缺血性脑卒中合并偏瘫患者中西医结合口腔干预的临床效果OA
Clinical Effect of Integrated Traditional Chinese and Western Medicine Oral Intervention in Patients with Ischemic Stroke Complicated by Hemiplegia
目的 探讨中西医结合口腔干预方案对缺血性脑卒中合并偏瘫患者口腔健康、吞咽功能及神经恢复的临床疗效.方法 采用随机对照试验设计,纳入吴起县人民医院 2024 年 2 月—2025 年 6 月收治的 154 例缺血性脑卒中后偏瘫患者,随机分为西医组(基础口腔护理+神经肌肉电刺激)、中医组(中药含漱+舌针疗法)及联合组(中西医综合方案),干预 4 周.主要结局包括改良Beck口腔评分、标准吞咽功能评估(SSA)及卒中相关性肺炎(SAP)等并发症与不良反应发生率.结果 干预4周后,联合组Beck口腔评分降至(2.55±1.55)分,低于西医组(5.92±2.89)分和中医组(6.34±3.02)分(P<0.05),口腔清洁有效率(评分≤5 分)达 96.1%,较西医组(50.0%)和中医组(39.2%)高(P<0.05);吞咽功能比较:干预 4 周后,联合组 SSA 中风险患者(9.8%)低于西医组(30.8%)和中医组(39.2%)(P<0.05).缺血性脑卒中合并偏瘫患者在不同口腔康复方案下的并发症与安全性评价三组之间差异无统计学意义(P＞0.05).结论 中西医结合干预方案(神经肌肉电刺激+舌针+中药含漱)通过功能重建、感染防控及神经修复协同机制,显著改善缺血性脑卒中合并偏瘫患者口腔健康状况.
Objective To explore the clinical efficacy of an integrated traditional Chinese and Western medicine oral intervention in restoring the oral health,swallowing function,and neurological function in the patients with ischemic stroke complicated by hemiplegia.Methods A randomized controlled trial design was adopted.A total of 154 patients with post-ischemic stroke hemiplegia treated in the People's Hospital of Wuqi County from February 2024 to June 2025 were included.They were randomized into a Western medicine group(basic oral care+neuromuscular electrical stimulation),a traditional Chinese medicine group(Chinese herbal mouthwash+tongue acupuncture therapy),and an integrated treatment group(combined Chinese and Western medicine treatment).The intervention lasted for 4 weeks.The main outcomes included the modified Beck oral score,standard swallowing function assessment(SSA),and the incidence of complications and adverse reactions such as stroke-related pneumonia(SAP).Results After 4 weeks of intervention,the Beck oral score of the integrated treatment group decreased to(2.55±1.55)points,which was lower than that of the Western medicine group[(5.92±2.89)points]and the traditional Chinese medicine group[(6.34±3.02)points](P<0.05).The response rate of oral hygiene(score≤5 points)reached 96.1%in the combined group,which was higher than that of the Western medicine group(50.0%)and the traditional Chinese medicine group(39.2%)(P<0.05).Swallowing function comparison:After 4 weeks of intervention,the proportion of patients with moderate risk of SSA in the integrated treatment group(9.8%)was lower than that of the Western medicine group(30.8%)and the traditional Chinese medicine group(39.2%)(P<0.05).There was no statistically significant difference in the complications and safety among the three groups(P>0.05).Conclusion The integrated traditional Chinese and Western medicine intervention(neuromuscular electrical stimulation+tongue acupuncture+Chinese herbal mouthwash)significantly improves the oral health status of patients with ischemic stroke complicated by hemiplegia through the synergistic mechanism of functional reconstruction,infection prevention and control,and nerve repair.
侯利娜;王春艳;蔺彦霞
吴起县人民医院(陕西 延安 717600)吴起县中医医院针灸康复科(陕西 延安 717600)吴起县人民医院(陕西 延安 717600)
缺血性脑卒中偏瘫口腔健康中西医结合随机对照试验神经肌肉电刺激舌针疗法
ischemic strokehemiplegiaoral healthintegrated traditional Chinese and Western medicinerandomized controlled trialneuromuscular electrical stimulationtongue acupuncture therapy
《基层中医药》 2026 (7)
52-57,6
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