| 引用本文:王胜芳，张小容，赵萍，张海波.补阳还五汤合涤痰汤加减联合吞咽功能训练治疗脑梗死后吞咽障碍（痰瘀互结证）的临床效果[J].世界中医药,2019,(10):. |
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| 补阳还五汤合涤痰汤加减联合吞咽功能训练治疗脑梗死后吞咽障碍（痰瘀互结证）的临床效果 |
| Clinical Effects of Modified Buyang Huanwu Decoction and Ditan Decoction Combined with Swallowing Function Training on the Improvement of Patients with Dysphagia after Cerebral Infarction(Intermingled Phlegm and Blood Stasis Syndrome) |
| 投稿时间：2018-09-17 |
| DOI：10.3969/j.issn.1673-7202.2019.10.024 |
| 中文关键词: 脑梗死 吞咽障碍 痰瘀互结证 补阳还五汤合涤痰汤加减 吞咽功能训练 吞咽功能 神经功能 生命质量 |
| English Keywords:Cerebral infarction Dysphagia Intermingled phlegm and blood stasis syndrome Modified Buyang Huanwu Decociton and Ditan Decoction Swallowing function training Swallowing function Nervous function Quality of life |
| 基金项目:国家科技支撑计划项目(2013BAI13B032)；青海省自然科学基金项目(2015-ZJ-913) |
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| 中文摘要: |
| 目的：观察补阳还五汤合涤痰汤加减联合吞咽功能训练改善脑梗死后吞咽障碍（痰瘀互结证）患者的效果，探讨其对患者吞咽功能、神经功能及生命质量的影响。方法：选取2017年1月至2018年4月青海红十字医院收治的脑梗死后吞咽障碍患者90例作为研究对象，随机分为对照组和观察组，每组45例。对照组患者给予吞咽功能训练，观察组患者则在对照组基础上加用补阳还五汤合涤痰汤加减内服治疗，2组连续治疗4周为1个疗程。治疗前后采用吞咽造影检查(VFSS)评分评定吞咽障碍程度，采用洼田饮水试验评定吞咽功能，用神经功能缺损程度评分量表（NIHSS）评价神经功能缺损程度，采用吞咽生命质量问卷（SWAL-QOL）评价生命质量，比较2组的临床疗效。结果：观察组的有效率91.11%显著高于对照组的73.33%（P<0.05）；治疗前，2组患者的VFSS、神经功能、洼田饮水试验、吞咽生命质量评分比较，差异无统计学意义（P>0.05）；治疗后，2组患者的吞咽障碍程度VFSS评分、吞咽生命质量SWAL-QOL评分较治疗前明显升高，且观察组高于对照组（P<0.05）；神经功能缺损程度NIHSS评分及洼田饮水试验评分则较治疗前明显降低，且观察组低于对照组（P<0.05）；观察组患者的吞咽功能分级显著优于治疗前和对照组（P<0.05）。结论：补阳还五汤合涤痰汤加减联合吞咽功能训练利于促进脑梗死后吞咽障碍（痰瘀互结证）患者吞咽功能的恢复，改善神经功能，提高患者的生命质量，疗效确切，有一定的临床推广价值。 |
| English Summary: |
| To investigate the clinical efficacy of modified Buyang Huanwu Decociton and Ditan Decoction combined with swallowing function training on the improvement of patients with dysphagia after cerebral infarction(intermingled phlegm and blood stasis syndrome)，and to investigate the effects on patients' swallowing function，nerve function and quality of life.Methods:A total of 90 patients with dysphagia after cerebral infarction admitted in Qinghai Red Cross Hospital from January 2017 to April 2018 were randomly divided into a control group of 45 cases and an observation group of 45 cases.Patients in the control group were given swallowing function training; while patients in the observation group were treated with oral administration of modified Buyang Huanwu Decoction and Ditan Decoction on the basis of the control group，4 weeks as a treatment course.The swallowing disorder degree was determined by video fluoroscopic swallowing study(VFSS）before and after the treatment.The swallowing function was evaluated by potable water swallow test.The nerve function defect degree was evaluated by National Institute of Health Stroke Scale(NIHSS).The quality of life was evaluated by the swallowing quality of life questionnaire(SWAL-QOL).The clinical curative effects of the 2 groups were compared.Results:The effective rate of the observation group was 91.11%，which was significantly higher than that of the control group(P<0.05); Before treatment，there was no significant difference in VFSS，neurologic function，potable water test and swallowing survival quality score between the 2 groups(P>0.05).After the treatment，VFSS score and SWAL-QOL score of swallowing quality of the 2 groups of patients were significantly increased than before the treatment，and the observation group was higher than the control group(P<0.05); The NIHSS score and the potable water test score of nerve function defect degree were significantly decreased than those before treatment，and the observation group was lower than the control group(P<0.05); The swallowing function of the observation group was significantly better than before treatment and that of the control group(P<0.05).Conclusion:Modified Buyang Huanwu Decociton and Ditan Decoction combined with swallowing function training is helpful to promote swallowing disorder after cerebral infarction(intermingled phlegm and blood stasis syndrome）patients with swallowing function recovery，improve nerve function and the quality of life of patients，which has curative effect and certain clinical value. |
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