摘要
目的探讨耳穴压豆联合重复经颅磁刺激(rTMS)对卒中患者吞咽功能及神经功能的影响。方法选取2022年1月至2023年6月该院收治的120例卒中后吞咽障碍患者为研究对象,按随机数字表法分为对照组、耳穴压豆组、rTMS组和联合组,每组30例。对照组接受常规治疗,耳穴压豆组在对照组基础上接受耳穴压豆治疗,rTMS组则接受rTMS治疗,联合组同时接受耳穴压豆和rTMS治疗,持续4周。通过功能性经口摄食分级量表(FOIS)、改良曼恩吞咽能力评估量表(MASA)与洼田饮水试验评估治疗前后吞咽功能改善情况,采用吞咽障碍特异性生活质量量表(SWAL-QOL)评估治疗前后吞咽相关生活质量,采用美国国立卫生研究院卒中量表(NIHSS)评估治疗前后神经功能缺损程度。结果治疗后,4组FOIS、MASA评分高于治疗前,且耳穴压豆组、rTMS组高于对照组,联合组高于其他3组,差异有统计学意义(P<0.05)。联合组吞咽功能总有效率(93.33%)高于对照组(60.00%)、耳穴压豆组(63.33%)、rTMS组(73.33%),差异有统计学意义(P<0.05);而其他3组总有效率比较,差异无统计学意义(P>0.05)。治疗后,4组SWAL-QOL评分高于治疗前,且耳穴压豆组、rTMS组高于对照组,联合组高于其他3组,差异有统计学意义(P<0.05)。治疗后,4组NIHSS评分低于治疗前,且联合组低于其他3组,差异有统计学意义(P<0.05)。结论耳穴压豆联合rTMS可改善卒中患者吞咽功能和生活质量,促进神经功能恢复。
Objective To investigate the influence of auricular acupressure combined with repetitive transcranial magnetic stimulation(rTMS)on swallowing function and neurological function in stroke patients.Methods A total of 120 patients with dysphagia after stroke admitted to the hospital from January 2022 to June 2023 were selected as the research objects and divided into the control group,the auricular acupressure group,the rTMS group and the combined group according to the random number table method,with 30 cases in each group.The control group received routine care,the auricular acupressure group received auricular acupressure treatment on the basis of the control group,while the rTMS group received rTMS treatment,and the combined group received both auricular acupressure and rTMS treatment.All interventions lasted 4 weeks.Swallowing function was assessed before and after treatment using Functional Oral Intake Scale(FOIS),modified Mann Assessment of Swallowing Ability(MASA),and Water Swallow Test.Swallowing-related quality of life was evaluated before and after treatment by the Swallowing Quality of Life(SWAL-QOL)questionnaire.Neurological impairment was assessed before and after treatment using National Institutes of Health Stroke Scale(NIHSS).Results After treatment,FOIS and MASA scores in the four groups were higher than those before treatment,with the auricular acupressure group and the rTMS group showing higher scores than the control group,and the combination group significantly higher than the other three groups(P<0.05).The overall effectiveness rate for swallowing function in the combination group was 93.33%,significantly higher than 60.00% in the control group,63.33% in the auricular acupressure group,and 73.33% in the rTMS group(P<0.05),while there was no significant difference among the other three groups(P>0.05).After treatment,SWAL-QOL scores in the four groups were higher than that before treatment,with the auricular acupressure group and the rTMS group showing higher scores than the control group,and the combination group significantly higher than the other three groups(P<0.05).After treatment,NIHSS scores in the four groups were lower than that before treatment,and the combination group had significantly lower scores compared to the other three groups(P<0.05).Conclusion Auricular acupressure combined with rTMS could improve swallowing function and quality of life,and promote neurological function recovery in stroke patients.
作者
韦婉丹
兰柳华
梁坚
陈小霞
梁声
蒋英
WEI Wandan;LAN Liuhua;LIANG Jian;CHEN Xiaoxia;LIANG Sheng;JIANG Ying(Department of Rehabilitation Medicine,the Second Affiliated Hospital of Guangxi Medical University,Nanning,Guangxi 530007,China)
出处
《重庆医学》
2025年第8期1811-1815,共5页
Chongqing Medical Journal
基金
广西壮族自治区中医药管理局自筹经费科研课题(GXZYA20244.0352)
广西壮族自治区卫生健康委员会自筹经费科研课题(Z-A20220600)
广西壮族自治区医疗卫生重点学科建设项目(桂卫科教发〔2022〕4号)。
关键词
耳穴压豆
重复经颅磁刺激
卒中
吞咽障碍
神经功能
生活质量
auricular acupressure
repetitive transcranial magnetic stimulation
stroke
dysphagia
neurological function
quality of life
