尼麦角林联合低频电刺激治疗对脑卒中后吞咽困难的影响OACSTPCD
Effects of nicergoline combined with low frequency electrical stimulation therapy on dysphagia after stroke and serum neurological function indicators
目的:观察尼麦角林联合低频电刺激治疗对脑卒中后吞咽困难患者及血清神经功能的影响.方法:选取90例脑卒中后吞咽困难患者,随机将患者分成3组,每组30例.A组给予常规治疗;B组给予常规治疗结合尼麦角林;C组给予常规治疗结合尼麦角林和吞咽障碍治疗仪治疗.比较3组患者治疗2周的治疗效果,比较治疗前后美国国立卫生研究院卒中量表(NIHSS)和标准吞咽功能量表(SSA)评分、洼田饮水等级、血清脑源性神经营养因子(BDNF)、神经生长因子(NGF)和神经元特异性烯醇化酶(NSE)变化,以及不良反应发生情况.结果:治疗后,3组患者NIHSS评分、SSA评分及血清NSE水平均较治疗前显著降低(均P＜0.05),且B、C组低于A组(P＜0.05),C组低于B组(P＜0.05);3组洼田饮水试验等级优于治疗前(P＜0.05),B、C组优于A组(P＜0.05),C组优于B组(P＜0.05);3组患者血清BDNF和NGF表达水平及总有效率均较治疗前明显升高(P＜0.05),且B、C组高于A组(P＜0.05),C组高于B组(P＜0.05).结论:尼麦角林联合低频电刺激治疗可有效治疗脑卒中后吞咽困难患者,升高血清BDNF和NGF水平,降低NSE水平,协助患者恢复吞咽功能,且具有良好的安全性.
Objective:To observe the effects of nicergoline combined with low frequency electrical stimulation ther-apy on patients with dysphagia after stroke and serum neurological function indicators.Methods:A total of 90 pa-tients with dysphagia after stroke who visited the Second Affiliated Hospital of Hebei North University from Sep-tember 2022 to June 2023 were randomly separated into three groups,with 30 patients in each group:group Ⅰ given routine treatment;group Ⅱ given conventional treatment combined with nicergoline;and group Ⅲ given convention-al treatment combined with nicergoline and low frequency electrical stimulation therapy.The efficacy after treatment for 2 weeks,changes in National Institutes of Health Stroke Scale(NIHSS)and Standard Swallowing Function Scale(SSA)scores,Kubota water swallow test level,serum brain derived neurotrophic factor(BDNF),nerve growth factor(NGF),and neuron specific enolase(NSE)levels before and after treatment,and the occurrence of untoward reactions of the three groups were compared.Results:The total effective rate of treatment in group Ⅲ was obviously higher than that in group Ⅰ and group Ⅱ(P＜0.05).Compared with those before treatment,the NIHSS score,SSA score,Kubota water swallow test level,and serum NSE expression level of patients in the three groups were obviously reduced after 2 weeks of treatment,those in groups B and C were better than group A(P＜0.05),and those in group C were better than group B(P＜0.05).while the expression levels of BDNF and NGF were obvi-ously increased(P＜0.05).After 2 weeks of treatment,the NIHSS score,SSA score,Wada drinking water level,and serum NSE expression level in group Ⅲ were obviously lower than those in group Ⅰ and group Ⅱ,while the ex-pression levels of BDNF and NGF were obviously higher than those in group Ⅰ and group Ⅱ(P＜0.05).There was no obvious difference in the incidence of untoward reactions among the three groups during treatment.Conclusion:The combination of nicergoline and low frequency electrical stimulation therapy can effectively treat patients with dysphagia after stroke,increase serum BDNF and NGF levels,reduce NSE level,assist patients in restoring swallo-wing function,and have good safety.
姚玉婷;赵鹏;李燕;姚玉鑫;刘敏肖
河北北方学院附属第二医院神经内三科 河北张家口 075100河北北方学院附属第二医院康复医学科 河北张家口 075100河北北方学院附属第二医院神经内二科 河北张家口 075100
临床医学
脑卒中后吞咽困难尼麦角林低频电刺激治疗神经功能
dysphagia after strokenicergolinelow frequency electrical stimulation therapyneurological func-tion
《中国康复》 2024 (004)
200-203 / 4
张家口市2022年科技计划项目(2221046D)
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