目的：观察火针治疗对肌萎缩侧索硬化（amyotrophic lateral sclerosis，ALS）患者吞咽困难等延髓麻痹症状的疗效。

方法：纳入2020年6月至2024年12月伴有吞咽困难等延髓麻痹症状的56例ALS患者，随机分为火针治疗组与普通针灸对照组。在现代医学治疗的基础上，火针治疗组联合舌下三针火针治疗，普通针灸对照组联合普通针刺治疗，治疗8周。火针取廉泉穴（舌Ⅰ针）以及廉泉左右旁开0.8寸穴位（舌Ⅱ针及舌Ⅲ针）。采用洼田饮水试验和藤岛一郎吞咽功能评分标准、ALS中西医结合症状评分（Amyotrophic Lateral Sclerosis Symptom Score in Integrative Treatments，ALS-SSIT）口咽功能评分、改良ALS症状功能分级量表（Amyotrophic Lateral Sclerosis Symptom Functional Rating Scale Revision，ALSFRS-R）以及流涎严重程度与频率量表（Drooling Severity and Frequency Scale，DSFS）评估疗效。

结果：入组56例患者，脱落5例，最终51例被纳入统计学分析（火针治疗组26例，普通针灸对照组25例）。治疗第8周时，火针治疗组洼田饮水试验评级为轻症者的比例较治疗前增加，差异有统计学意义（P＜0.05）。8周治疗结束后，火针治疗组的藤岛一郎吞咽功能评分、ALS-SSIT口咽功能评分和DSFS评分均显著优于治疗前（P＜0.05），并且显著优于普通针灸对照组治疗后（P＜0.05）。火针治疗组治疗后的ALSFRS-R评分亦显著优于普通针灸对照组（P＜0.05）。

结论：与普通针灸相比，火针治疗能够明显改善ALS患者的吞咽困难及流涎症状，并且能够在一定程度上延缓疾病进展。火针治疗或许可以作为有吞咽困难和流涎等延髓麻痹症状ALS患者的辅助治疗手段。

Objective: To observe the clinical efficacy of fire needle therapy in treating symptoms of bulbar paralysis such as dysphagia in patients with amyotrophic lateral sclerosis (ALS).

Method: The study included 56 ALS patients with bulbar palsy symptoms such as dysphagia from June 2020 to December 2024, who were randomly divided into a fire acupuncture group and conventional acupuncture group. Based on modern medical treatment, the fire acupuncture group received sublingual three-needle fire acupuncture therapy, while the conventional acupuncture group received conventional acupuncture therapy, with an 8-week treatment period. Fire acupuncture points selected were Lianquan (tongue I acupuncture) and bilateral points 0.8 cun lateral to Lianquan (tongue II and III acupuncture). Efficacy was evaluated using the Water Swallowing Test, Fujimura Swallowing Function Scoring Standard, Amyotrophic Lateral Sclerosis Symptom Score in Integrative Treatments (ALS-SSIT) oropharyngeal function score, modified Amyotrophic Lateral Sclerosis Symptom Functional Rating Scale (ALSFRS-R) and Drooling Severity and Frequency Scale (DSFS).

Results: Fifty-six patients were enrolled, 5 patients dropped out, and 51 patients were finally included in the statistical analysis (26 cases in the fire acupuncture group, 25 cases in the conventional acupuncture group). At the 8th week of treatment, the proportion of patients with mild symptoms according to the Water Swallowing Test in the fire acupuncture group increased compared to before treatment, and the difference was statistically significant (P<0.05). After 8 weeks of treatment, Fujimura Swallowing Function score, ALS-SSIT oropharynx function score and DSFS score in the fire acupuncture group were significantly better than those before treatment (P<0.05), and were significantly better than those after treatment in the conventional acupuncture group (P<0.05). The ALSFRS-R score of the fire acupuncture group after treatment was also significantly better than that of the conventional acupuncture group (P<0.05).

Conclusion: Compared with conventional acupuncture, fire acupuncture can significantly improve the dysphagia and salivation symptoms of ALS patients, and can delay the disease progress to a certain extent. Fire acupuncture may serve as an adjuvant treatment for ALS patients with symptoms of medullary paralysis such as swallowing difficulties and drooling.