摘要
目的本研究旨在探讨经皮神经电刺激(TENS)联合吞咽功能训练治疗急性期、恢复期脑卒中后吞咽功能障碍的疗效评价,对比急、慢性期患者治疗的效果差异;以及对比急性期患者TENS联合治疗与单纯吞咽功能训练的疗效差异。方法 118例脑卒中后吞咽功能障碍的患者分为急性期治疗组和恢复期TENS联合功能训练治疗组(简称:恢复期联合治疗组);其中急性期治疗组随机分为急性期TENS联合吞咽功能训练治疗组(简称:急性期联合治疗组)和急性期吞咽功能训练组(急性期功能训练组)两个亚组。三组均使用常规药物治疗和吞咽功能训练,除急性期吞咽功能训练组外其他两组在此基础上加用TENS治疗,疗程两周。在治疗前、治疗1周、治疗2周后采用吞咽X线电视透视检查吞咽功能进行评价。急性期联合治疗组、急性期吞咽功能训练组分别与恢复期联合治疗组比较;以及急性期两亚组间进行比较。结果治疗后2周急性期联合治疗组有效35例,有效率87.5%;急性期功能训练组有效32例,有效率82%;恢复期联合治疗组有效24例,有效率61.5%。急性期联合治疗组和急性期功能训练组均与恢复期联合治疗组比较,差异有统计学意义(P<0.05);但急性期两亚组间差异无统计学意义(P>0.05)。结论脑卒中后吞咽功能障碍患者采用吞咽功能训练联合TENS治疗和单纯吞咽功能训练均有效改善脑卒中后的吞咽功能,急性期明显高于慢性期患者的疗效。但是急性期采用吞咽功能训练联合TENS与单纯吞咽功能训练的效果相当。
Objectives This study aimed to evaluate the clinical effects of transcutaneous electrical nerve stimulation （TENS） combined with functional training on swallowing dysfunction after stroke, compare the effects of functional training in acute and convalescent phase and observe the differences between simple training and training combined TENS therapy. Methods One hundred and eighteen cases of swallowing dysfunction after stroke were divided into acute and chronic groups. In acute group, patients were subsequently divided into simple routine functional training group （acute training group） and TENS combined with functional training （acute TENScombined training group） which patients received the routine functional training and TENS. All the patients in chronic group received TENS combined with training （chronic TENS combined training group）. All patients in three groups had been received basic conventional medicines, and all kinds of treatments were continued for 2 weeks. The video fluoroscopic swallowing exam was applied for assessing efficacy among three groups before treatment, one week and two weeks after treatments. Results At two weeks after treatments, the number of patients with effectiveness were 35 （87.5%） in the acute TENS combined training group, 32 （82%） in the acute training group and 24 （61.5%） in the chronic TENS combined training group. There was significant difference between acute groups （including acute training group and acute training combined TENS group） and chronic combined TENS group （/＇〈0.05）. However, between acute training group and acute TENS combined training group the difference was not statistically significant （/9〉 0.05）. Conclusion Both of TENS combined with training and training alone could improve the swallowing function in acute and chronic phases of stroke. The effects in two acute groups are better than of TENS combined with training in chronic group. However, the effects appeared to be similar between two acute groups.
出处
《中华脑血管病杂志（电子版）》
2013年第4期17-21,共5页
Chinese Journal of Cerebrovascular Diseases(Electronic Edition)
关键词
脑卒中
吞咽障碍
经皮神经电刺激
吞咽训练
Stroke
Swallowing dysfunction
Transcutaneous electrical nerve stimulation
Function training
