针刺联合经颅直流电刺激治疗脑卒中后假性球麻痹吞咽障碍的临床观察

【目的】 观察针刺联合经颅直流电刺激治疗脑卒中后假性球麻痹吞咽障碍的临床疗效。【方法】 将60例脑卒中后假性球麻痹吞咽障碍患者随机分为观察组和对照组，每组各30例。2组均给予基础治疗及常规吞咽康复训练，对照组给予经颅直流电刺激治疗，观察组在对照组治疗的基础上，给予针刺治疗。共治疗4周。治疗1个月后，观察2组患者治疗前后洼田饮水试验分级（WST）的变化情况，以及电视透视吞咽功能检查（VFSS）的情况。比较 2组患者治疗前后功能性经口摄食量表评分（FOIS）和吞咽障碍特异性生活质量量表评分（SWAL-QOL）的变化情况。并评价2组的安全性及不良反应的发生情况。【结果】（1）研究过程中，对照组脱落 2例，观察组脱落 1例，最终对照组 28例、观察组 29例纳入统计。（2）2组患者 WST评级比较，差异无统计学意义（P＞0.05）。治疗后，2组患者WST评级明显改善（P＜0.05），且观察组在WST评级方面明显优于对照组，差异有统计学意义（P＜0.05）。（3）治疗后，2组患者 FOIS评级明显改善（P＜0.05），且观察组在 FOIS评级方面明显优于对照组，差异有统计学意义（P＜0.05）。（4）治疗后，2组患者VFSS、SWAL-QOL评分明显改善（P＜0.05），且观察组在改善VFSS、SWAL-QOL评分方面明显优于对照组，差异有统计学意义（P＜0.05）。（5）观察组不良反应发生率为10.34%（3/29）；对照组为3.57%（1/28）；观察组与对照组的不良反应发生率比较，差异无统计学意义（P＞0.05）。【结论】 针刺联合经颅直流电刺激治疗脑卒中后假性球麻痹吞咽障碍，能明显改善患者的临床症状，改善患者的吞咽功能，从而提高患者生活质量，疗效显著。

Clinical Observation on Acupuncture Combined with Transcranial DirectCurrent Stimulation in the Treatment of Post-strokePseudobulbar Palsy Dysphagia

Objective To observe the clinical efficacy of acupuncture combined with transcranial direct currentstimulation in the treatment of post-stroke pseudobulbar palsy dysphagia. Methods Sixty patients with dysphagiadue to pseudobulbar palsy after stroke were randomly divided into observation group and control group，30 cases ineach group. Both groups were given basic treatment and routine swallowing rehabilitation training. The control groupwas treated with transcranial direct current stimulation，and the observation group was treated with acupuncture onthe basis of the control group. A total of four weeks of treatment. After one month of treatment，the changes of waterSwallow Test（WST）and Video Fluoroscopy Swallowing Function Test（VFSS）were observed before and after treatment in the two groups. The changes of Functional Oral Intake Scale（FOIS）and Swallowing Quality of LifeScale score（SWAL-QOL）were compared before and after treatment between the two groups. The safety andadverse reactions of the two groups were evaluated. Results（1）During the study，two cases in the control groupand one case in the observation group were lost. Finally， 28 cases in the control group and 29 cases in theobservation group were included in the statistics.（2）There was no significant difference being found in thecomparison of WST scores between the two groups（P＞0.05）. After treatment，the WST rating of the two groupswas significantly improved（P＜0.05），and the WST rating of the observation group was significantly superior tothat of the control group，the difference was statistically significant（P＜0.05）.（3）After treatment，the FOISrating of the two groups was significantly improved（P＜0.05），and the FOIS rating of the observation group wassignificantly superior to that of the control group，the difference was statistically significant（P＜0.05）.（4）Aftertreatment，the VFSS and SWAL-QOL scores of the two groups were significantly improved（P＜0.05），and theimprovement of VFSS and SWAL-QOL scores in the observation group was significantly superior to that in thecontrol group，the difference was statistically significant（P＜0.05）.（5）The incidence of adverse reactions in theobservation group was 10.34%（3/29），the control group was 3.57%（1/28），there was no significant difference inthe incidence of adverse reactions between the observation group and the control group（P＞0.05）. ConclusionAcupuncture combined with transcranial direct current stimulation in the treatment of post-stroke pseudobulbarpalsy dysphagia can significantly improve the clinical symptoms of patients，improve the swallowing function ofpatients，so as to improve the quality of life of patients，and the curative effect is remarkable.