不同强度经颅直流电刺激治疗真性球麻痹吞咽障碍的疗效观察  

Clinical Effect of Transcranial Direct Current Stimulation with Different Intensities on Dyspha⁃gia after True Bulbar Paralysis

作　　者：孙莉 王舒 沈晓艳 SUN Li;WANG Shu;SHEN Xiao-yan(Department of Rehabilitation,General Hospital of the Yangtze River Shipping,Wuhan 430010,China)

机构地区：[1]长江航运总医院康复科,武汉430010

出　　处：《神经损伤与功能重建》2022年第10期587-590,共4页Neural Injury and Functional Reconstruction

基　　金：武汉市卫生健康科研基金(No.WX19D58);武汉市卫生计生科研基金(No.WX18Y01)。

摘　　要：目的:探讨不同强度经颅直流电刺激(tDCS)治疗真性球麻痹吞咽障碍的临床疗效。方法:选取符合入选标准的真性球麻痹患者42例,随机分为假刺激组、低强度组、高强度组,每组14例。3组患者均给予常规吞咽康复训练,假刺激组予以假性tDCS刺激,低强度组予以1 mA tDCS电刺激,高强度组予以2 mA tDCS电刺激;均为20 min/次,5次/周,共治疗3周。分别于治疗前和治疗3周后,采用纤维内镜下吞咽困难严重程度量表(FEDSS)、改良曼恩吞咽能力评估量表(MMASA)评分和表面肌电(sEMG)数据进行评定和分析。结果:治疗后,低强度组和高强度组的FEDSS评分低于假刺激组(均P<0.05),且高强度组低于低强度组(均P<0.05);低强度组和高强度组的MMASA评分和sEMG平均肌电值均高于假刺激组(均P<0.05),且高强度组高于低强度组(P<0.05)。结论:低强度、高强度tDCS电刺激均可改善真性球麻痹吞咽障碍,且高强度刺激疗效可能优于低强度刺激。Objective:To explore the therapeutic effect of transcranial direct current stimulation(tDCS)with different intensities in the treatment of swallowing disorder of patients with true bulbar paralysis.Methods:Forty-two patients with true bulbar palsy were enrolled and randomly divided into control group,low intensity group,and high intensity group,with 14 cases in each group.All cases were given routine swallowing rehabilitation training.Cases in high-intensity group were given 2 mA stimulation,cases in low-intensity group were given 1 mA stimulation,and those in control group were given sham stimulation,20 min per time,5 times per week and for 3 weeks.Before and after 3-week of treatment,the severity scale of dysphagia under fiberoptic endoscope(FEDSS),modified Mann swallowing ability assessment scale(MMASA)and surface electromyography(sEMG)data of three groups were got and analyzed.Results:After treatment,the FEDSS score of low and high intensity groups were lower than that of control group(P<0.05)and the FEDSS score of high intensity group was lower than that of low intensity group(P<0.05).After treatment,the MMASA score and sEMG of low and high intensity groups were higher than that of control group(P<0.05)and the MMASA score and sEMG of high intensity group was higher than that of low intensity group(P<0.05).Conclusion:tDCS electrical stimulation can improve swallowing disorder of patients with true bulbar paralysis,and the therapeutic effect of high-intensity is probably better than low-intensity.

关 键 词：经颅直流电刺激 真性球麻痹 吞咽障碍 

分 类 号：R741[医药卫生—神经病学与精神病学] R743[医药卫生—临床医学] R493