針灸合併穴位按摩對於失智病患吞嚥困難的治療效果

Acupuncture combined with acupressure for the treatment of swallowing difficulties in dementia patients

背景
失智症患者常見的吞嚥困難不僅影響其生活品質，也增加了各種健康風險。針灸與穴位按摩作為非藥物治療方法，在傳統中醫中被認為能有效改善吞嚥功能。本研究旨在探討這些治療方法對失智症患者吞嚥困難的改善效果。
方法
這是一項前瞻性非劣性試驗，共納入76位年齡超過60歲的失智症患者，分為兩組：42人接受針灸治療，30人接受針灸加按摩治療。評估指標包括吞嚥困難篩選工具表(Eating Assessment Tool-10，EAT-10)和吞嚥困難臨床嚴重程度分級(Dysphagia Severity Scale，DSS)。治療周期為八週，每週兩次。
結果
治療前兩組在基本人口學特徵及量表評分上無明顯差異。兩組病患於治療四週後均呈現顯著的吞嚥功能改善情形，但是在治療八週後，僅有針灸加上穴位按摩的病患，吞嚥功能有更進一步的改善。重複性ANOVA分析顯示，經過八週治療後，針灸加按摩組在EAT-10和DSS評分上的改善顯著優於單獨針灸組。這表明綜合治療方法在改善失智症患者吞嚥困難方面更為有效。
結論
結合針灸和穴位按摩的治療方法對於改善失智症患者的吞嚥困難具有顯著效果，顯示這種綜合治療策略在臨床應用中具有潛力和可行性。

Background
Dysphagia in dementia patients not only impacts their quality of life but also increases various health risks. Acupuncture and acupoint massage, as non-pharmacological treatments, are traditionally considered effective in improving swallowing function. This study aimed to investigate the efficacy of these treatments in alleviating dysphagia in dementia patients.
Methods
This prospective non-inferiority trial included 76 dementia patients aged above 60, divided into two groups: 42 received acupuncture, and 30 received acupuncture with massage. The primary evaluation indicators were the Eating Assessment Tool-10 (EAT-10) and Dysphagia Severity Scale (DSS). The treatment period was eight weeks with sessions twice a week.
Results
Before treatment, there were no significant differences between the two groups in terms of basic demographic characteristics and scale scores. Both groups of patients showed significant improvement in swallowing function after four weeks of treatment. However, after eight weeks, only the group receiving acupuncture combined with acupoint massage showed further improvement in swallowing function. Repeated measures ANOVA analysis indicated that after eight weeks of treatment, the group receiving acupuncture with massage showed significantly greater improvement in EAT-10 and DSS scores than the acupuncture-only group. This suggests that the integrated treatment approach is more effective in improving dysphagia in patients with dementia.
Conclusion
The combined approach of acupuncture and acupoint massage significantly improves swallowing difficulties in patients with dementia, demonstrating potential and feasibility for clinical application.