中文摘要：

目的 研究吞咽训练配合针刺对病程超过1个月的慢性期不同病程脑卒中和脑外伤患者吞咽障碍的影响.方法 将符合入选标准的吞咽障碍患者61例分成治疗组（n=30）和对照组（n=31）.再根据病程的不同将2组患者分别分成2个亚组：病程1～2个月组（治疗组n=14,对照组n=17）和病程＞2个月组（治疗组n=16,对照组n=14）.治疗组患者在吞咽训练的基础上配合舌咽和颈项部腧穴针刺,每周针刺治疗5 d,4周为1个疗程,共治疗2个疗程,疗程间休息1周;对照组患者只接受吞咽训练,每周5 d,每日1次,每次30 min,连续训练9周.在治疗前后进行疗效评价.结果 治疗结束后,各组的吞咽评分较治疗前均有显著提高（P＜0.01）,且治疗组的吞咽评分提高更为明显,与对照组比较差异有统计学意义（P＜0.01）.分别比较2组患者不同病程亚组间吞咽评分增加值,治疗组2个亚组之间差异无统计学意义（P＞0.05）,对照组之间差异亦无统计学意义（P＞0.05）.2组患者疗效比较,治疗组的治愈率（40.0%）显著高于对照组（16.1%）,差异有统计学意义（P＜0.05）,而总有效率比较,差异无统计学意义（P＞0.05）.结论 吞咽训练配合针刺能够改善脑卒中和脑外伤吞咽障碍患者的吞咽功能,且病程的长短对疗效无影响.

英文摘要：

Objective To study the effect of swallowing training combined with acupuncture on patients with dysphagia more than one month after stroke or traumatic brain injury （TBI）. Methods 61 patients with dysphagia meeting the inclusion criteria were randomly divided into a control group （31 cases） and a treatment group （30 cases）. Both groups were subdivided according to the course of disease-1 ～ 2 months or 〉 2 months. The patients in the control group received only swallowing training, 30 min per day, 5 times a week for 9 weeks. The patients in the treatment group were treated with the same swallowing training as the control group, additionally combined with acupuncture at the acupoints around the neck, including Lianquan （Ren23）, Jinjin （EX-HN12）, Yuye （EX-HNI3）,Fengchi （GB20） , Yifeng （SJ17） and Wangu （GB12）. Acupuncture was performed 5 times a week, 30 min per session for 8-week courses with a week＇s break between them. Results Both groups and their sub-groups demonstrated statistically and clinically significant improvements in swallowing function. Scores in the 2 treatment subgroups showed more improvement than in the control group. There was, however, no significant difference between the 2 treated subgroups in either their post-treatment or pre-treatment swallowing function scores. The cure rate in the treatment group was significantly higher than in the control group, but there was no significant difference in the total effectiveness rate between the two groups. Conclusion Swallowing training alone or combined with acupuncture can improve the swallowing of patients with chronic neurogenic dysphagia. The combination therapy was more effective. The improvement was not related with the course of the disease.