文章摘要
林冬露,黄定根,欧春培.高频率rTMS联合靶向针刺治疗脑卒中后吞咽障碍临床研究[J].中国康复,2021,36(5):270-273
高频率rTMS联合靶向针刺治疗脑卒中后吞咽障碍临床研究
Clinical study of altofrequency rTMS combined with targeted acupuncture in the treatment of post-stroke dysphagia
  
DOI:
中文关键词: 脑卒中吞咽障碍  高频率  重复经颅磁刺激  靶向针刺
英文关键词: post-stroke dysphagia  altofrequency  repetitive transcranial magnetic stimulation  targeted acupuncture
基金项目:
作者单位
林冬露 深圳市龙华中心医院创伤骨科深圳 518110 
黄定根 深圳市龙华中心医院创伤骨科深圳 518110 
欧春培 深圳市龙华中心医院创伤骨科深圳 518110 
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中文摘要:
  目的:探讨高频率重复经颅磁刺激(rTMS)联合靶向针刺治疗脑卒中吞咽障碍(PSD)的效果。方法:选择PSD患者90例分为rTMS组和联合组各45例,2组均给与常规治疗,rTMS组在常规治疗基础上予以高频率rTMS治疗,联合组在rTMS组治疗基础上予以靶向针刺治疗。比较2组治疗前后标准吞咽功能量评价量表(SSA)评分、渗透误吸量表(PAS)评分和吞咽时间参数(包括口腔运送时间、吞咽反应时间、咽运送时间、喉关闭时间);并比较2组治疗前后舌喉复合体移动度(包括舌骨上移、舌骨前移、甲状软骨上移、甲状软骨前移),比较2组舌骨上肌群肌电活动时域指标-均方根(RMS)值。结果:治疗4周后,2组SSA及PAS评分及口腔运送、吞咽反应、咽运送和喉关闭时间均较治疗前明显下降(均P<0.01),且联合组SSA及PAS评分均低于rTMS组(P<0.01),联合组口腔运送、吞咽反应、咽运送时间均少于rTMS组(均P<0.01),治疗后2组喉关闭时间差异无统计学意义;治疗后2组舌喉复合体移动度及舌骨上肌群RMS值均较治疗前明显提高(均P<0.01),且联合组两项评分均高于rTMS组(均P<0.01)。结论:高频率rTMS联合靶向针刺可增加舌喉复合体移动度,改善舌部肌肉运动,缩短吞咽时间,治疗PSD效果显著。
英文摘要:
  Objective: To investigate the effect of altofrequency repetitive transcranial magnetic stimulation (rTMS) combined with targeted acupuncture on post-stroke dysphagia (PSD). Methods: A total of 90 PSD patients were selected and divided into 2 groups according to the random number table method, with 45 patients in each group. RTMS group received altofrequency rTMS treatment on the basis of conventional treatment, and the combined group received targeted acupuncture treatment on the basis of rTMS group. The Standard swallowing function Assessment Scale (SSA) score, permeation aspiration scale (PAS) score and the swallowing time parameters (including oral transport time, swallowing response time, pharyngeal transport time, and laryngeal closure time) were compared between the two groups before and after treatment. In addition, the mobility of the hyoid laryngeal complex (including hyoid moving up, hyoid antedisplacement, thyroid cartilage moving up, thyroid cartilage antedisplacement) before and after treatment in the two groups was compared, and the value of root mean square (RMS), a time-domain indicator of myoelectric activity of the suprahyoid muscle group, was compared between the two groups. Results: After treatment, SSA and PAS scores were significantly lower, oral transport time, swallowing response time and pharyngeal transport time were significantly shorter, the mobility of the hyoid laryngeal complex was greater, and the RMS value of suprahyoid muscle group was greater in the combined group than those in the control group (P<0.01). Conclusion: Altofrequency rTMS combined with targeted acupuncture can increase the mobility of hyoid laryngeal complex, improve tongue muscle movement, shorten swallowing time, and has a significant effect in the treatment of PSD.
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