辣椒素联合重复经颅磁刺激用于脑卒中后吞咽障碍患者的疗效观察  

Efficacy of capsaicin combined with repetitive transcranial magnetic stimulation in patients with dysphagia after stroke

作　　者：郑继青 龙耀斌[1] 徐金 ZHENG Jiqing;LONG Yaobin;XU Jin(Department of Rehabilitation,the Second Affiliated Hospital,Guangxi Medical University,Nanning 530007,China)

机构地区：[1]广西医科大学第二附属医院康复医学科,530007

出　　处：《天津医药》2024年第9期950-953,共4页Tianjin Medical Journal

基　　金：广西自然科学基金资助项目(2022GXNSFAA035511);广西壮族自治区医疗卫生重点学科建设项目(桂卫科教发[2022]4号)。

摘　　要：目的探讨辣椒素联合重复经颅磁刺激(rTMS)用于脑卒中后吞咽障碍患者的治疗效果。方法选取脑卒中后吞咽障碍且无真性球麻痹的患者85例,采用随机数字表法分为辣椒素组(28例)、rTMS组(29例)及辣椒素联合rTMS组(联合组,28例)。在常规康复治疗的基础上,辣椒素组给予辣椒素刺激患者口咽部,每日3次(餐前30 min),6 d/周;rTMS组给予健侧初级躯体感觉皮质S1热点磁刺激,1次/d,6 d/周;辣椒素联合rTMS组采用辣椒素结合S1热点磁刺激,3组疗程均为3周。治疗前后分别使用洼田饮水试验(WST)、标准化床边吞咽功能检查(SSA)、进食评估工具(EAT)-10、电视X线透视吞咽功能检查(VFSS)评估患者吞咽功能改善的程度。结果3组患者WST、SSA、EAT-10、VFSS评分在治疗前差异均无统计学意义,治疗后3组上述指标较治疗前均改善,其中联合组改善较其余2组更明显(P<0.05)。结论辣椒素联合rTMS较单一使用辣椒素或rTMS能更明显改善脑卒中后吞咽障碍患者的吞咽功能。Objective To investigate the efficacy of capsaicin combined with repetitive transcranial magnetic stimulation(rTMS)in the treatment of dysphagia after stroke.Methods A total of 85 stroke patients with dysphagia and no true bulbar palsy were included and divided into 3 groups by random number table method:the capsaicin group(28 cases),the rTMS group(29 cases)and the capsaicin combined with rTMS group(28 cases).On the basis of conventional rehabilitation treatment,patients of the capsaicin group were given capsaicin to stimulate oropharynx 3 times a day(30 min before breakfast,lunch and dinner)for 6 days/week.Patients of the rTMS group were given S1 hot spot magnetic stimulation of the primary somatosensory cortex on the healthy side,once a day,6 times a week,and patients of the capsaicin combined with rTMS group were treated with capsaicin combined with S1 hot spot magnetic stimulation.The treatment course of the 3 groups was 3 weeks.Before and after treatment,patients were evaluated by WST,SSA,EAT-10 and VFSS,respectively,to determine the degree of improvement in their swallowing function.Results There were no significant differences in WST,SSA,EAT-10 and VFSS scores before treatment between the 3 groups,and the above indexes were improved after treatment in the 3 groups.The improvement in the capsaicin combined with rTMS group was more obvious than that of the other 2 groups(P<0.05).Conclusion Capsaicin combined with rTMS can significantly improve swallowing function of patients with swallowing disorder after stroke compared with capsaicin or rTMS alone.

关 键 词：卒中 辣椒辣素 经颅磁刺激 吞咽障碍 口咽 

分 类 号：R743.3[医药卫生—神经病学与精神病学]