孟阳,胡川,王珊珊,等.基于“中枢-外周-中枢”理念的咽喉上升强化训练联合重复经颅磁刺激对脑卒中恢复期患者吞咽障碍的影响[J].中华物理医学与康复杂志,2025,47(4):295-299
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| 基于“中枢-外周-中枢”理念的咽喉上升强化训练联合重复经颅磁刺激对脑卒中恢复期患者吞咽障碍的影响 |
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| DOI：10.3760/cma.j.cn421666-20240826-00688 |
| 中文关键词: 吞咽障碍 脑卒中 中枢-外周-中枢理念 咽喉上升强化训练 重复经颅磁刺激 |
| 英文关键词: Dysphagia Stroke Central-peripheral-central concept Throat rise strengthening training Transcranial magnetic stimulation |
| 基金项目:山东省医药卫生科技项目（202416010267） |
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| 摘要点击次数: 1099 |
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| 中文摘要: |
| 目的 探讨基于“中枢-外周-中枢（CPC）”理念的咽喉上升强化训练联合重复经颅磁刺激(rTMS)对脑卒中恢复期患者吞咽障碍的影响。 方法 选取脑卒中恢复期吞咽障碍患者80例，按照随机数字表法将其分为对照组、抬升组、rTMS组和联合组，每组20例。4组患者均给予神经科药物治疗和常规吞咽功能训练，在此基础上，抬升组进行咽喉上升强化训练，rTMS组给予rTMS治疗，联合组采用咽喉上升强化训练和rTMS治疗。治疗前、治疗4周后，采用视频吞咽造影检查（VFSS）、渗漏-误吸量表（PAS）、功能性经口摄食量表（FOIS）评定4组患者的吞咽情况。 结果 治疗4周后，4组患者的VFSS、PAS、FOIS评分均较组内治疗前改善（P＜0.05）。治疗4周后，抬升组、rTMS组、联合组的VFSS、PAS、FOIS评分均优于对照组（P＜0.05），联合组的VFSS评分、PAS评分、FOIS评分均优于其它3组（P＜0.05），抬升组与rTMS组的上述指标比较，差异无统计学意义（P＞0.05）。 结论 基于CPC理论的咽喉上升强化训练联合rTMS可显著改善脑卒中恢复期吞咽障碍患者的吞咽功能。 |
| 英文摘要: |
| Objective To explore the effect of combining intensive laryngeal elevation training with repeated transcranial magnetic stimulation (rTMS) based on the concept of "central-peripheral-central" (CPC) on dysphagia in stroke survivors. Methods Eighty stroke survivors with dysphagia were selected and randomly divided into a control group, a lift group, an rTMS group and a combination group, each of 20. In addition to neurologic drug therapy and routine swallowing training, the lift group received intensive throat elevation training, the rTMS group received rTMS, while the combination group underwent both before and after 4 weeks of treatment, all were evaluated using video swallowing angiography (VFSS), a leakage-aspiration scale (PAS) and a functional oral feeding scale (FOIS). Results After the treatment, the average VFSS, PAS and FOIS scores had improved significantly in all 4 groups, with those of the lift group, the rTMS group and the combination group then significantly better than the control group′s averages. The combination group′s scores were significantly better than those of the other 3 groups. There was no significant difference in any of the indexes between the lift and TMS groups. Conclusions CPC-based intensive laryngeal ascent training combined with rTMS can significantly improve the swallowing of stroke survivors with dysphagia in convalescence. |
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