Objective: To observe the clinical efficacy on post-stroke cricopharyngeus muscle dysfunction treated with auricular acupuncture of magnetic pellet combined with catheter balloon dilatation, and the effect on the adverse reaction during catheter balloon dilatation and the patients' quality of life.
Methods: A total of 106 patients with post-stroke cricopharyngeus muscle dysfunction were randomly divided into an observation group (53 cases, 3 cases dropped off, 1 case excluded) and a control group (53 cases, 5 cases dropped off). The catheter balloon dilatation was provided in the control group, once a day. In the observation group, on the base of the treatment as the control group, auricular acupuncture of magnetic pellet was added. Before catheter balloon dilatation, the magnetic pellet was pressed at Yanhou (TG3), Xin (CO15), Naogan (AT3,4i), etc. These auricular points were pressed 5 min, as well as in every morning and evening for another 5 min, totally 3 times a day. The auricular acupuncture of magnetic pellet was applied on the ears alternatively each time, once every 3 days. One session treatment contained 6 days and 4 sessions of treatment were required in both groups. Before and after treatment, the scores of standardized swallowing assessment (SSA), Rosenbek penetration-aspiration scale (PAS) and swallowing quality of life (SWAL-QOL) were observed in both groups. Separately, on day 1 (T1) of treatment, in 2 weeks into treatment (T2) and on the last day of treatment (T3), the score of visual analogue scale (VAS) was recorded in both groups. The incidence of nausea and vomiting and the clinical efficacy were compared between the two groups.
Results: After treatment, SSA and PAS scores were reduced (P<0.05) and SWAL-QOL scores were increased (P<0.05) in both groups compared with those before treatment, and the changes in the observation group were larger than those in the control group (P<0.05). At T2 and T3, VAS scores were lower than those at T1 in both groups (P<0.05), while VAS score at each time point in the observation group was lower than that of the control group (P<0.05). The incidence of nausea and vomiting in the observation group was 51.0% (25/49), lower than the control group (79.2%, 38/48, P<0.05). The total effective rate was 95.9% (47/49) in the observation group, better than the control group (87.5%, 42/48, P<0.05).
Conclusion: Auricular acupuncture of magnetic pellet combined with catheter balloon dilatation effectively improve the swallowing function, relieve the discomforts during the dilatation and promote the quality of life in patients with post-stroke cricopharyngeus muscle dysfunction.
目的：观察耳穴磁贴联合导管球囊扩张术治疗脑卒中后环咽肌功能障碍的临床疗效及对导管球囊扩张术中不良反应、患者生活质量的影响。方法：将106例脑卒中后环咽肌功能障碍患者随机分为观察组（53例，脱落3例、剔除1例）和对照组（53例，脱落5例）。对照组采用导管球囊扩张术治疗，每天1次；观察组在对照组治疗基础上加用耳穴磁贴疗法，每次导管球囊扩张术治疗前按压咽喉、心、脑干等耳穴5 min，早晚各再按压5 min，每天共3次，两耳交替进行，3 d更换1次。两组均治疗6 d为一疗程，共治疗4个疗程。分别于治疗前后观察两组标准吞咽功能评估量表（SSA）评分、Rosenbek渗透/误吸量表（PAS）评分、吞咽生活质量量表（SWAL-QOL）评分；并于治疗第1天（T1）、治疗2周后（T2）、治疗最后1 d（T3）记录两组疼痛视觉模拟量表（VAS）评分；比较两组恶心呕吐发生率及临床疗效。结果：与治疗前比较，两组患者治疗后SSA、PAS评分降低（P<0.05），SWAL-QOL评分升高（P<0.05），且观察组评分变化幅度均大于对照组（P<0.05）。两组患者T2、T3时VAS评分均低于T1时（P<0.05），观察组各时点VAS评分均低于对照组（P<0.05）。观察组恶心呕吐的发生率为51.0%（25/49），低于对照组的79.2%（38/48，P<0.05）。观察组总有效率为95.9%（47/49），优于对照组的87.5%（42/48，P<0.05）。结论：耳穴磁贴联合导管球囊扩张术能有效改善脑卒中后环咽肌功能障碍患者的吞咽功能，缓解操作过程中患者不适症状，提高患者生活质量。.
Keywords: auricular acupuncture of magnetic pellet; catheter balloon dilatation; cricopharyngeus muscle dysfunction; dysphagia; randomized controlled trial (RCT); stroke.