益生菌肠内营养支持联合经颅磁刺激在脑卒中后吞咽障碍康复中的应用  

Application of probiotic enteral nutrition support combined with transcranial magnetic stimulation in the rehabilitation of dysphagia after stroke

作　　者：张玉珍[1] 于小明[1] 徐海辰 马双双 ZHANG Yuzhen;YU Xiaoming;XU Haichen;MA Shuangshuang(The Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine,Shanghai 200137,China;The Third People's Hospital of Yancheng,Yancheng 224005,China)

机构地区：[1]上海中医药大学附属第七人民医院,上海200137 [2]盐城市第三人民医院,江苏盐城224005

出　　处：《中国实用神经疾病杂志》2024年第3期351-355,共5页Chinese Journal of Practical Nervous Diseases

基　　金：上海中医药大学附属第七人民医院人才培养计划(编号:QMX2021-10;PWZzb2022-11)。

摘　　要：目的探讨益生菌肠内营养支持联合经颅磁刺激在脑卒中后吞咽障碍康复中的临床应用效果。方法选取2019-01—2022-12上海中医药大学附属第七人民医院收治的98例脑卒中吞咽障碍患者,分为观察组和对照组各49例。对照组实施经颅磁刺激疗法+营养支持干预,观察组辅助应用益生菌肠内营养干预。对比2组间疗效、吞咽功能、营养健康状况、免疫功能、肠道屏障功能。结果观察组临床疗效优于对照组(P<0.05)。治疗后,观察组洼田饮水试验(KWST)、功能性吞咽障碍量表(FDS)、EAT-10评分均低于对照组(P<0.05),血红蛋白(Hb)、白蛋白(ALB)、前白蛋白(PAB)水平均高于对照组(P<0.05),免疫球蛋白A(IgA)、免疫球蛋白G(IgG)、免疫球蛋白M(IgM)水平均高于对照组(P<0.05),ET、DAO、D-LA低于对照组(P<0.05)。结论益生菌肠内营养支持结合经颅磁刺激对脑卒中吞咽障碍有较好干预效果,能提高吞咽功能和营养水平,提升免疫水平,提高患者肠黏膜屏障功能。Objective To investigate clinical application of probiotic enteral nutrition support combined with transcranial magnetic stimulation in the rehabilitation of swallowing disorders after stroke.Methods Ninety-eight stroke patients admitted to the Seventh Peoples Hospital of Shanghai University of Traditional Chinese Medicine from January 2019 to December 2021 were selected as the subjects.They were randomly divided into the observation group and the control group by computer,with 49 cases in each group.The control group was treated by regular nutritional support and transcranial magnetic stimulation,observation group applied probiotic enteral nutrition support treatment on the basis of the control group.The clinical efficacy,swallowing function score,nutritional indicators,immune function,intestinal barrier function,and quality of life scores between two groups were compared.Results The clinical efficacy of the observation group after treatment was better than control group(P<0.05).After treatment,the scores of kubote water swallowing test(KWST),functional dysphagia scale(FDS)and eating assessment questionnaire-10(EAT-10)in the observation group were lower that those of the control group(P<0.05).The levels of serum albumin(ALB),hemoglobin(Hb),and prealbumin(PAB)in the observation group were higher than those of the coutrol group(P<0.05).The levels of immunoglobulin A(IgA),immunoglobulin G(IgG),and immunoglobulin M(IgM)in the observation group were higher those of the control group(P<0.05).The intestinal mucosal barrier function indicators including diamine oxidase(DAO),D-lactate(D-LA)and ET levels were lower than those of the control group(P<0.05).Conclusion The combination of probiotic enteral nutrition support and transcranial magnetic stimulation has a good effect in the rehabilitation treatment of swallowing disorders after stroke.It can improve the patient’s swallowing function score and nutritional health status,and it can enhance their immune function and intestinal mucosal barrier function.

关 键 词：脑卒中 吞咽障碍 经颅磁刺激 益生菌 肠内营养 免疫功能 肠黏膜屏障功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]