项针结合Vitalstim电刺激治疗脑外伤后吞咽障碍的研究

Clinical study of cervical acupuncture combined with Vitalstim electrical stimulation treatment on swallowing disorder after traumatic brain injury

目的观察项针联合Vitalstim电刺激治疗脑外伤后吞咽障碍的临床疗效。方法将62例脑外伤后吞咽障碍患者随机分为3组,3组均给吞咽训练,在此基础上项针组给予项针治疗,电刺激组给予Vitalstim电刺激治疗,联合组给予项针加Vitalstim电刺激治疗,均治疗2个月。治疗前及治疗后1个月、2个月分别应用洼田饮水试验、才藤7级评价法评估吞咽功能情况。结果治疗后3组吞咽功能均较治疗前明显改善(P均<0.05),且治疗后2个月均优于治疗后1个月(P均<0.05);联合组治疗后1个月、2个月吞咽功能均明显优于项针组和电刺激组(P均<0.05),而项针组和电刺激组比较差异均无统计学意义(P均>0.05)。结论项针、Vitalstim电刺激及吞咽康复训练相结合治疗脑外伤后吞咽障碍效果优于项针加吞咽训练或Vitalstim电刺激加吞咽训练,临床中应采用综合方法治疗。

Objective It is to observe the clinical curative effect of cervical acupuncture combined with Vitalstim electrical stimulation treatment on swallowing disorder after traumatic brain injury. Methods 62 patients with swallowing disorder after traumatic brain injury were randomly divided into 3 groups： the cervical acupuncture plus swallowing training group, Vitalstim electrical stimulation plus swallowing training group, and cervical acupuncture plus Vitalstim electrical stimulation and swallowing training group, all the groups were treated for two months. The swallowing functions of patients in each group were evaluated by Watian water drinking test and Caiteng seven degree evaluation method before treatment, one and two months after treatment respectively. Results Swallowing function were significantly improved （ P 〈 O. 05 ） after treatment in the three groups, and the improvements were better after 2 months＇ treatment than that after one month（P 〈 0.05）. The patients in the cervical acupuncture plus Vitalstim electrical stimulation and swallowing training group got better effect than that in the other two groups one and two months after treatment. There was no statistical difference between patients in cervical acupuncture group and electrical stimulation group. Conclusion The effect of combination of cervical acupuncture plus Vitalstim electrical stimulation and swallowing training is prior to the combination of cervical acupuncture and swallowing training or the combination of Vitalstim electrical stimulation and swallowing training in the treatment of swallowing disorder after traumatic brain injury. Comprehensive treatment approach is recommended in clinic.