经颅电刺激联合口肌生物反馈训练对中风后吞咽困难患者吞咽功能、吞咽损伤程度、神经营养指标水平的影响

Effects of transcranial electrical stimulation combined with oral muscle biofeedback training on swallowing function,swallowing injury and neurotrophic index levels in patients with dysphagia after stroke

目的:探究经颅电刺激(Transcranial direct current stimulation,tDCS)联合口肌生物反馈训练在中风后吞咽障碍患者治疗中的应用价值。方法:选取2019年5月~2021年2月我院神经科收治的86例中风后吞咽障碍患者作为研究对象,根据就诊序号采用随机数字表法分为对照组和观察组,各43例。对照组采用基础西药治疗联合口肌生物反馈训练,观察组于此基础上采用tDCS治疗。两组均治疗3 m后评估临床效果、对比治疗前及治疗3 m后神经营养指标水平、吞咽功能、吞咽障碍严重程度、神经损伤程度及生活质量。结果:治疗3 m后,观察组总有效率高于对照组,神经营养指标水平、改良曼恩吞咽功能量表(Modified Mann Assessment of Swallowing Ability,MMASA)评分、吞咽障碍的结局与严重度量表(Dysphagia outcome and severity scale,DOSS)评分、吞咽功能生活质量量表(Swallowing quality of life questionnaire,SWAL-QOL)评分均高于对照组,美国国立卫生研究院卒中量表(National institute of health stroke scale,NIHSS)评分低于对照组(P<0.05)。结论:对中风后吞咽障碍患者实施tDCS联合口肌生物反馈训练治疗效果确切,能调节神经营养因子水平,减轻神经功能损伤程度,有助于改善吞咽功能,且能提高患者生活质量。

Objective:To investigate the effect of transcranial direct current stimulation(tDCS)combined with oral muscle biofeedback training application value in the treatment of patients with dysphagia after stroke.Methods:A total of 86 patients with dysphagia after stroke admitted to the Department of Neurology of our hospital were selected as the research objects,and were randomly divided into the control group and the observation group(43 cases in each).Both groups were treated with conventional western medicine,the control group was treated with oral muscle biofeedback training,and the observation group was treated with tDCS on the basis of control group.The two groups were treated for 3 months to evaluate the clinical effect,compared the levels of neurotrophic indicators,swallowing function,dysphagia Severity,degree of neurological impairment,and quality of life before and after 3 months of treatment.Results:After 3 months of treatment,the total effective rate in the observation group was higher than that in the control group,the levels of neurotrophic indexes and Modified Mann Assessment of Swallowing Ability(MMASA),Dysphagia outcome and severity scale(DOSS),Swallowing quality of life questionnaire(SWAL-QOL)scores were higher than those in the control group,and the National institute of health stroke scale(NIHSS)score was lower than that in the control group(P<0.05).Conclusion:The treatment effect of tDCS combined with oral muscle biofeedback training for patients with dysphagia after stroke is accurate,which can regulate the level of neurotrophic factors,reduce the degree of neurological damage,help to improve swallowing function,and improve the quality of life of patients.