神经肌肉治疗仪联合吞咽训练治疗脑梗后吞咽困难的临床观察

Clinical Observation of Neuromuscular Therapeutic Apparatus Combined with Swallowing Training to Treat Dysphagia After Cerebral Infarction

目的:探讨神经肌肉治疗仪联合吞咽训练治疗脑梗死后吞咽困难的临床效果。方法:将68例脑梗死后吞咽困难患者随机分为两组各34例,对照组接受吞咽训练治疗,研究组在对照组基础上采取神经肌肉治疗仪治疗。治疗前后两组患者均检测血清脑源性神经营养因子(BDNF)、胰岛素样生长因子-1(IGF-1)及Nogo-A蛋白水平。同时通过洼田饮水实验(WTDWT)和吞咽障碍特异性生活质量量表(SWAL-QOL)对患者进行评估。结果:研究组治疗后的血清BDNF为(7.91±2.52)ng/mL、IGF-1为(144.25±37.61)ng/mL,Nogo-A为(23.92±5.48)pg/mL,对照组分别为(5.48±1.49)ng/mL、(121.62±33.92)ng/mL,(35.93±6.06)pg/mL,研究组改善明显优于对照组(P<0.05)。研究组治疗后的WTDWT评分为(3.34±0.81)分,SWAL-QOL评分为(116.05±24.37)分,对照组分别为(2.27±0.62)分,(94.37±22.93)分,研究组明显高于对照组(P<0.05)。结论:脑梗死后吞咽困难患者采用单纯吞咽训练的效果有限,联合神经肌肉治疗仪治疗可更有效地促进神经功能恢复,改善吞咽障碍。

Objective:To explore the clinical effect of neuromuscular therapy instrument combined with swallowing training in the treatment of dysphagia after cerebral infarction.Methods:68 patients with dysphagia after cerebral infarction were randomly divided into two groups with 34 cases in each group.The control group received swallowing training treatment,and the study group was treated with neuromuscular therapy on the basis of the control group.Both groups of patients were tested for serum brain-derived neurotrophic factor(BDNF),insulin-like growth factor-1(IGF-1)and Nogo-A protein levels before and after treatment.At the same time,patients were evaluated by the Watian Drinking Water Test(WTDWT)and the Dysphagia Specific Quality of Life Scale(SWAL-QOL).Results:After treatment,the serum BDNF of the study group was(7.91±2.52)ng/mL,IGF-1 was(144.25±37.61)ng/mL,Nogo-A was(23.92±5.48)pg/mL,and the control group was(5.48±1.49)ng/mL,(121.62±33.92)ng/mL,(35.93±6.06)pg/mL,the improvement of the study group was significantly better than that of the control group(P<0.05).The WTDWT score of the study group after treatment was(3.34±0.81)points,the SWAL-QOL score was(116.05±24.37)points,and the control group were(2.27±0.62)points and(94.37±22.93)points,which were significantly higher in the study group(P<0.05).Conclusion:Patients with dysphagia after cerebral infarction have limited effect on swallowing training alone,combined with neuromuscular therapy treatment can more effectively promote the recovery of nerve function and improve dysphagia.