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针刺治疗中风慢性期中重度吞咽障碍机理探讨张 维 刘志顺 孙书臣 黄 漫 刘元石


  [摘要]目的:探讨针刺风府、人迎、廉泉、百劳治疗中风吞咽障碍的机理。方法:测定针刺前、后5分钟和疗前、疗后的吞咽相关肌肉肌电图和脑干诱发电位。结果:真性球麻痹患者疗后环甲肌振幅、时限及舌肌时限较疗前降低。假性球麻痹患者疗前、疗后各项指标变化差异无显著意义。结论:对于假性球麻痹吞咽障碍,针刺主要是调节皮质和脑干网状结构当中的吞咽中枢对于吞咽反射的控制作用,协调吞咽诸肌的运动;而对于真性球麻痹障碍, 针刺的作用主要是直接促使损伤的周围神经恢复,从而起到治疗效应。

  [主题词]吞咽障碍/针灸疗法;中风/针灸疗法

  study on mechanisms of acupuncture treatment for moderate-severe dysphagia at chronic stage of apoplexy

  zhang wei, liu zhishun, sun shuchen, et al. (guang'anmen hospital of china academy of tcm, beijing 100053, china)

  [abstract]purposeto study on mechanisms of acupuncture treatment for dysphagia due to apoplexy. methods electromyogram of swallowing-related muscles and evoked potentials in brainstem were determined before and after acupuncture treatment. results amplitude and time limit of cricothyroid muscle, and time limit of muscles of tongue in the patient of true bulbar paralysis after treatment decreased as compared with that before treatment respectively. there was no significant difference before and after treatment in the indexes in the patient of false bulbar paralysis. conclusion for swallowing disturbance due to false bulbar paralysis, acupuncture regulates mainly the cortex and the swallowing center of the reticular structure of brain stem to control swallowing reflection and coordinate motor of swallowing-related muscles; and for swallowing disturbance due to the true bulbar paralysis, acupuncture improves directly recovery of injuried peripheral nerves, resulting in therapeutic effects.

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