| 王超臣,蔺姗,宋宝忠.头项针联合神经肌肉电刺激治疗卒中后吞咽困难的临床研究[J].中国医药导报,2024,21(5):95-99 |
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| 头项针联合神经肌肉电刺激治疗卒中后吞咽困难的临床研究 |
| Clinical study on treatment of post-stroke dysphagia with head and neck acupuncture combined with neuromuscular electrical stimulation |
| 收稿日期： 修订日期：2023-06-27 |
| DOI：10.20047/j.issn1673-7210.2024.05.23 |
| 关键词: 脑卒中 吞咽困难 头项针 神经肌肉电刺激 临床效果 |
| Key Words: |
| 基金项目:江苏省卫生健康委员会科研项目（S2020055） |
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| 摘要:目的 探讨头项针联合神经肌肉电刺激（NMES）治疗卒中后吞咽困难（PSD）的临床效果。 方法 选取2020年2月至2022年3月南京医科大学第四附属医院收治的90例PSD患者，根据随机数字表法将其分为三组，每组30例。头项针组接受头项针治疗，NMES组接受NMES治疗，联合组接受头项针联合NMES治疗。治疗3周后，比较三组临床疗效和治疗前后的洼田饮水试验（WST）分级、标准吞咽功能评估（SSA）、吞咽生活质量问卷（SWAL-QOL）、颏下肌群表面肌电图（sEMG），评估3种措施的安全性。 结果 联合组临床疗效优于头项针组、NMES组（P＜0.05）。治疗后，三组WST分级优于治疗前，且联合组优于头项针组、NMES组（P＜0.05）。治疗后，三组SSA评分、SWAL-QOL评分、吞咽时限低于治疗前，颏下肌群sEMG平均波幅、最大波幅高于治疗前，且联合组SSA评分、SWAL-QOL评分、吞咽时限低于头项针组、NMES组，颏下肌群sEMG平均波幅、最大波幅高于头项针组、NMES组（P＜0.05）。联合组不良反应总发生率与头项针组、NMES组比较，差异无统计学意义（P＞0.05）。结论 头项针联合NMES治疗PSD的临床效果确切，且安全性高。 |
| Abstract:Objective To investigate the clinical effect of hand and neck acupuncture combined with neuromuscular electrical stimulation (NMES) in the treatment of post-stroke dysphagia (PSD). Methods A total of 90 patients with PSD admitted to the Fourth Affiliated Hospital of Nanjing Medical University from February 2020 to March 2022 were selected and divided into three groups with 30 cases in each group according to random number table method. The head and neck acupuncture group were treated with head and neck acupuncture, the NMES group was treated with NMES, and the combined group was treated with head and neck acupuncture and NMES. After three weeks of treatment, the clinical efficacy of the three groups was compared, and the classification of Kubota water swallowing test (WST), standardized swallowing assessment (SSA), swallowing-quality of life questionnaire (SWAL-QOL), and surface electromyography (sEMG) of submental muscle in three groups before and after treatment were compared, and the safety of the three measures was evaluated. Results The clinical effect of combined group was better than that of head and neck acupuncture group and NMES group (P＜0.05). After treatment, classification of WST in the three groups was better than that before treatment, and those in combined group were better than those in head and neck acupuncture group and NMES group (P＜0.05). After treatment, the SSA score, SWAL-QOL score, and swallowing time of the three groups were lower than those before treatment, and the average and maximum sEMG amplitude of the submental muscle of the three groups were higher than those before treatment, and the SSA score, SWAL-QOL score, and swallowing time of the combined group were lower than those of the head and neck acupuncture group and NMES group, the average and maximum sEMG amplitude of submental muscle of the combined group were higher than those of head and neck acupuncture group and NMES group (P＜0.05). There was no significant difference in the total incidence of adverse reactions between the combined group and the head and neck acupuncture group, and NMES group (P＞0.05). Conclusion Head and neck acupuncture combined with NMES in the treatment of PSD has definite clinical efficacy and high safety. |
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