口腔定位疗法治疗脑卒中后流涎的疗效观察

The effectiveness of oral placement therapy in management of sialorrhea of stroke patients

目的观察口腔定位疗法（OPT）治疗脑卒中后流涎患者的疗效。方法共收集2011年1月至2013年9月期间在我科住院治疗的脑卒中后流涎患者37例，根据入选时间将其分为对照组及治疗组。2组患者均给予常规康复治疗，包括神经肌肉促进技术（以Bobath、Rood、运动再学习等疗法为主）、神经肌肉电刺激、冰刺激等。治疗组则在此基础上辅以OPT综合治疗。于入选前、治疗1周、2周及4周时分别采用Frenchay构音障碍评定法对2组患者流涎程度进行评定，并对其临床疗效进行比较。结果治疗1周后，治疗组流涎程度较入选前显著改善（P〈0．05），而对照组流涎程度无明显改善（P〉0．05）；治疗2周及4周后，2组患者流涎症状均较前一次评定结果明显改善（P〈0．05）。治疗1周、2周及4周时，治疗组总有效率分别为63．16％、94．74％和94．74％，对照组总有效率则分别为5．88％、61．11％和61．11％，上述时间点治疗组总有效率均显著优于对照组水平（P〈0．05）。结论OPT疗法可显著改善脑卒中后流涎症状，其疗效及起效时间均明显优于常规康复治疗。

Objective To observe the therapeutic effects of oral placement therapy （OPT） on managing sialorrhea after stroke. Methods A total of 37 stroke inpatients with sialorrhea were enrolled from January 2011 to September 2013 in the authors＇ department for the study and divided into 2 group on the basis of the time of enrollment. The control group （n = 18 ） received 30rain of routine treatment （including such neuromuscular facilitation techniques as Bobath and Rood techniques, motor relearning program, neuromuscular electrical stimulation and ice stimulation） , twice daily, and the treatment group （ n = 19） received 15min of routine treatment plus 15 min of OPT, twice daily. Frenehay Dysarthria Assessment was used to evaluate the sialorrhea severity and clinical efficacy before and 1 , 2 and 4 weeks after initiation of treatment. Results Sialorrhea symptom was significantly improved in treatment group after 1 week （ P 〈 0.05 ） , while no significant improvement was observed in control group （ P 〉 0.05 ）. After 2 and 4 weeks of treatments, significant improvements of sialorrhea were noted in both groups. After 1 , 2 and 4 weeks of treatment, the total effective rate were 63. 16% , 94.74% and 94.74% , respectively, in the treatment group, versus 5.88% , 61.11% and 61.11% , respectively, in the control group. The total effective rate of the treatment group were significantly higher in the above three time-points than the control group （P 〈 0.05 ）. Conclusions Oral placement therapy can improve sialorrhea symptom after stroke more effectively than routine treatment.