化痰通络汤结合项针治疗风痰阻络证卒中后吞咽障碍患者的临床疗效

袁强强; 孙璐璐; 郑琦; 孔令忠; 张坤

doi:10.16766/j.cnki.issn.1674-4152.004426

化痰通络汤结合项针治疗风痰阻络证卒中后吞咽障碍患者的临床疗效

doi: 10.16766/j.cnki.issn.1674-4152.004426

亳州市人民医院针灸科，安徽亳州 236800

基金项目:

安徽省临床医学研究转化专项项目 202304295107020113

详细信息

通讯作者:
袁强强，E-mail：15805516816@163.com

中图分类号: R246.6 R743.3
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- 文章访问数: 12
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- PDF下载量: 1
- 被引次数: 0
出版历程
- 收稿日期: 2025-10-12
- 网络出版日期: 2026-06-02

The clinical efficacy of Huatan Tongluo Decoction+Acupuncture on nuchal region for dysphagia disorder after stroke with wind-phlegm-blocked collateral syndrome

Department, Bozhou People's Hospital, Bozhou, Anhui 236800, China

摘要

摘要: 目的本研究旨在验证化痰通络汤结合项针的临床有效性,明确其改善患者吞咽功能、减轻临床症状的作用并提供诊疗参考。方法研究对象为2024年3月-2025年8月在亳州市人民医院治疗的94例风痰阻络证卒中后吞咽障碍患者,以随机数字表法分为对照组(47例,采用常规治疗联合康复训练)及观察组(47例,在对照组基础上采用化痰通络汤结合项针治疗),比较2组患者的临床疗效、中医证候积分、吞咽功能、炎症因子水平及不良反应发生率。结果治疗4周后,观察组治疗总有效率为95.74%(45/47),高于对照组的80.85%(38/47,χ²=5.045,P=0.025);治疗4周后,观察组中医证候积分更低(P<0.05);治疗4周后,观察组吞咽功能Ⅰ级占比为29.79%,较对照组的12.77%高(P<0.05);治疗4周后,观察组炎症因子水平均低于对照组(P<0.05);2组不良反应发生率分别为6.38%(3/47)、12.77%(6/47),差异无统计学意义(χ²=0.490,P=0.483)。结论化痰通络汤结合项针治疗风痰阻络证卒中后吞咽障碍的效果较好,可显著改善患者的吞咽困难症状,并提高吞咽功能,减轻炎症反应,安全性较高。
- 化痰通络汤 /
- 项针 /
- 风痰阻络证卒中后吞咽障碍 /
- 临床疗效
Abstract: Objective To verify the clinical effect of Huatan Tongluo Decoction combined with acupuncture,clarify its role in improving patients'swallowing function and alleviating clinical symptoms,and provide a reference for diagnosis and treatment. Methods A total of 94 patients with dysphagia disorder after stroke with wind-phlegm-blocked collateral syndrome treated in Bozhou People's Hospital from March 2024 to August 2025 were chosen and separated into the control group (n=47,conventional treatment+rehabilitation training) and the observation group (n=47,Huatan Tongluo Decoction+acupuncture on the nuchal region on the basis of the control group) by random number table method.The clinical efficacy,TCM syndrome score,swallowing function,inflammatory factor level,and adverse reactions were compared. Results After 4 weeks of treatment,the total effective rate of the observation group was 95.74%(45/47),which was higher than that of the control group (80.85%,38/47,χ²=5.045,P=0.025);after 4 weeks of treatment,the TCM syndrome score of the observation group was lower (P<0.05);after 4 weeks of treatment,the proportion of grade Ⅰ swallowing function in the observation group was 29.79%,which was higher than that of the control group (12.77%,P<0.05);after 4 weeks of treatment,the levels of inflammatory factors in the observation group were lower than those in the control group (P<0.05);the incidence of adverse reactions in the two groups was 6.38%(3/47) and 12.77%(6/47) respectively,and there was no significant difference (χ²=0.490,P=0.483). Conclusion Huatan Tongluo Decoction combined with acupuncture on the nuchal region has a good effect on dysphagia disorder after stroke,which can significantly improve the symptoms of dysphagia,improve the swallowing function,reduce inflammation,and have high safety.
- Huatan Tongluo Decoction /
- Acupuncture on nuchal region /
- Dysphagia after stroke in wind-phlegm-blocked collateral syndrome /
- Clinical effect

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表 1 2组风痰阻络证卒中后吞咽障碍患者临床疗效比较[例(%)]

Table 1. Comparison of clinical efficacy of patients with dysphagia after stroke due to wind-phlegm-blocked collateral syndrome [cases (%)]

组别	例数	基本痊愈	显效	有效	无效	总有效
观察组	47	26(55.32)	12(25.53)	7(14.89)	2(4.26)	45(95.74)
对照组	47	11(23.40)	21(44.68)	6(12.77)	9(19.15)	38(80.85)
统计量		2.990^a				5.045^b
P值		0.003				0.025
注：^a为Z值，^b为χ²值。

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表 2 2组风痰阻络证卒中后吞咽障碍患者治疗前后中医证候积分比较(x±s，分)

Table 2. Comparison of TCM syndrome scores before and after treatment for patients with dysphagia after stroke of wind-phlegm-blocked collateral syndrome (x±s, points)

组别	例数	口眼歪斜		言语表达含混不清		肢体麻木无力
组别	例数	治疗前	治疗4周	治疗前	治疗4周	治疗前	治疗4周
观察组	47	4.37±0.28	2.12±0.33^b	4.25±0.41	2.04±0.39^b	4.06±0.43	1.97±0.46^b
对照组	47	4.29±0.32	2.46±0.36^b	4.14±0.47	2.37±0.42^b	4.12±0.38	2.25±0.41^b
统计量		1.290^a	22.802^c	1.209^a	15.557^c	0.717^a	9.703^c
P值		0.200	<0.001	0.230	<0.001	0.475	0.003

组别	例数	饮水呛咳不止		视物昏蒙		痰黏难咯
组别	例数	治疗前	治疗4周	治疗前	治疗4周	治疗前	治疗4周
观察组	47	2.06±0.52	1.03±0.29^b	2.33±0.25	1.11±0.13^b	1.94±0.48	0.92±0.21^b
对照组	47	1.97±0.54	1.24±0.27^b	2.26±0.31	1.26±0.17^b	1.86±0.51	1.05±0.23^b
统计量		0.823^a	13.204^c	1.205^a	23.196^c	0.783^a	8.204^c
P值		0.413	0.001	0.231	<0.001	0.436	0.005
注：^a为t值，^c为F值;与同组治疗前比较，^bP<0.05。

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表 3 2组风痰阻络证卒中后吞咽障碍患者治疗前后吞咽功能比较[例(%)]

Table 3. Comparison of swallowing function before and after treatment in patients with dysphagia after stroke of wind-phlegm-blocked collateral syndrome [cases (%)]

组别	例数	治疗前					治疗4周
组别	例数	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级	Ⅰ级	Ⅱ级	Ⅲ级	Ⅳ级	Ⅴ级
观察组	47	0	23(48.94)	17(36.17)	7(14.89)	0	14(29.79)	25(53.19)	6(12.77)	2(4.26)	0
对照组	47	0	22(46.81)	20(42.55)	5(10.64)	0	6(12.77)^a	21(44.68)	16(34.04)	4(8.51)	0
Z值		0.030					2.850
P值		0.977					0.004
注：与观察组比较，^aP<0.05。

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表 4 2组风痰阻络证卒中后吞咽障碍患者治疗前后炎症因子水平比较(x±s)

Table 4. Comparison of inflammatory factor levels before and after treatment of patients with post-stroke dysphagia of wind-phlegm-blocked collateral syndrome (x±s)

组别	例数	IL-4(pg/mL)		TNF-α(μg/L)		hs-CRP(mg/L)
组别	例数	治疗前	治疗4周	治疗前	治疗4周	治疗前	治疗4周
观察组	47	33.42±2.69	11.09±0.83^b	0.89±0.21	0.48±0.11^b	6.43±0.54	3.07±0.48^b
对照组	47	32.84±2.76	12.52±0.92^b	0.86±0.23	0.61±0.13^b	6.29±0.62	3.51±0.53^b
统计量		1.032^a	62.535^c	0.660^a	27.258^c	1.167^a	17.761^c
P值		0.305	<0.001	0.511	<0.001	0.246	<0.001
注：^a为t值，^c为F值;与同组治疗前比较，^bP<0.05。

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表 5 2组风痰阻络证卒中后吞咽障碍患者不良反应发生率比较[例(%)]

Table 5. Comparison of the incidence of adverse reactions in patients with dysphagia after stroke of wind-phlegm-blocked collateral syndrome [cases (%)]

组别	例数	视线模糊	呼吸困难	发热	头晕	总发生
观察组	47	0	0	1(2.13)	2(4.26)	3(6.38)
对照组	47	2(4.26)	1(2.13)	2(4.26)	1(2.13)	6(12.77)
注：2组不良反应总发生率比较，χ²=0.490，P=0.483。

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