequency group and high frequency group using random number table method with 48 cases in each group, the patients in the reference group accepted swallowing rehabilitation training, low frequency group received 1 Hz electroacupuncture at Lianquan points on the foundation of the therapy the reference group accepted, high frequency group 5 Hz electroacupuncture at Lianquan points based on swallowing rehabilitation training. To observe clinical effects, swallowing function, cerebral blood flow, the levels of serum BDNF and SP and the incidence of adverse reaction in three groups. ResultsTotal effective rates of low frequency group and high frequency group were 95.83%（46/48） and 81.25%（39/48）, higher than 68.75%（33/48） of the reference group (P<0.05), low frequency group was higher than high frequency group (P<0.05). After the treatment, Vs and Vm of low frequency group and high frequency group were higher than these of the reference group, PI and SSA lower than these of the reference group (P<0.05); Vs and Vm of low frequency group were higher than these of high frequency group, PI and SSA were lower than these of high frequency group (P<0.05). After the treatment, the levels of BDNF, IGF-1 and SP of low frequency group and high frequency group were higher than these of the reference group (P<0.05), low frequency group was higher than high frequency group (P<0.05). The difference had no statistical meaning in the incidence of adverse reaction between three groups during therapeutic period (χ2=0.447, P=0.800). ConclusionLow frequency electroacupuncture at Lianquan (RN23) points combined with swallowing rehabilitation training could raise the levels of BDNF and SP in the treatment of dysphagia after stroke, improve the patients' swallowing function, and its clinical effects better than these of single swallowing rehabilitation training, as well as high frequency electroacupuncture in combination with swallowing rehabilitation training.

相似文献/References:

[1]胡敏棣,李晓娟,边笑梅.中医体质学说在脑卒中防治中的应用[J].西部中医药,2012,25(10):99.
　HU Min-li,LI Xiao-juan,BIAN Xiao-mei.Application of TCM Constitution Theory to the Prevention of Cerebral Apoplexy[J].Western Journal of Traditional Chinese Medicine,2012,25(07):99.
[2]刘智斌,牛晓梅,王 渊,等.针刺“新膀胱俞”穴治疗脑卒中后尿潴留疗效观察[J].西部中医药,2013,26(01):100.
　LIU Zhibin,NIU Xiaomei,WANG Yuan,et al.Observation on Therapeutic Effects of Needling“Xin PangGuang Shu"[J].Western Journal of Traditional Chinese Medicine,2013,26(07):100.
[3]何君芳,冯海霞△,姚惠侠,等.甘肃省脑卒中康复治疗现状*[J].西部中医药,2012,25(12):118.
　HE Jun-fang,FENG Hai-xia,YAO Hui-xia,et al.On Rehabilitation Treatments for Cerebral Apoplexy in Gansu Province[J].Western Journal of Traditional Chinese Medicine,2012,25(07):118.
[4]李飞.针灸联合神经肌肉电刺激治疗脑出血伴吞咽障碍51例[J].西部中医药,2013,26(03):109.
　LI Fei.Acupuncture and Neuromuscular Electrical Stimulation in the Treatment for 51 Cases of Cerebral Hemorrhage Complicated with Dysphagia[J].Western Journal of Traditional Chinese Medicine,2013,26(07):109.
[5]陈松涛.蒙古族人群原发性高血压ABPM参数与脑卒中筛查的相关性分析[J].西部中医药,2013,26(06):35.
　CHEN Songtao.Study on ABPM Parameter of Primary Hypertension in Mongolian Nationality and Screening of Cerebral Apoplexy[J].Western Journal of Traditional Chinese Medicine,2013,26(07):35.
[6]姚惠侠,冯海霞△,何君芳,等.脑卒中患者对负性情绪及心理治疗认知状况的调查[J].西部中医药,2012,25(08):56.
　YAO Hui-xia,FENG Hai-xia,HE Jun-fang,et al.Survey on Stroke Patients′ Cognition of Negative Emotion and Psychological Treatment[J].Western Journal of Traditional Chinese Medicine,2012,25(07):56.
[7]陈松涛.蒙古族人群原发性高血压晨峰现象与脑卒中筛查的研究分析[J].西部中医药,2013,26(07):56.
　CHEN Songtao.Study between Cerebral Apoplexy Screening and Morning Surge in Patients from Mongolian Nationality with Primary Hypertension[J].Western Journal of Traditional Chinese Medicine,2013,26(07):56.
[8]李西兄.早期康复介入对急性脑卒中偏瘫患者运动功能的影响[J].西部中医药,2013,26(07):107.
　LI Xixiong.Effects of Early Rehabilitation Intervention on Motor Function of Hemiplegic Patients with Acute Cerebral Apoplexy[J].Western Journal of Traditional Chinese Medicine,2013,26(07):107.
[9]曾贤翠,王文彦,顾克繁,等.白银市气象因素与脑卒中的相关性研究[J].西部中医药,2012,25(07):55.
　ZENG Xian-cui,WANG Wen-yan,GU Ke-fan,et al.Relativity Study between Cerebral Apoplexy and Meteorological Factors of Baiyin Municipality[J].Western Journal of Traditional Chinese Medicine,2012,25(07):55.
[10]刘超,李成山,李妍怡△.中风膏对缺血性脑卒中患者血小板聚集率的影响[J].西部中医药,2013,26(12):5.
　LIU Chao,LI Chengshan,LI Yanyi.Effects of ZhongFeng Ointment on Platelet Aggregation Rate of the Patients with Ischemic Stroke[J].Western Journal of Traditional Chinese Medicine,2013,26(07):5.
[11]赵红梅,李宝娥,贺艳霞,等.护理干预在脑卒中后吞咽障碍治疗中的应用价值[J].西部中医药,2015,28(06):133.[doi:2015/6/16 0:00:00]
[12]杨春林,包兄兄.球囊扩张术对卒中后假性球麻痹引起吞咽障碍患者训练的可行性分析及质量把控[J].西部中医药,2022,35(08):147.[doi:10.12174/j.issn.2096-9600.2022.08.36]
　YANG Chunlin,BAO Xiongxiong.Feasibility Analysis of Balloon Dilatation Applied in Training Patients with Dysphagia Caused by Pseudobulbar Paralysis after Stroke and Its Quality Control[J].Western Journal of Traditional Chinese Medicine,2022,35(07):147.[doi:10.12174/j.issn.2096-9600.2022.08.36]

备注/Memo

备注/Memo:
张雯（1983—），女，硕士学位，主治医师。研究方向：神经系统疾病的针灸治疗。武汉市医学科研项目（WZ20C36）。
更新日期/Last Update: 2023-07-15