中国全科医学2025，Vol.28Issue(29)：3625-3630,6.DOI:10.12114/j.issn.1007-9572.2024.0441
间歇性θ短阵脉冲刺激联合下颌抗阻力训练治疗脑卒中患者吞咽障碍:一项随机对照试验
Intermittent θ Burst Stimulation Combined with Chin Tuck Against Resistance Training for Dysphagia in Stroke Patients:a Randomized Controlled Trial
摘要
Abstract
Background Swallowing dysfunction is a common complication after stroke,and the recovery of swallowing function is important regarding patients'intake of nutrients,improved quality of life,reduced risk of complications,and improved quality of life.Although intermittent θ burst stimulation(iTBS)and chin tuck against resistance(CTAR)have been shown to have significant effects in improving dysphagia,fewer studies have been performed on combining iTBS with CTAR in the treatment of patients with dysphagia in stroke,and its rehabilitative effects need to be further investigated.Objective To observe the clinical effects of iTBS combined with CTAR training on swallowing function in stroke patients.Methods From March 2023 to July 2024,90 patients with post-stroke dysphagia attending the Department of Rehabilitation Medicine of the First Affiliated Hospital of Bengbu Medical University were selected.The patients were randomly divided into the routine group(n=30),the CTAR group(n=30),and the combined group(n=30)according to the method of random number table.The routine group received conventional swallowing training,the CTAR group received CTAR training based on the routine group,and the combined group received iTBS based on the CTAR group.Both groups received treatment five times per week for four weeks.The Standard Swallowing Assessment(SSA)and Functional Oral Intake Scale(FOIS)were used before and after the treatment.Surface electromyography(sEMG)was used to measure the duration of swallowing and the maximum amplitude value of the supraglottic muscle group and to compare the clinical effects of the three groups of patients.Results Thirty cases in the routine group,30 cases in the CTAR group,and 30 cases in the combined group were finally included.After 4 weeks of treatment,the SSA score of the patients in the three groups was lower than those before treatment in the group,the FOIS score and the maximum amplitude value of sEMG were higher than those before treatment in the group,and the duration of swallowing was shorter than those before treatment in the group(P<0.05).After 4 weeks of treatment,the SSA score of the patients in the CTAR group and the combined group was lower than those in the routine group,the FOIS score and the maximum amplitude value of sEMG in the CTAR group and the combined group were higher than those in the routine group,and the duration of swallowing in the CTAR group and the combined group was shorter than those in the routine group(P<0.05);the SSA score of the patients in the combined group was lower than those in the CTAR group,the FOIS score and the maximum amplitude value of sEMG in the combined group were higher than those in the CTAR group,and the duration of swallowing in the combined group was shorter than those in the CTAR group(P<0.05).And the overall effective rate of the CTAR group and the combined group was higher than that of the routine group(P<0.017),and the overall effective rate of the combined group was higher than that of the CTAR group(P<0.017).Conclusion CTAR combined with iTBS can improve the swallowing function of stroke patients with dysphagia,reinforce the strength of swallowing muscle groups,and enhance their quality of life.关键词
吞咽障碍/脑卒中/康复/经颅磁刺激/间歇性θ短阵脉冲刺激/下颌抗阻力训练/随机对照试验Key words
Deglutition disorders/Stroke/Rehabilitation/Transcranial magnetic stimulation/Intermittent θ burst stimulation/Chin tuck against resistance/Randomized controlled trial分类
医药卫生引用本文复制引用
韩雪,刘换,娄晓乐,宋佳苧,张子昂,耿宗晓,王姗,张永卿,徐磊..间歇性θ短阵脉冲刺激联合下颌抗阻力训练治疗脑卒中患者吞咽障碍:一项随机对照试验[J].中国全科医学,2025,28(29):3625-3630,6.基金项目
安徽省高校自然科学项目(2023AH051912) （2023AH051912）
安徽省青年江淮名医人才项目(皖卫函[2022]392) （皖卫函[2022]392）
蚌埠医学院2021年度研究生科研创新计划105项资助立项项目(Byycx21089) （Byycx21089）
