针灸联合神经肌肉电刺激对颅脑损伤吞咽障碍患者吞咽功能及相关指标的影响

Effect of Acupuncture and Moxibustion Combined with Neuromuscular Electrical Stimulation on Swallowing Function and Related Indexes in Patients with Dysphagia Due to Craniocerebral Injury

目的:探讨采用针灸联合神经肌肉电刺激治疗颅脑损伤吞咽障碍患者的临床疗效,并研究其对吞咽功能及生活质量的影响。方法:92例颅脑损伤吞咽障碍患者,根据治疗方案不同分成两组,每组46例。对照组给予神经肌肉电刺激进行治疗,观察组给予神经肌肉电刺激联合针灸进行治疗。观察两组吞咽功能、血清IL-6、hs-CRP水平变化、表面肌电图(sEMG)、神经功能评分、不良反应、临床治疗效果以及生活质量评分变化情况。结果:观察组治疗总有效率(97.83%)、WST(1.49±0.23)分、VFSS(5.69±0.47)分、NIHSS(2.43±0.71)分、SWAL-QOL(199.56±20.05)分、IL-6(8.24±2.15)ng/L、hs-CRP(5.24±1.23)mg/L、sEMG最大波幅值(752.31±40.11)μV、吞咽过程(1.05±0.16)s均高于对照组治疗总有效率(84.78%)、WST(2.24±0.26)分、VFSS(5.34±0.26)分、NIHSS(5.89±1.26)分、SWAL-QOL(135.91±20.09)分、IL-6(11.45±2.27)ng/L、hs-CRP(7.62±2.04)mg/L、sEMG最大波幅值(571.95±40.39)μV、吞咽过程(1.38±0.24)s,差异有统计学意义(P<0.05)。两组不良反应发生情况比较无统计学差异(P>0.05)。结论:采用针灸联合神经肌肉电刺激治疗颅脑损伤吞咽障碍患者,能够显著改善其吞咽功能,促进患者疾病相关炎症因子水平恢复,使得表面肌电图波幅升高,能够明显提升临床疗效,同时安全性较好,有助于改善患者生活质量及预后。

Objective: To discuss the clinical efficacy of acupuncture and moxibustion combined with neuromuscular electrical stimulation in the treatment of swallowing disorders in craniocerebral injury and study its effect on swallowing and quality of life. Methods: 92 patients with dysphagia of craniocerebral injury were divided into two groups, 46 cases in each group according to the different treatment schemes. The control group received neuromuscular electrical stimulation, and the observation group received neuromuscular electrical stimulation combined with acupuncture and moxibustion. The changes of swallowing function, serum IL - 6, hs - CRP level, surface electromyography ( sEMG), neurological function score, adverse reaction, clinical treatment effect and quality of life score were observed in the two groups. Results: The total effective rate (97.83%), WST (1.49 ± 0.23), VFSS (5.69 ±0.47), NIHSS (2.43 ±0.71), SWAL - QOL (199. 56 ± 20. 05 ), IL - 6 ( 8. 24 ± 2. 15 ) ng/L, hs - CRP ( 5. 24 ± 1. 23 ) mg/L, sEMG maximum amplitude (752. 31 ±2.43)μV, and swallowing process were higher than the control groups total effective rate (84. 78%), WST (2. 24 ±0.26), VFSS (5.34±0.26), NIHSS (5.89±1.26), SWAL - QOL (135.91±20.09), IL-6 (11.45± 2. 27 ) ng/L, hs - CRP (7. 62 ±2. 04) mg/L, sEMG maximum amplitude (571.95± 5. 89)μV , and swallowing process (1.05 ±0. 16)s, with different statistically significance(P <0. 05). There was no difference in the incidence of adverse reactions between the two groups ( P > 0. 05). Conclusion: Acupuncture and moxibustion combined with neuromuscular electrical stimulation can improve the swallowing function of the patients with craniocerebral injury, improve the swallowing function, promote the recovery level of the inflammatory factors related to the disease, increase the amplitude of the surface electromyography, and can obviously improve the clinical effect, and the safety is good, which can help to improve the quality of life of the patients.