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高冰洁, 顾雪彤, 李晓宁.针刺颈前五穴对卒中后吞咽障碍患者吞咽功能及血清炎症因子的影响[J].湖南中医药大学学报,2026,46(1):82-89[点击复制] |
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| 针刺颈前五穴对卒中后吞咽障碍患者吞咽功能及血清炎症因子的影响 |
| 高冰洁,顾雪彤,李晓宁 |
| (黑龙江中医药大学第二临床医学院, 黑龙江 哈尔滨 150040;黑龙江中医药大学附属第二医院针灸科, 黑龙江 哈尔滨 150001) |
| 摘要: |
| 目的 观察针刺颈前五穴对卒中后吞咽障碍（PSD）患者吞咽功能及血清炎症因子的影响。方法 采用随机数字表法将66例PSD患者分为颈前五穴组与常规针刺组，各33例，试验过程中颈前五穴组脱落1例、常规针刺组脱落1例，最终纳入颈前五穴组32例、常规针刺组32例。两组患者均予以神经内科基础治疗和卒中病基础针刺治疗，在此基础上，颈前五穴组予以针刺颈前五穴、常规针刺组予以常规针刺治疗，疗程均为14 d。治疗前后，比较两组患者的洼田饮水试验（WST）等级、标准吞咽功能评价量表（SSA）评分、吞咽生活质量量表（SWAL-QOL）评分、血清超敏C反应蛋白（hs-CRP）及血清肿瘤坏死因子-α（TNF-α）的变化情况；治疗后，比较两组患者的临床疗效和不良反应发生情况。结果 治疗后，两组WST等级均较治疗前降低（P＜0.01），等级分布优化，且颈前五穴组优于常规针刺组（P＜0.01）；两组SSA评分均较治疗前降低（P＜0.01），且颈前五穴组低于常规针刺组（P＜0.05）；两组SWAL-QOL评分均较治疗前升高（P＜0.01），且颈前五穴组高于常规针刺组（P＜0.05）；两组血清hs-CRP、TNF-α水平均较治疗前降低（P＜0.01），且颈前五穴组均低于常规针刺组（P＜0.05）；颈前五穴组临床总有效率（93.75%）明显高于常规针刺组（81.25%）（P＜0.01），且两组均无不良事件发生。结论 针刺颈前五穴治疗PSD可有效改善患者吞咽功能及生活质量，同时降低血清炎症因子hs-CRP和TNF-α水平，安全性较高，且优于常规针刺治疗。 |
| 关键词: 卒中后吞咽障碍 颈前五穴 针刺 吞咽功能 生活质量 超敏C反应蛋白 肿瘤坏死因子-α |
| DOI：10.3969/j.issn.1674-070X.2026.01.010 |
| 投稿时间：2025-08-06 |
| 基金项目:国家中医药管理局高水平中医药重点学科建设项目（14061230010）；黑龙江省自然科学基金项目（PL2024H228）；黑龙江省中医药科研项目（GY2022-09）。 |
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| Effects of acupuncture at five anterior cervical acupoints on swallowing function and serum inflammatory factors in patients with post-stroke dysphagia |
| GAO Bingjie, GU Xuetong, LI Xiaoning |
| (The Second Clinical Medical School, Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150040, China;Department of Acupuncture, The Second Hospital of Heilongjiang University of Chinese Medicine, Harbin, Heilongjiang 150001, China) |
| Abstract: |
| Objective To observe the effects of acupuncture at the five anterior cervical acupoints on swallowing function and serum inflammatory factors in patients with post-stroke dysphagia (PSD). Methods A total of 66 PSD patients were divided into five anterior cervical acupoints group and conventional acupuncture group using a random number table method, with 33 cases in each group. During the trial, one case dropped out from the five anterior cervical acupoints group and one from the conventional acupuncture group, resulting in the final inclusion of 32 cases in each group. All patients in both groups were administered basic neurological treatment and basic acupuncture treatment for stroke. On this basis, the five anterior cervical acupoints group received specific acupuncture at the five anterior cervical acupoints, while the conventional acupuncture group received conventional acupuncture treatment. The treatment course was 14 days for both groups. Before and after treatment, the water swallowing test (WST) grade, standardized swallowing assessment (SSA) score, swallowing quality of life (SWAL-QOL) questionnaire score, serum high-sensitivity C-reactive protein (hs-CRP), and serum tumor necrosis factor-α (TNF-α) levels were compared between the two groups. After treatment, the clinical efficacy and occurrence of adverse reactions were compared between the two groups. Results After treatment, the WST grades of both groups decreased compared to before treatment (P＜0.01), with an optimized grade distribution, and the five anterior cervical acupoints group was superior to the conventional acupuncture group (P＜0.01); the SSA scores of both groups decreased compared to before treatment (P＜0.01), and the score of the five anterior cenvical acpoints group was lower than that of the conventional acupuncture group (P＜0.05). The SWAL-QOL scores of both groups increased compared to before treatment (P＜0.01), and the score of the five anterior cervical acpoints group was higher than that of the conventional acupuncture group (P＜0.05); The serum levels of hs-CRP and TNF-α in both groups decreased compared to before treatment (P＜0.01), and the levels of the five anterior cervical acupoints group were lower than those in the conventional acupuncture group (P＜0.05). The total clinical effective rate of the five anterior cervical acupoints group (93.75%) was significantly higher than that in the conventional acupuncture group (81.25%) (P＜0.01), and no adverse events occurred in either group. Conclusion Acupuncture at the five anterior cervical acupoints for PSD can effectively improve patients' swallowing function and quality of life, while reducing serum inflammatory factors (hs-CRP and TNF-α) levels. It is safer and more effective than conventional acupuncture treatment. |
| Key words: post-stroke dysphagia five anterior cervical acupoints acupuncture swallowing function quality of life high-sensitivity C-reactive protein tumor necrosis factor-α |
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