经皮穴位电刺激疗法联合吞咽功能训练在卒中后吞咽功能障碍患者中的应用效果  

Application effects of transcutaneous electrical acupoint stimulation therapy combined with swallowing function training in patients with dysphagia after stroke

作　　者：张志芳 桂飞飞 郝婷婷[1] ZHANG Zhifang;GUI Feifei;HAO Tingting(Department of Rehabilitation Medicine of the First Affiliated Hospital of Henan University,Kaifeng 475000 Henan,China)

机构地区：[1]河南大学第一附属医院康复医学科,河南开封475000

出　　处：《中国民康医学》2025年第3期88-90,94,共4页Medical Journal of Chinese People’s Health

摘　　要：目的:观察经皮穴位电刺激疗法(TEAS)联合吞咽功能训练在卒中后吞咽功能障碍患者中的应用效果。方法:回顾性分析2022年9月至2023年9月该院收治的94例卒中后吞咽功能障碍患者的临床资料,根据治疗方法不同将其分为对照组与观察组各47例。对照组进行吞咽功能训练,观察组在对照组基础上联合TEAS。比较两组干预前后吞咽及摄食功能[标准吞咽功能评价量表(SSA)、功能性经口摄食量表(FOIS)]评分,吞咽上、下肌群平均振幅,以及舌骨上、下肌群和患侧咀嚼肌肌电积分值(iEMG)。结果:干预4周后,两组SSA评分均低于干预前、干预2周后,且观察组低于对照组,两组FOIS评分均高于干预前、干预2周后,且观察组高于对照组,差异有统计学意义(P<0.05);干预4周后,两组舌骨上、下肌群平均振幅均高于干预前、干预2周后,且观察组高于对照组,差异有统计学意义(P<0.05);干预4周后,两组舌骨上肌群、舌骨下肌群、患侧咀嚼肌iEMG均高于干预前、干预2周后,且观察组高于对照组,差异有统计学意义(P<0.05)。结论:TEAS联合吞咽功能训练治疗卒中后吞咽功能障碍患者可提高舌骨上、下肌群平均振幅和舌骨上肌群、舌骨下肌群、患侧咀嚼肌iEMG,以及改善吞咽及摄食功能评分,效果优于单纯吞咽功能训练。Objective:To observe application effects of transcutaneous electrical acupoint stimulation(TEAS)combined with swallowing function training in patients with dysphagia after stroke.Methods:The clinical data of 94 patients with dysphagia after stroke admitted to this hospital from September 2022 to September 2023 were retrospectively analyzed.According to different treatment methods,they were divided into control group and observation group,47 cases in each group.The control group was treated with swallowing function training,while the observation group was combined with TEAS on the basis of that of the control group.The swallowing and feeding function[standardized swallowing assessment(SSA),Functional Oral Intake Scale(FOIS)],the average amplitudes of upper and lower muscles of swallowing,and the electromyography integral(iEMG)values of suprahyoid muscle group,infrahyoid muscle group and ipsilateral masticatory muscles were compared between the two groups before and after the intervention.Results:After 4 weeks of intervention,the SSA scores of both groups were lower than before intervention and 2 weeks after intervention,and the observation group was lower than the control group.The FOIS scores of both groups were higher than before intervention and 2 weeks after intervention,and the observation group was higher than the control group,with statistical significance(P<0.05);After 4 weeks of intervention,the average amplitude of the upper and lower muscles of the tongue bone in both groups was higher than before and after 2 weeks of intervention,and the observation group was higher than the control group,with statistical significance(P<0.05);After 4 weeks of intervention,the levels of iEMG in the suprahyoid and infrahyoid muscle groups,as well as the affected chewing muscle,were higher in both groups than before and after 2 weeks of intervention,and the observation group was higher than the control group,with statistical significance(P<0.05).Conclusions:TEAS combined with swallowing function training in the treatment

关 键 词：卒中 吞咽功能障碍 经皮穴位电刺激 吞咽功能训练 吞咽功能 咀嚼肌 摄食功能 

分 类 号：R493[医药卫生—康复医学]