电针廉泉穴联合经颅直流电刺激对脑卒中吞咽障碍老年患者吞咽功能及长期预后的影响  

Effect of Electroacupuncture at Lianquan Point Combined with Transcranial Direct Current Stimulation on Swallowing Function and Long-term Prognosis in Elderly Patients with Swallowing Disorder after Stroke

作　　者：程晓娜 郝棚娜 梁志娟 要志兴 张丽萍 郎晓光 胡芳 吕学海[1] Cheng Xiaona;Hao Pengna;Liang Zhijuan;Yao Zhixing;Zhang Liping;Lang Xiaoguang;Hu Fang;Lv Xuehai(Handan Central Hospital,Handan 056000)

机构地区：[1]邯郸市中心医院,邯郸056000

出　　处：《国际老年医学杂志》2024年第6期707-711,共5页International Journal of Geriatrics

基　　金：河北省医学科学研究计划项目(20220549)。

摘　　要：目的 探讨电针廉泉穴联合经颅直流电刺激(tDCS)对脑卒中后吞咽障碍老年患者的治疗效果。方法 选择2022年7月—2023年11月在邯郸市中心医院收治的116例脑卒中后吞咽障碍老年患者作为研究对象,根据随机数字表法分为对照组和研究组,各58例。对照组采用tDCS治疗,研究组采用电针廉泉穴联合tDCS治疗。比较两组总有效率、吞咽困难情况[改良曼恩吞咽能力评估量表(MASA)]、营养指标[血清前白蛋白(PA)及白蛋白(ALB)]、表面肌电结果(肌电图吞咽时程及最大波幅)、神经损伤指标[脑源性神经营养因子(BDNF)及神经肽Y(NPY)]及长期预后指标[日常生活活动能力量表(ADL)]。结果 治疗后,研究组总有效率、MASA评分高于对照组,PA及ALB水平高于对照组,吞咽时程短于对照组,最大波幅大于对照组,BDNF高于对照组,NPY低于对照组,ADL评分高于对照组,差异均有统计学意义(P<0.05)。结论 脑卒中后吞咽障碍老年患者接受电针廉泉穴联合tDCS治疗,可有效缩短机体吞咽时程,增强吞咽功能,效果确切,有一定临床应用价值。Objective To investigate the therapeutic effect of electroacupuncture at Lianquan point combined with transcranial direct current stimulation(tDCS)on elderly patients with swallowing disorder after stroke.Methods From July 2022 to November 2023,a total of 116 elderly patients with swallowing disorder after stroke admitted to Handan Central Hospital were divided into a control group and a study group according to random number table,each had 58 cases.The control group was treated with tDCS,and the a study group was treated with electroacupuncture at Lianquan point combined with tDCS.The total effective rate,swallowing difficulties[modified Mann assessment of swallowing ability scale(MASA)],nutritional indexes[serum prealbumin(PA)and albumin(ALB)],surface electromyography results(EMG swallowing duration and maximum amplitude),nerve injury indexes[brain-derived neurotrophic factor(BDNF)and neuropeptide Y(NPY)]and long-term prognostic indicators[activities of daily living scale(ADL)]were compared between the two groups.Results After treatment,the total effective rate and MASA score in the study group were higher than those in the control group;PA and ALB were higher than those in the control group,swallowing duration was shorter than that in the control group,and the maximum amplitude was larger than that in the control group.BDNF was higher than that in the control group,NPY was lower than that in the control group;the ADL score was higher than that in the control group,with statistical significance(P<0.05).Conclusion Electroacupuncture at Lianquan point combined with tDCS can effectively shorten the swallowing time duration and enhance swallowing function in elderly patients with swallowing disorder after stroke,with exact effect,which has certain clinical application value.

关 键 词：脑卒中 吞咽障碍 电针廉泉穴 经颅直流电刺激 吞咽功能 

分 类 号：R246.6[医药卫生—针灸推拿学]