项五针联合重复经颅磁刺激治疗脑卒中后吞咽功能障碍的疗效及对BDNF、VILIP-1水平的影响OA
Efficacy of five-needle-in-nape acupuncture combined with repetitive transcranial magnetic stimulation for post-stroke dysphagia and its effects on BDNF and VILIP-1 levels
目的 探讨项五针联合重复经颅磁刺激(rTMS)治疗脑卒中后吞咽功能障碍(DAS)的疗效及对血清脑源性神经营养因子(BDNF)、视锥蛋白样蛋白1(VILIP-1)水平的影响.方法 选取2022年12月至2024年12月该院收治的120例DAS患者作为研究对象,按照随机数字表法将患者分为rTMS组和联合组,每组60例.rTMS组给予常规治疗和rTMS,联合组在rTMS组基础上联合项五针治疗.观察2组患者的临床疗效、吞咽功能、DAS严重程度、BDNF、VILIP-1水平、摄食能力、生活质量.结果 干预后,联合组临床总有效率为95.00%,显著高于rTMS组的80.00%(P<0.05).干预后,2组患者吞咽功能评价量表(SSA)评分、VILIP-1水平较干预前降低(P<0.05),且联合组低于rTMS组(P<0.05).干预后,2组患者吞咽障碍结局与严重程度量表(DOSS)评分、功能性经口摄食量表(FOIS)评分、日常生活活动能力量表(ADL)评分、吞咽障碍特异性生存质量量表(SWAL-QOL)评分及BDNF水平较干预前升高(P<0.05),且联合组显著高于rTMS组(P<0.05).结论 采用项五针联合rTMS治疗DAS,能够提高患者的临床疗效,降低DAS严重程度,改善吞咽功能和摄食能力,提升BDNF、降低VILIP-1水平,改善日常生活能力.
Objective To investigate the efficacy of five-needle-in-nape acupuncture combined with repeti-tive transcranial magnetic stimulation(rTMS)in treating dysphagia after stroke(DAS)and its effects on ser-um levels of brain-derived neurotrophic factor(BDNF)and visinin-like protein 1(VILIP-1).Methods A total of 120 patients with DAS admitted to the hospital from December 2022 to December 2024 were selected as study subjects.According to a random number table,the patients were allocated to an rTMS group and a com-bination group,with 60 patients in each group.The rTMS group received conventional treatment plus rTMS,while the combination group received five-needle-in-nape acupuncture in addition to the rTMS group's regi-men.Clinical efficacy,swallowing function,DAS severity,neurotrophic factor(BDNF and VILIP-1)levels,feeding ability and quality of life were assessed in both groups.Results After the intervention,the total clini-cal effective rate in the combination group was 95.00%,which was significantly higher than 80.00%in the rTMS group(P<0.05).After the intervention,the Standardized Swallowing Assessment(SSA)scores and serum VILIP-1 level were significantly decreased compared with those before the intervention in both groups(P<0.05),and were lower in the combination group than those in the rTMS group(P<0.05).After treat-ment,the Dysphagia Outcome and Severity Scale(DOSS)scores,Functional Oral Intake Scale(FOIS)scores,Activity of Daily Living(ADL)scale scores,Swallowing-Related Quality of Life(SWAL-QOL)questionnaire scores and serum BDNF level were significantly increased compared with those before the intervention in both groups(P<0.05),and all were significantly higher in the combination group than those in the rTMS group(P<0.05).Conclusion The application of five-needle-in-nape acupuncture combined with rTMS for DAS can enhance clinical efficacy,reduce the severity of dysphagia,improve swallowing function and oral intake ability,elevate serum BDNF level,lower VILIP-1 level,and improve activities of daily living.
李永芹;张静玺;王洁;贾永芳;谢玉洁
河北省邯郸市中医院康复科,河北 邯郸 056000河北省邯郸市中医院康复科,河北 邯郸 056000河北省邯郸市中医院康复科,河北 邯郸 056000河北省邯郸市中医院康复科,河北 邯郸 056000河北省邯郸市中医院康复科,河北 邯郸 056000
医药卫生
项五针脑卒中吞咽功能障碍重复经颅磁刺激视锥蛋白样蛋白1脑源性神经营养因子
five-needle-in-nape acupuncturestrokedysphagiarepetitive transcranial magnetic stimulationvisinin-like protein 1brain-derived neurotrophic factor
《检验医学与临床》 2026 (6)
815-821,7
河北省中医药管理局项目(2024522).
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