| 摘要: |
| 目的 观察VitalStim电针治疗脑卒中后环咽肌失弛缓（CPD）患者吞咽障碍的临床疗效。方法 纳入重庆医科大学附属第二医院康复医学科2018年10月至2019年10月脑卒中后CPD患者40例，随机分为试验组和对照组，每组20例。所有患者均接受常规吞咽障碍康复治疗，此外试验组接受改良VitalStim电针干预，对照组接受普通电针干预。两组患者在治疗前及治疗结束后采用荧光吞咽造影和喉部超声检查分别评估两组患者吞咽不同钡剂食团所用时间（吞咽通过时间）、环咽肌开放幅度及舌骨位移量，比较两组患者治疗前后这些指标的变化，在治疗过程中观察患者是否发生相关不良事件和并发症。结果 与治疗前相比，治疗后两组患者吞咽通过时间缩短，环咽肌的开放幅度及舌骨位移量增大（P均＜0.01）。治疗后，试验组患者的吞咽通过时间短于对照组，环咽肌开放幅度和舌骨位移量大于对照组（P均＜0.01）。治疗过程中患者未发生相关不良事件及并发症。结论 康复训练结合普通电针或改良VitalStim电针可通过增加喉上抬幅度、促进环咽肌开放，改善CPD患者吞咽功能；改良VitalStim电针治疗可以让患者获得更好的康复效果。 |
| 关键词: VitalStim 电针 脑卒中 吞咽障碍 环咽肌失弛缓症 |
| DOI：10.16781/j.CN31-2187/R.20211087 |
| 投稿时间：2021-10-27修订日期：2022-01-06 |
| 基金项目:国家自然科学基金青年科学基金（81802234），重庆市卫生和计划生育委员会、重庆市科学技术委员会科卫联合中医药科技项目（ZY201802104）. |
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| Modified VitalStim electroacupuncture in the treatment of stroke survivors with cricopharyngeal dysfunction: a clinical study |
| JIANG Wei,LI Dong-qian,WEI Xia,JIA Lang* |
(Department of Rehabilitation Medicine, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
*Corresponding author) |
| Abstract: |
| Objective To observe the clinical efficacy of modified VitalStim electroacupuncture in the treatment of dysphagia in stroke patients with cricopharyngeal dysfunction (CPD). Methods A total of 40 stroke survivors with CPD in Department of Rehabilitation Medicine of The Second Affiliated Hospital of Chongqing Medical University from Oct. 2018 to Oct. 2019 were randomly divided into experimental group and control group, with 20 patients in each group. The experimental group received modified VitalStim electroacupuncture＋routine rehabilitation, and the control group received routine electroacupuncture＋routine rehabilitation. The patients in the 2 groups were assessed by video fluoroscopic swallowing study (VFSS) and laryngeal ultrasonography before and after treatment. The swallowing time, cricopharyngeal muscle expansion and hyoid bone displacement were analyzed respectively. The changes of above indexes were compared between the 2 groups before and after treatment. Adverse events and complications were observed during the treatment. Results Compared with before treatment, shortened swallowing time and increased cricopharyngeal muscle expansion and hyoid bone displacement were observed in both groups after treatment (all P＜0.01). After treatment, the swallowing time of patients in the experimental group was shorter than that in the control group, and the cricopharyngeal muscle expansion and hyoid bone displacement were greater than those in the control group (all P＜0.01). No adverse events or complications occurred during the treatment. Conclusion Routine rehabilitation combined with routine electroacupuncture or modified VitalStim electroacupuncture can improve the swallowing function of stroke survivors with CPD by increasing the hyoid bone displacement and relieving the cricopharyngeal muscle spasm, and modified VitalStim electroacupuncture has better clinical efficacy. |
| Key words: VitalStim electropuncture stroke dysphagia achalasia of cricopharyngeus muscle |
