神经肌肉电刺激联合针灸及康复锻炼治疗颅脑损伤吞咽障碍患者的临床观察

Clinical Observation on Neuromuscular Electrical Stimulation Combined with Acupuncture and Rehabilitation Exercise for Relieving Dysphagia in Patients with Craniocerebral Injury

目的探讨神经肌肉电刺激联合针灸及康复锻炼治疗颅脑损伤吞咽障碍患者的临床疗效。方法共纳入90例因颅脑损伤致不同程度吞咽障碍患者,采用随机数字法平均分为A、B、C3组,A组给予常规治疗及康复锻炼,B组在A组基础上给予神经肌肉电刺激,C组在B组基础上联合针灸治疗。所有患者均治疗4周,记录治疗前后的吞咽功能、吞咽障碍程度及日常生活质量等进行比较。结果 3组患者治疗后总有效率分别为93.3%、73.3%、53.3%,差异有统计学意义(P<0.05),且C组明显高于A组、B组,B组高于A组,差异有统计学意义(P<0.05)。治疗后3组VFG评分均明显高于治疗前,且WST评分均明显低于治疗前,差异有统计学意义(P<0.05);治疗后C组VFG评分高于A组、B组,WST评分低于A组、B组,差异有统计学意义(P<0.05)。治疗后3组SWAL-QOL评分均有明显下降,差异有统计学意义(P<0.05);治疗后C组SWAL-QOL评分明显低于A组、B组,差异有统计学意义(P<0.05)。结论神经肌肉电刺激联合针灸及康复锻炼相互有协同作用,可以明显改善患者的吞咽功能,提高患者生活质量。

OBJECTIVE To explore the clinical effects of neuromuscular electrical stimulation combined with swallowing training for relieving dysphagia in patients with craniocerebral injury, providing reference basis for further study. METHODS 90 patients with craniocerebral injury suffered from dysphagia were selected and divided into A, B, C groups. Patients in group A received conventional treatment and rehabilitation exercise. Patients in group B were also given neuromuscular electrical stimulation and combined all the treatment in group A. Neuromuscular electrical stimulation and moxibustion therapy were added for patients in group C. The swallowing function, dysphagia degree and the quality of daily life were compared before and after the treatment. RESULTS The total effective rate in the three groups was 93. 3%, 73. 3% and 53. 3% respectively with statistically significant differences（ P〈 0. 05）. The VFG scores after treatment were higher than those before treatment in all the groups, showing statistically significant differences（ P〈0. 05）.The WST scores after treatment were lower than those before treatment in the three groups with statistically significant differences（ P〈0. 05）. The VFG score of group C were higher than that of group A and group B after treatment, which showed statistically significant differences（ P〈0. 05）. The WST score of group C were lower than that of group A and group B after treatment, indicating statistically significant differences（ P〈0. 05）. The SWAL-QOL scores after treatment were lower than those before treatment in all the groups with statistically significant differences（ P〈0. 05）. The SWAL-QOL score in group C were lower than that of both group A and B after treatment, which showed statistically significant differences（ P 0. 05）. CONCLUSION Neuromuscular electrical stimulation combined with acupuncture and rehabilitation exercise can significantly improve patients＇ swallowing function and quality of life.