舌三针联合间歇性θ爆发刺激对脑卒中后吞咽障碍患者 吞咽功能及表面肌电的影响

Effect of Tongue Triple Acupuncture Combined with Intermittent Theta Burst Stimulation on Swallowing Function and Surface Electromyography in Patients with Post-stroke Dysphagia

目的观察舌三针联合间歇性θ爆发刺激(intermittent theta burst stimulation,iTBS)对脑卒中后吞咽障碍患者吞咽功能及表面肌电(surface electromyography,sEMG)的影响。方法将40例脑卒中后吞咽障碍患者随机分为对照组和观察组,每组20例;两组患者均进行常规吞咽训练,对照组在此基础上行舌三针治疗,观察组在对照组治疗基础上增加iTBS治疗,疗程均为4周;观察和比较两组患者治疗前后洼田饮水试验(water swallowing test,WST)评分、标准吞咽功能评估(standardized swallowing assessment,SSA)量表评分、吞咽生活质量(swallowing quality of life,SWAL-QOL)量表评分、sEMG最大波幅值及吞咽时程。结果治疗后两组患者WST评分、SSA量表评分、吞咽时程均较治疗前显著减少(P<0.05),SWAL-QOL量表评分、sEMG最大波幅值均较治疗前显著增加(P<0.05);且观察组WST评分、SSA量表评分、吞咽时程减少程度,SWAL-QOL量表评分、sEMG最大波幅值增加程度均显著大于对照组(P<0.05)。结论舌三针联合iTBS治疗可显著改善脑卒中后吞咽障碍患者吞咽功能并提高生活质量。

Objective To investigate the effect of tongue triple acupuncture combined with intermittent theta burst stimulation(iTBS)on swallowing function and surface electromyography(sEMG)in patients with post-stroke dysphagia.Methods A total of 40 patients with post-stroke dysphagia were randomly divided into observation group and control group,with 20 patients in each group.The patients in the control group were given conventional swallowing training and tongue triple acupuncture,while those in the observation group were given iTBS in addition to the treatment in the control group;the course of treatment was 4 weeks for both groups.The two groups were observed and compared in terms of water swallowing test(WST)score,standardized swallowing assessment(SSA)score,swallowing quality of life(SWAL-QOL)score,the maximum amplitude of sEMG,and swallowing duration before and after treatment.Results After treatment,both groups had significant reductions in WST score,SSA score,and swallowing duration(P<0.05)and significant increases in SWAL-QOL score and the maximum amplitude of sEMG(P<0.05),and compared with the control group,the observation group had significantly greater reductions in WST score,SSA score,and swallowing duration and significantly greater increases in SWAL-QOL score and the maximum amplitude of sEMG(P<0.05).Conclusion Tongue triple acupuncture combined with iTBS can significantly improve the swallowing function and quality of life of patients.