“高氏项针”结合电刺激改善脑卒中后吞咽障碍的疗效及对颏下肌群sEMG的影响

Effect of GAO’s Neck Acupuncture Combined with Electrical Stimulation on Post-Stroke Dysphagia and Its Influence to sEMG of Submental Muscle Group

目的:探讨“高氏项针”结合电刺激治疗脑卒中后吞咽障碍的临床效果及对颏下肌群表面肌电信号(sEMG)的影响。方法:筛选2017年11月—2019年10月期间我院收治的脑卒中后吞咽障碍患者80例纳入研究,采用随机数字表法分为对照组和观察组各40例。两组均给予脑卒中的常规治疗,对照组在以上治疗基础上给予吞咽功能康复训练及饮食、体位调整;观察组在对照组基础上给予高氏项针结合电刺激治疗。比较两组治疗前后的洼田饮水试验(WST)评分、MASA量表评分、SWAL-QOL量表评分及空吞咽、吞咽5 mL温水时颏下肌群的平均肌电值(AEMG)和吞咽时间。结果:观察组患者经治疗后的总有效率(92.5%,37/40)明显高于对照组(75.0%,30/40),组间比较差异有统计学意义(P<0.05)。两组患者经治疗后的WST评分较治疗前显著降低,差异有统计学意义(P<0.05),且观察组明显低于对照组,差异有统计学意义(P<0.05);MASA和SWAL-QOL量表评分较治疗前显著升高,差异有统计学意义(P<0.05),且观察组明显高于对照组,差异有统计学意义(P<0.05)。经治疗后,两组患者空吞咽和吞咽5 mL温水时的AEMG和吞咽时间均明显低于治疗前,差异有统计学意义(P<0.05),且观察组明显低于对照组,差异有统计学意义(P<0.05)。结论:“高氏项针”结合电刺激治疗脑卒中后吞咽障碍能够有效改善患者在吞咽时颏下肌群的痉挛强度,缩短吞咽时间,明显促进患者吞咽功能的恢复,并提高患者的生活质量。

Objective:To investigate the effect of GAO’s neck acupuncture combined with electrical stimulation on post-stroke dysphagia and its influence to sEMG of submental muscle group.Methods:80 patients with post-stroke dysphagia were randomly divided into the control group and the observation group,with 40 cases in each group.Both the two groups were given the routine treatment for stroke,and the control group was also given the rehabilitation training of swallowing function and the adjustment of diet and body position;on which basis,the observation group was treated with GAO’s neck acupuncture combined with electrical stimulation.The scores of WST,MASA scale and SWAL-QOL scale,AEMG value of empty swallowing and swallowing 5ml of warm water,as well as swallowing time were compared between the two groups before and after the treatment.Results:The total effective rate of the observation group was 92.5%(37/40),which was significantly higher than 75.0%(30/40)of the control group(P<0.05).The WST scores were significantly decreased after the treatment than those before the treatment in the two groups(P<0.05),and the decreases in the observation group were more significant(P<0.05).The scores of MASA and SWAL-QOL scale were obviously increased after the treatment than those before the treatment in the two groups(P<0.05),and increases were more significant in the observation group(P<0.05).The AEMG values were significantly lower and the swallowing time was greatly shortened after the treatment in the two groups(P<0.05),of which the improvements in the observation group were more significant(P<0.05).Conclusion:GAO’s neck acupuncture combined with electrical stimulation can effectively reduce the spasm intensity of submental muscle group,shorten the swallowing time,promote the recovery of swallowing function and improve the life quality of the patients in the treatment of post-stroke dysphagia.