目的：探究针刺在脑卒中后吞咽障碍患者中的应用效果。方法：选取90例脑卒中后吞咽障碍患者，以随机数字表法分为对照组、观察1组、观察2组，每组各30例。对照组接受常规治疗，在此基础上，观察1组进行针刺治疗，不留针，观察2组针刺后留针30 min。对比三组疗效、肠道屏障功能[D-乳酸（D-LA）、脂多糖（LPS）、二胺氧化酶（DAO）]、营养状况[血红蛋白（Hb）及血清白蛋白（ALB）、总蛋白（TP）]、吞咽功能[吞咽造影检查（VFSS）、标准吞咽功能评定量表（SSA）]、胃肠功能、生活质量[Barthel指数（BI）]、睡眠质量[匹兹堡睡眠质量量表（PSQI）]及不良反应。结果：观察1组、2组总有效率分别为83.33%、93.33%，均高于对照组60.00%（均P<0.05）；治疗后三组SSA、胃肠功能评分均较治疗前降低，且观察2组<观察1组<对照组（均P<0.05）,VFSS评分均升高，且观察2组>观察1组>对照组（均P<0.05）；治疗后三组LPS、DAO、D-LA水平均降低，且观察2组<观察1组<对照组（均P<0.05）,Hb、ALB、TP水平均升高，且观察2组>观察1组>对照组（均P<0.05）；治疗后三组BI评分均升高，且观察2组、1组高于对照组（均P<0.05），三组PSQI评分均降低，且观察2组、1组低于对照组（均P<0.05）。结论：针刺应用于脑卒中后吞咽障碍临床中可提升疗效，改善患者睡眠及生活质量，且针刺后留针对患者吞咽功能、营养状况及肠道屏障功能的改善程度优于不留针方案。

Objective:To explore the application effect of acupuncture on patients with dysphagia after stroke. Methods:A total of 90 patients with dysphagia after stroke were selected as the study subjects and divided into the control group,observation group 1 and observation group 2 by using random number table method,with 30 cases in each group. The control group received conventional treatment. On this basis,observation group 1 was treated with acupuncture without needle retention,observation group 2 was treated with needle retention for 30 minutes after acupuncture. The therapeutic effect,intestinal barrier function [D-lactic acid(D-LA),lipopolysaccharide(LPS),diamine oxidase(DAO)],nutritional status [hemoglobin(Hb) and serum albumin(ALB),total protein(TP)],swallowing function [deglutigraphy examination(VFSS),standardized swallowing assessment scale(SSA)],gastrointestinal function and life quality [Barthel Index(BI)],sleep quality [Pittsburgh Sleep Quality Scale(PSQI)] and adverse effects of the three groups were compared. Results:The total effective rate of the observation group 1 and group 2 was 83.33% and 93.33%,respectively,which was higher than that of the control group,60.00%(all P<0.05). After treatment,the SSA and gastrointestinal function scores of the three groups were lower than those before treatment,and observation group 2 < observation group 1 < the control group(all P<0.05),VFSS scores were increased,and observation group 2 > observation group 1 > the control group(all P<0.05). After treatment,the levels of LPS,DAO,and D-LA were decreased in all three groups,and observation group 2 < observation group 1 < the control group(all P<0.05),and the levels of Hb,ALB and TP were increased,and observation group 2 > observation group 1 > the control group(all P<0.05). After treatment,BI scores in all three groups were increased,and the observation group 2 and group 1 were higher than the control group(all P<0.05),PSQI scores in all three groups were decreased,and the observation group 2 and group 1 were lower than the control group(all P<0.05). Conclusion:The application of acupuncture in the clinical treatment of dysphagia after stroke can enhance the therapeutic effect,improve the sleep and quality of life of patients,and the degree of improvement of swallowing function,nutritional status and intestinal barrier function of patients with needle retention after acupuncture is better than that of the no-needle retention program.