| 王晓晗,王雅男,郭立颖,刘思,尹昱.经颅直流电刺激联合口腔内低频电刺激对脑卒中后口腔期吞咽障碍的效果观察[J].中国康复,2025,40(10):594-598 |
| 经颅直流电刺激联合口腔内低频电刺激对脑卒中后口腔期吞咽障碍的效果观察 |
| Effect of transcranial direct current stimulation combined with intraoral low-frequency electrical stimulation for post-stroke dysphagia in the oral phase |
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| DOI：10.3870/zgkf.2025.10.003 |
| 中文关键词: 脑卒中 吞咽障碍 经颅直流电刺激 口腔内低频电刺激 口腔期吞咽障碍 |
| 英文关键词: stroke dysphagia transcranial direct current stimulation intraoral low-frequency electrical stimulation oral phase dysphagia |
| 基金项目:河北省中医药管理局科研计划项目（2019143） |
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| 中文摘要: |
| 目的：观察经颅直流电刺激联合口腔内低频电刺激对脑卒中后口腔期吞咽障碍的临床疗效。方法：选取脑卒中后口腔期吞咽障碍患者64例,随机分为对照组和观察组各32例。对照组采用经颅直流电刺激联合常规吞咽康复训练治疗，观察组在对照组基础上给予口腔内低频电刺激治疗，均治疗2周。比较2组患者治疗前后改良银剂吞咽障碍造影评估（MBSImp）结果、口腔运送时间、软腭上抬时间、吞咽生存质量量表（SWAL-QOL）评分及营养状态(外周血总蛋白、白蛋白、血红蛋白)和体重的变化。结果：治疗2周后，2组患者SWAL-QOL评分、外周血总蛋白、白蛋白 、血红蛋白和体重均增加(P＜0.01)，MBSImp评分、口腔运送时间和软腭上抬时间均减少(P＜0.01)；观察组SWAL-QOL评分、总蛋白、白蛋白、血红蛋白、体重高于对照组(P＜0.01，0.05)；MBSImp评分低于对照组(P＜0.05)，口腔运送时间和软腭上抬时间均较对照组缩短(P＜0.01，0.05)。结论：经颅直流电刺激联合口腔内低频电刺激能促进口腔功能恢复，改善脑卒中后口腔期吞咽障碍，提高患者生活质量。 |
| 英文摘要: |
| Objective: To investigate the clinical efficacy of transcranial direct current stimulation (tDCS) combined with intraoral low-frequency electrical stimulation in treating oral-phase dysphagia following stroke, providing new therapeutic insights and empirical evidence for enhancing the rehabilitation of post-stroke patients experiencing dysphagia. Methods: A single-center, randomized, controlled, and single-blind clinical trial was conducted to assess the intervention’s effectiveness. A total of 64 patients diagnosed with oral-phase dysphagia after stroke were recruited from the Department of Rehabilitation Medicine. Participants were randomly assigned into two groups: a control group (n=32) and an experimental group (n=32). The control group received transcranial direct current stimulation in combination with conventional swallowing rehabilitation therapy. The experimental group received the same treatment as the control group, with the addition of intraoral low-frequency electrical stimulation. The treatment course lasted for 2 weeks. Key outcome measures included the modified swallowing dysphagia imaging assessment scores（MBSImp）, oral transit time, soft palate elevation time, scores on the swallowing function-specific quality of life scale（SWAL-QOL）, and indicators of nutritional status（total protein, albumin, hemoglobin levels）and body weight. These measures were recorded and analyzed before and after the intervention to evaluate the changes in clinical outcomes. Results: After 2 weeks of treatment, both groups showed improvement in the SWAL-QOL scores, total protein, albumin, hemoglobin, and body weight(P<0.01); the MBSImp scores, oral transit time, and soft palate elevation time were all reduced (P<0.01). The improvements in the SWAL-QOL scores, total protein, albumin, and hemoglobin were significantly greater in the experimental group than in the control group (P<0.01，0.05). The MBSImp scores in the experimental group were lower than those in the control group (P<0.05). Oral transit time and soft palate elevation time in the experimental group were both significantly shorter than those in the control group, with statistically significant differences (P<0.01,0.05). Conclusion: Transcranial direct current stimulation combined with intraoral low-frequency electrical stimulation can promote the recovery of oral motor function, improve oral-phase dysphagia after stroke, and enhance patients’ quality of life. This combined approach demonstrates greater therapeutic benefits than conventional rehabilitation alone, particularly in improving nutritional indicators and reducing key physiological markers of dysphagia. These findings suggest that integrating neuromodulation with targeted intraoral stimulation may serve as a promising and effective rehabilitation strategy for post-stroke dysphagia. |
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