Objectives: 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).
Conclusions: 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.
目的: 采用纤维喉镜吞咽功能检查（FEES）观察针刺治疗创伤性脑损伤后吞咽障碍的临床疗效。方法: 将68例创伤性脑损伤后吞咽障碍患者随机分为对照组及针刺组，每组34例。对照组予内科基础治疗、常规康复治疗及吞咽康复训练，针刺组在对照组治疗的基础上针刺廉泉、夹廉泉及双侧人迎、双侧风池、风府，每次留针30 min;康复训练及针刺治疗均每日1次，每周6次，共治疗3周。于治疗前后比较两组患者洼田饮水试验评分、标准吞咽功能评定量表评分（SSA），采用FEES观察两组患者咽部感觉功能、咽部运动功能及分泌物积聚、渗漏-误吸、食物残留情况。结果: 两组患者治疗后洼田饮水试验评分、SSA评分均较治疗前下降（P<0.05），针刺组优于对照组（P<0.05）;两组患者咽部感觉功能、咽部运动功能、分泌物积聚评分、渗漏-误吸评分、食物残留程度均较治疗前改善（P<0.05），针刺组优于对照组（P<0.05）。针刺组总有效率为94.12%（32/34），优于对照组的79.41%（27/34，P<0.05）。结论: 在常规内科治疗及康复训练的基础上，针刺治疗可有效改善创伤性脑损伤后吞咽功能障碍患者的吞咽功能，尤其在咽部运动功能、感觉功能方面表现出显著效果，并且能有效减少咽喉部分泌物的聚集及吞咽时食物渗漏、误吸和残留的程度。.
Keywords: Acupuncture therapy; Dysphagia following traumatic brain injury; Fiberoptic endoscopic evaluation of swallowing (FEES); Swallowing function.