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| 不同强度经颅直流电刺激治疗真性球麻痹吞咽障碍的疗效观察 |
| Clinical effect of different intensities transcranial direct current stimulation for dysphagia after bulbar paralysis |
| 投稿时间：2022-10-26 修订日期：2022-10-26 |
| DOI： |
| 中文关键词: 经颅直流电刺激 真性球麻痹 吞咽障碍 |
| 英文关键词: transcranial direct current stimulation bulbar paralysis dysphagia |
| 基金项目:武汉市卫生健康科研基金(WX19D58);武汉市卫生计生科研基金(WX18Y01) |
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| 中文摘要: |
| 目的 探讨不同强度经颅直流电刺激（tDCS）治疗真性球麻痹吞咽障碍的临床疗效。方法 选取符合入选标准的真性球麻痹患者42例，采用随机数字表法将其分为低强度组、高强度组、假刺激组，每组14例。3组患者均给予常规吞咽康复训练，高强度组予以2mA刺激，低强度组予以1mA刺激，假刺激组仅在最初30s内予以tDCS刺激，每次20min，5次/周，共治疗3周。分别于治疗前和治疗3周后，采用纤维内镜下吞咽困难严重程度量表（FEDSS）、改良曼恩吞咽能力评估量表(MMASA)和表面肌电数据进行评定和分析。结果 治疗后，低强度组和高强度组的FEDSS评分低于假刺激组（均P＜0.05），且高强度组低于低强度组（均 P＜0.05）；低强度组和高强度组的MMASA评分和sEMG平均肌电值均高于假刺激组（均P＜0.05），且高强度组高于低强度组（P＜0.05）。结论 低强度、高强度tDCS电刺激均可改善真性球麻痹吞咽障碍，且高强度组优于低强度组。 |
| 英文摘要: |
| Objective To explore the clinical efficacy of transcranial direct current stimulation (tDCS) with different intensities in the treatment of true bulbar paralysis dysphagia. Methods Forty-two patients with true bulbar palsy were selected and randomly divided into low intensity group, high intensity group and sham stimulation group, with 14 cases in each group. All patients in the three groups were given routine swallowing rehabilitation training. The high-intensity group was given 2mA stimulation, the low-intensity group was given 1mA stimulation, and the sham stimulation group was given tDCS stimulation for 20min each time, 5 times a week for 3 weeks. Before and after 3 weeks of treatment, respectively, the severity scale of dysphagia under fiberoptic endoscope (FEDSS), modified Mann swallowing ability assessment scale (MMASA) and surface electromyography data were used for evaluation and analysis. Results After treatment, the FEDSS score of low and high intensity groups were lower than that of control group (P<0.05) and the FEDSS score of high intensity group was lower than that of low intensity group (P<0.05). After treatment, the MMASA score and sEMG of low and high intensity groups were higher than that of control group (P<0.05) and the MMASA score and sEMG of high intensity group was higher than that of low intensity group (P<0.05).Conclusion Both low-intensity and high-intensity tDCS electrical stimulation can improve swallowing disorder of true bulbar paralysis, and the high-intensity group is better than the low-intensity group. |
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