上海交通大学学报（医学版）

上海交通大学学报（医学版）

• 论著（临床研究） • 上一篇    下一篇

改良Vitalstim电针仪治疗脑卒中后吞咽障碍的临床研究

蒋 玮，谭波涛，周 媛，贾功伟，吴雪莲，贾 朗，虞乐华   

  1. 重庆医科大学附属第二医院康复医学科， 重庆 400010
  • 出版日期:2014-09-28 发布日期:2014-09-26
  • 通讯作者: 虞乐华, 电子信箱: yuleuadoc@aliyun.com; 贾 朗, 电子信箱: duckbill1983@sohu.com。
  • 作者简介:蒋 玮（1982—）， 女， 主管护师; 电子信箱: jiangwei_24@126.com。
  • 基金资助:

    国家自然科学基金（81171859）；重庆市卫生局中医药科技重点项目（2008-1-11）；重庆市卫生局医学重点学科建设项目（201053）

Clinical study on treatment of patients with dysphagia after stroke by improved Vitalstim electroacupuncture

JIANG Wei, TAN Bo-tao, ZHOU Yuan, JIA Gong-wei, WU Xue-lian, JIA Lang, YU Le-hua   

  1. Department of Rehabilitation, the Second Affiliated Hospital, Chongqing Medical University, Chongqing 400010, China
  • Online:2014-09-28 Published:2014-09-26
  • Supported by:

    National Natural Science Foundation of China, 81171859; Key Project of Traditional Chinese Medicine of Chongqing Municipal Health Bureau, 2008-1-11; Leading Academic Discipline Project of Chongqing Municipal Health Bureau, 201053

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摘要：

目的 观察改良Vitalstim电针治疗仪对脑卒中后吞咽障碍的治疗效果。方法 脑卒中后吞咽障碍的患者108例，随机分为电针组、Vitalstim组和联合组，每组36例。所有患者在接受常规的康复治疗基础上，电针组接受电针治疗，Vitalstim组接受Vitalstim吞咽障碍治疗仪治疗，联合组接受改良Vitalstim电针仪治疗。采用洼田饮水试验和标准吞咽功能评定量表（SSA）分别对患者进行吞咽功能筛查和康复评定。表面肌电图（sEMG）检测患者治疗前后颏下肌群肌电活动。结果 3组患者的吞咽功能均有不同程度的改善，总有效率比较，差异无统计学意义（P>0.05），但联合组患者在治愈率上优于其他两组（P<0.05）；Vitalstim组和联合组在SSA评分上低于电针组（P<0.05）；sEMG结果显示：联合组的颏下肌群收缩能力改善情况优于其他两组（P<0.05）。结论 康复训练结合电针、Vitalstim治疗或改良Vitalstim电针治疗均能有效改善脑卒中患者的吞咽障碍；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, 脑卒中, 吞咽障碍, 电针

Abstract:

Objective To observe the therapeutic effects of improved Vitalstim electroacupuncture on patients with dysphagia after stroke. Methods One hundred and eight patients with dysphagia after stroke were randomly divided into the electroacupuncture group (n=36), Vitalstim group (n=36), and combined group (n=36). Based on the routine rehabilitation therapy, patients of the electroacupuncture group underwent electroacupuncture therapy; patients of the Vitalstim group underwent Vitalstim therapy; and patients of the combined group underwent improved Vitalstim electroacupuncture therapy. The swallowing function and rehabilitation of patients were assessed by the water swallowing test and standard swallowing assessment (SSA). The myoelectric activity of submental muscles was detected by the surface electromyography (sEMG). Results The swallowing function of three groups improved in different degrees. The differences of overall efficiency were not statistically significant (P>0.05), but the cure rate of the combined group was higher than those of the two other groups (P<0.05). The SSA scores of the Vitalstim group and combined group were lower than those of the electroacupuncture group (P<0.05). The results of sEMG showed that the improvement of contraction ability of submental muscles of the combined group was better than that of the two other groups (P<0.05). Conclusion Rehabilitation training combined with electroacupuncture therapy, Vitalstim therapy, or improved Vitalstim electroacupuncture therapy can efficiently improve the swallowing function of patients with stroke. The rehabilitation effect of improved Vitalstim acupuncture therapy is better.

Key words: Vitalstim, stroke, dysphagia, electroacupuncture