纤维喉镜吞咽功能检查评估针刺治疗创伤性脑损伤后吞咽障碍的临床疗效OA

Objective To investigate the clinical therapeutic effect on dysphagia following traumatic brain injury(TBI)treated with acupuncture using fiberoptic endoscopic evaluation of swallowing(FEES).Methods A total of 68 patients with dysphagia following TBI were enrolled and randomly divided into a control group and an acupuncture group,with 34 patients in each group.In the control group,the routine medical treatment and swallowing rehabilitation training were given.On the basis of the treatment as the control group,the patients in the acupuncture group received acupuncture at Lianquan(CV23),Jia-lianquan(Extra),bilateral Renying(ST23)and Fengchi(GB20),and Fengfu(GV16),with needles retained for 30 min in each treatment.The treatment was delivered once daily,with 6 treatments a week,and for a total of 3 weeks in the two groups.The scores of the standard swallowing assessment(SSA)and Kubota's water swallow test were compared between the two groups before and after treatment.FEES was used to observe the pharyngeal sensory function,pharyngeal motor function,accumulation of secretions,leakage-aspiration and food residue of the two groups.Results The scores of SSA and Kubota's water swallow test in both groups were reduced in comparison with those before treatment,and the decrease range in the acupuncture group was greater than that in control group(P<0.05).Pharyngeal sensory function,pharyngeal motor function,the score for accumulation of secretion,leakage-aspiration score and food residue degree were all improved in both groups compared with those before treatment,and the improvements in the acupuncture group were superior to the control group(P<0.05).The total effective rate in the acupuncture group was 94.12%(32/34),which was better than that of the control group(79.41%,27/34,P<0.05).Conclusion On the basis of routine medical treatment of internal medicine and rehabilitation training,acupuncture therapy significantly improves swallowing function in patients with dysphagia following TBI,particularly in enhancing pharyngeal motor function and sensory function.Besides,acupuncture effectively reduces the accumulation of pharyngeal secretions,and the severity of food leakage,aspiration,and residue during swallowing.