肌电生物反馈疗法与神经肌肉电刺激治疗脑卒中后吞咽障碍的疗效比较

Curative effect comparison of electromyographic biofeedback therapy vs.neuromuscular electrical stimulation therapy for stroke patients with dysphagia

目的:比较肌电生物反馈疗法与神经肌肉电刺激(NMES)治疗脑卒中后吞咽障碍的疗效。方法:吞咽障碍患者90例,随机分为对照组、NMES组和反馈组各30例。对照组进行常规吞咽训练、NMES组加用NMES治疗,反馈组加用肌电生物反馈治疗。治疗前后采用洼田饮水试验进行吞咽功能评定,并评价临床疗效。结果:治疗2个疗程后,3组洼田饮水试验吞咽功能评级均较治疗前明显提高(P<0.05,0.01),NMES组、反馈组更优于对照组(均P<0.05),反馈组更优于NMES组(P<0.05)。3组临床疗效比较,反馈组总有效率更高于NMES组及对照组(均P<0.05),NMES组更高于对照组(P<0.05)。结论:肌电生物反馈训练应用于脑卒中后吞咽障碍治疗效果优于神经肌肉电刺激疗法。

Objective： To compare the curative effect between electromyographic biofeedback therapy vs. neuro- muscular electrical stimulation （NMES） therapy for stroke patients with dysphagia. Methods：All 90 stroke patients with dysphagia were randomly divided into deglutition training group （control group）, NMES therapy group （NMES group） and electromyographic biofeedback therapy group （biofeedback group）. Before and after treatment, Kubota Toshio＇s drinking tests were performed on 3 groups of patients to evaluate swallowing function and clinical effects. Results：After two courses of treatments,Kubota Toshio＇s drinking tests to three groups were improved as compared with pretreatment （P〈0. 05,0. 01）, those in the feedback group were improved most significantly （all P〈0.05）, and those in the NMES group were improved more significantly than in the control group （P〈0.05）. The total ef- fective rate in feedback group was higher than in NMES group and control group （all P〈0. 05） ,and that in NMES group was higher than in control group （P〈0.05）. Conclusion：Electromyographic biofeedback therapy was more ef- fective than NMES therapy on stroke patients with dysphagia.