| 张敏,王爽,邓蓉,张允建.功能训练联合尼麦角林治疗脑卒中无症状吞咽困难的疗效及机制研究[J].中国康复,2012,27(6):423-425 |
| 功能训练联合尼麦角林治疗脑卒中无症状吞咽困难的疗效及机制研究 |
| Effects and mechanism of functional training combined with nicergoline on stroke patients with asymptomatic dysphagia |
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| DOI： |
| 中文关键词: 尼麦角林 脑卒中 无症状吞咽困难 P物质 |
| 英文关键词: nicergoline stroke asymptomatic dysphagia substance P |
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| 中文摘要: |
| 目的：探讨功能训练联合尼麦角林对脑卒中无症状吞咽困难患者的治疗效果及其作用机制。 方法：经过简单2步法 吞咽激惹试验（STS-SPT）筛选出具有无症状吞咽困难的脑卒中患者60例，随机分为A组和B组各30例，2组患者均予基础吞咽功能及进食训练，A组加用尼麦角林（15mg，tid）治疗。治疗后采用STS-SPT测定患者吞咽功能；治疗前及治疗12周后采用放射免疫分析法测定患者血清P物质浓度。结果：治疗4周后，A组无症状吞咽困难缓解率明显高于B组（P＜0.01）。根据STS-SPT检查吞咽功能是否改善再将2组各分为吞咽功能缓解组（A1、B1组）与未缓解组（A2、B2组）。治疗12周后，A组血清P物质水平较治疗前及B组治疗后明显升高（均P＜0.01）；A1及B1组的血清P物质水平均较治疗前明显升高，且A1组更高于B1组（P＜0.01，0.05）。结论：吞咽功能训练联合尼麦角林能够显著改善脑卒中患者无症状吞咽困难，其机制可能与上调患者P物质水平有关。 |
| 英文摘要: |
| Objective:To investigate the clinical effect and mechanism of nicergoline in the treatment of stroke patients with symptomless dysphagia.Methods:Sixty cases of stroke patients with symptomless dysphagia through a simple two-step swallowing provocation test (STS-SPT) were randomly divided into the observation group and control group with 30 cases in each group.Both groups were given the basic swallowing function and eating training,and the observation group was given nicergoline (15 mg,tid) additionally.The STS-SPT was repeated 4 weeks after the start of treatment. Before and 12 weeks after the treatment,serum concentration of substance P (SP) was measured by using radioimmunoassay.Results:Four weeks after treatment,the remission rate of stroke patients with asymptomatic dysphagia in observation group was significantly higher than in control group (P<0.01).The two groups were divided into subgroup A1，B1 and A2，B2 depending on swallowing function better or not through STS-SPT test.Twelve weeks after treatment,the level of serum SP in observation group was significantly increased as compared with pretreatment and in control group after treatment(all P<0.01).Patients in subgroup A1 and B1 showed significantly increased serum levels of SP,and more significantly in subgroup A1 than in subgroup B1(P<0.01,0.05).Conclusion:Nicergoline can significantly improve asymptomatic dysphagia in stroke patients probably by increasing serum levels of SP. |
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