摘要
目的 观察地黄止痉汤联合血管紧张素转化酶抑制剂(Angiotensin converting enzyme inhibitors, ACEI)治疗老年吞咽困难合并高血压患者的临床效果。方法 选取2023年11月—2024年5月南京中医药大学附属中西医结合医院收治的72例吞咽困难合并高血压患者,按随机数字表法分为对照组35例和观察组37例。两组患者均接受常规吞咽功能训练,对照组在此治疗的基础上给予ACEI治疗,观察组在对照组治疗的基础上给予地黄止痉汤治疗。连续治疗28 d。观察比较两组患者临床疗效,治疗前后洼田饮水试验分级(Water swallow test, WST)、标准吞咽功能评价量表评分(Standardized swallowing assessment, SSA)(包括:口唇控制、意识情况、自主咳嗽及吞咽能力)、吞咽障碍生活质量量表评分(Swallowing quality of life, SWAL-QOL)(包括:进食恐惧、食欲、心理健康、语言交流等)、血压(收缩压、舒张压)、血清脑源性神经营养因子水平(Brain-derived neurotrophic factor, BDNF)、P物质水平。结果 治疗后观察组临床总有效率89.19%(33/37)明显高于对照组68.57%(24/35),差异有统计学意义(P<0.05)。治疗后两组患者WST、SSA评分均较治疗前降低,SWAL-QOL评分均较治疗前升高,差异有统计学意义(P<0.05);且观察组WST、SSA评分均明显低于对照组,SWAL-QOL评分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者收缩压、舒张压水平均较治疗前降低,差异有统计学意义(P<0.05);且观察组收缩压、舒张压水平均明显低于对照组,差异有统计学意义(P<0.05)。治疗后两组患者BDNF、P物质水平均较治疗前升高,差异有统计学意义(P<0.05);且观察组BDNF、P物质水平均明显高于对照组,差异有统计学意义(P<0.05)。结论 地黄止痉汤联合ACEI治疗老年吞咽困难并高血压患者可有效改善吞咽功能,并改善血压水平。
Objective To investigate the clinical effect of Dihuang Zhijing Decoction combined with angiotensin-converting enzyme inhibitors(ACEI)in treating elderly patients with dysphagia and hypertension.Methods A total of 72patients with dysphagia and hypertension treated in the Affiliated Hospital of Integrated Traditional Chinese and WesternMedicine of Nanjing University of Chinese Medicine from November 2023 to May 2024 were selected and assigned by therandom number table method into a control group(n=35)and an observation group(n=37).All the patients received routine swallowing function training.The control group was treated with ACEI,and the observation group was treated with Dihuang Zhijing Decoction on the basis of the therapy in the control group.Both groups were treated for 28 consecutive days.The clinical efficacy was compared between the two groups of patients.The water swallow test(WST)score,standardizedswallowing assessment(SSA)scores(lip control,consciousness,and autonomous coughing and swallowing ability),swallowing quality of life(SWAL-QOL)scores(fear of eating,appetite,mental health,and language communication),bloodpressure(systolic blood pressure and diastolic blood pressure),and serum levels of brain-derived neurotrophic factor(BDNF)and substance P were compared between before and after treatment as well as between the two groups.Results The total clinical response rate in the observation group was 89.19%(33/37),which was higher than that(68.57%,24/35)inthe control group(P<0.05).After treatment,both groups showed declined WST and SSA scores and raised SWAL-QOLscores(P<0.05).Moreover,the observation group had lower WST and SSA scores and high SWAL-QOL scores than thecontrol group(P<0.05).After treatment,the systolic blood pressure and diastolic blood pressure in both groups becamelower(P<0.05).Moreover,the systolic blood pressure and diastolic blood pressure in the observation group were lowerthan those in the control group(P<0.05).After treatment,the levels of BDNF and substance P in both groups increased(P<0.05),and the observation group had higher levels of BDNF and substance P than the control group(P<0.05).Conclusion Dihuang Zhijing Decoction combined with ACEI can effectively improve the swallowing function and lowerblood pressure in the elderly patients with dysphagia and hypertension.
作者
王海翔
缪卫红
刘红权
毛文晴
陆王娟
李慧
WANG Hai-xiang;MIAO Wei-hong;LIU Hong-quan;MAO Wen-qing;LU Wang-juan;LI Hui(Department of Geriatrics,Affiliated Hospital of Integrated Traditional Chinese and Western Medicine,Nanjing Universityof Chinese Medicine/Jiangsu Province Academy of Traditional Chinese Medicine,Nanjing Jiangsu 210008)
出处
《世界中西医结合杂志》
2025年第7期1415-1419,共5页
World Journal of Integrated Traditional and Western Medicine
基金
江苏省老年健康科研项目(LKM20222014)。
关键词
地黄止痉汤
血管紧张素转化酶抑制剂
吞咽困难
高血压
Dihuang Zhijing decoction
Angiotensin-Converting Enzyme Inhibitors
Dysphagia
Hypertension
作者简介
通信作者:王海翔,Email:Wanggongwen2024@126.com。
