气脉冲训练联合冰柠檬刺激治疗脑干卒中后吞咽障碍的疗效观察

Curative Effect of Air Pulse Training Combined with Ice Lemon Stimulation on Dysphagia after Brainstem Stroke

目的观察气脉冲训练联合冰柠檬刺激治疗脑干卒中患者吞咽障碍的疗效,并探讨其可能机制。方法将2016年1月—2017年5月收集的77例吞咽障碍患者随机分为试验组(n=38)和对照组(n=39),2组均给予常规药物治疗及20min吞咽功能训练。对照组在常规训练的基础上给予15min冰柠檬刺激,试验组给予15min冰柠檬刺激联合气脉冲训练,每天2次,每周5d,训练4周。治疗后,采用GUSS评估量表评估吞咽功能并计算吞咽障碍治疗有效率。结果治疗后2组GUSS吞咽功能量表评分均较治疗前提高(均P<0.01),试验组GUSS吞咽功能量表评分优于对照组(t=-3.382,P<0.01),且试验组治疗吞咽障碍的有效率更高[(92.1%vs 76.9%),P<0.05]。结论气脉冲训练联合冰柠檬刺激治疗脑干卒中后吞咽障碍疗效显著,有一定的临床应用价值。

Objective To observe the effect of air pulse training combined with ice lemon stimulating on cases with dysphagia after brainstem stroke and to explore the possible mechanism. Methods 77 cases with dysphagia collected from Jan.,2016 to May, 2017 were randomly divided into 2 groups： experiment group（n=38） and control group（n=39）; besides the conventional medical treatment and 20 min swallowing function training in both groups, 15-minute ice lemon stimulation was added to cases in control group and 15-minute ice lemon stimulating combined with air pulse training was added to cases in experiment group; the courses for both groups lasted for 4 week, twice a day and 5 days a week; after treatment, Gugging Swallowing Screen（GUSS） was performed on all the cases in the 2 groups and the swallowing function was assessed and the curative effect was evaluated. Results After treatment, the scores of the GUSS in both groups were higher than those before treatment（P0.01） and the scores of GUSS of the cases in experiment group was much superior to those of the cases in control group（t=-3.382, P0.01）; the curative effect on dysphagia in experiment group was better than that in control group [（92.1%vs 76.9%）, P0.05]. Conclusions Air pulse training combined with ice lemon stimulating is of obvious effect on dysphagia after brainstem stroke and is of certain clinical application value.