头针联合低频脉冲电刺激治疗脑卒中恢复期患者吞咽功能障碍的临床效果

Clinical effect of scalp acupuncture combined with low-frequency pulse electrical stimulation in the treatment of swallowing dysfunction in patients with cerebral apoplexy during convalescence

目的评估头针联合低频脉冲电刺激治疗脑卒中恢复期患者吞咽功能障碍的临床效果。方法选取2013年1月~2017年12月大连市友谊医院康复科病房收治的90例脑卒中恢复期存在吞咽功能障碍的患者作为研究对象,随机分为头针组、低频组和综合组(头针联合低频脉冲电组),每组各30例。三组患者均给予常规药物治疗(包括脑血管病二级预防药物及基础病常规用药)、偏瘫肢体功能训练及吞咽功能障碍训练。头针组由同一针灸师给予头针治疗,低频组患者接受低频脉冲电刺激治疗,综合组接受头针治疗及低频脉冲电刺激治疗。疗程30d,采用洼田饮水试验(WST)及标准化床边吞咽功能检查表(SSA)进行吞咽功能评估,比较三组的临床疗效。结果三组患者治疗后WST评分及SSA评分均低于治疗前,差异有统计学意义(P<0.05);综合组患者治疗后的WST及SSA评分低于头针组与低频组,差异有统计学意义(P<0.05)。结论头针联合低频脉冲电刺激治疗可显著改善脑卒中恢复期吞咽功能障碍。

Objective To evaluate the clinical effects of scalp acupuncture combined with low-frequency pulse electrical stimulation in the treatment of swallowing dysfunction in patients with stroke recovery. Methods A total of 90 stroke patients with swallowing dysfunction who were admitted to the Department of Rehabilitation of the Dalian Friendship Hospital from January 2013 to December 2017 were selected as the subjects. They were randomly divided into scalp acupuncture group, low-frequency stimulation group and the combined group (scalp combined with the low-frequency pulse electrical stimulation), with 30 cases in each group. All three groups were given conventional drug treatment including secondary prevention drugs for cerebrovascular disease and routine medication for basic diseases, hemiplegia limb function training and training for swallowing dysfunction. In the scalp acupuncture group, participants were treated by the same acupuncturist. In the low-frequency group, patients were provided with low-frequency pulse electrical stimulation. In the combined group, scalp acupuncture treatment and low-frequency pulse electrical stimulation treatment were used together. The courses of treatment lasted for 30 days. The swallowing function was evaluated using the water swallow test (WST) and the standardized bedside swallowing function checklist (SSA). The clinical efficacy of the three groups was compared. Results After treatment, the scores of WST score and and SSA score were significantly lower than those before treatment, with statistical significances (P<0.05). The WST and SSA scores in the combined group were lower than those in the scalp acupuncture group and the low-frequency stimulation group, with statistical significances (P<0.05). Conclusion Scalp acupuncture combined with low-frequency pulse electrical stimulation can markedly improve swallowing dysfunction during recovery from stroke.