针刺结合Stroop范式用于脑卒中后假性球麻痹致吞咽障碍的临床效果

Clinical Effects of Acupuncture Combined with Stroop Paradigm for Swallowing Disorder Caused by Pseudobulbar Palsy After Stroke

目的分析针刺结合Stroop范式对脑卒中后假性球麻痹致吞咽障碍患者吞咽功能、认知功能、面部痉挛的影响。方法按照随机对照原则,将2021年1月至2023年1月就诊于河南省老干部康复医院的90例脑卒中后假性球麻痹致吞咽障碍患者分为两组。两组均接受基础治疗及常规吞咽功能训练,对照组(45例)接受Stroop范式认知任务训练,研究组(45例)接受针刺联合Stroop范式认知任务训练,共训练2周。对比两组临床疗效、吞咽功能、面部痉挛情况、脑源性神经营养因子、认知功能、不良事件发生率。结果研究组训练2周后的总有效率比对照组高(P<0.05);研究组训练2周后面部痉挛等级轻于对照组,总正常率高于对照组(P<0.05);研究组训练2周后标准吞咽功能评估法(SSA)评分比对照组低(P<0.05);研究组训练2周后血清S100β蛋白、神经元特异性烯醇化酶(NSE)水平均比对照组低,血清脑源性神经营养因子(BDNF)水平以及蒙特利尔认知评估量表(MoCA)评分比对照组高(P<0.05);研究组不良事件发生率和对照组相比差异无统计学意义(P>0.05)。结论针刺结合Stroop范式用于脑卒中后假性球麻痹致吞咽障碍患者中,能有效提升患者吞咽功能以及认知功能,改善面部痉挛情况以及脑神经损伤。

Objective To analyze the effects of acupuncture combined with Stroop paradigm on swallowing function,cognitive function and facial spasm in patients with swallowing disorder caused by pseudobulbar palsy after stroke.Methods A total of 90 patients with dysphagia caused by pseudobulbar palsy after stroke admitted to Veteran Cadres Rehabilitation Hospital of Henan Province from January 2021 to January 2023 were selected and grouped into randomized control groups.The two groups received basic treatment and routine swallowing function training.The control group(45 cases)received Stroop paradigm cognitive task training,and the study group(45 cases)received acupuncture and Stroop paradigm cognitive task training for a total of 2 weeks.The clinical efficacy,swallowing function,facial spasm,brain-derived neurotrophic factor,cognitive function and incidence of adverse events were compared between the two groups.Results The total effective rate of the study group after 2 weeks of training was higher than that of the control group(P<0.05).After 2 weeks of training,the grade of facial spasm in the study group was lighter than that in the control group,and the total normal rate was higher than that in the control group(P<0.05).The standard swallowing function assessment(SSA)score of the study group was lower than that of the control group after 2 weeks of training(P<0.05).After 2 weeks of training,the levels of serum S100βprotein and neuron-specific enolase(NSE)in the study group were lower than those in the control group,and the levels of serum brain-derived neurotrophic factor(BDNF)and Montreal cognitive assessment scale(MoCA)score in the study group were higher than those in the control group(P<0.05).There was no significant difference in the incidence of adverse events in the study group compared with the control group(P>0.05).Conclusion Acupuncture combined with Stroop paradigm can effectively improve the swallowing function and cognitive function of patients with dysphagia caused by pseudobulbar palsy after stroke,and improve the condition of facial spasm and brain nerve injury.