穴位注射联合Vitalstim电刺激治疗脑卒中后吞咽障碍:随机对照研究

Acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia:a randomized controlled trial

目的:观察穴位注射联合Vitalstim电刺激治疗脑卒中后吞咽障碍的疗效。方法:将98例首次脑卒中后吞咽障碍患者随机分为穴位注射组(35例,脱落2例)、电刺激组(31例,脱落3例)和联合组(32例,脱落3例)。分别予"吞咽"穴注射甲钴胺注射液治疗、Vitalstim电刺激治疗及二者联合治疗,每天1次,10次为一疗程,共治疗2个疗程。观察各组患者治疗前后舌肌厚度及电视透视吞咽功能检查(VFSS)评分。结果:治疗后,各组患者舌肌厚度均较治疗前降低(P<0.05),VFSS评分均较治疗前增加(P<0.05);治疗后,联合组患者舌肌厚度及VFSS评分变化幅度均大于穴位注射组和电刺激组(P<0.05)。结论:甲钴胺注射液穴位注射和Vitalstim电刺激均对脑卒中后吞咽障碍有治疗作用,且二者有协同作用。

Objective To observe the clinical efficacy of acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia. Methods A total of 98 patients with dysphagia after first stroke were randomized into an acupoint injection group(35 cases, 2 cases dropped off), an electrical stimulation group(31 cases, 3 cases dropped off) and a combination group(32 cases, 3 cases dropped off). Injection of mecobalamin into Tunyan point, Vitalstim electrical stimulation and the combination of injection of mecobalamin into Tunyan point and Vitalstim electrical stimulation were applied respectively in the 3 groups, once a day, 10 times as one course, 2 courses were required. Before and after treatment,the tongue muscle thickness and video fluoroscopic swallowing study(VFSS) score were observed in the 3 groups. Results After treatment, the tongue muscle thickness was decreased(P<0.05), the VFSS scores were increased(P<0.05) compared with before treatment in the 3 groups, and the variation of tongue muscle thickness and VFSS score in the combination group was greater than the acupoint injection group and the electrical stimulation group(P<0.05). Conclusion Both acupoint injection of mecobalamin and Vitalstim electrical stimulation have therapeutic effect on dysphagia after stroke, and the two have synergistic effect.