"环项三维立体"针法结合经皮直流电刺激迷走神经治疗脑卒中后吞咽障碍疗效观察OA

[Objective To investigate the clinical efficacy of three-dimensional cervical acupuncture combined with transcutane-ous direct current stimulation of the vagus nerve(TDCSVN)in the treatment of patients with post-stroke dysphagia(PSD).Methods A total of 80 patients with PSD were randomly divided into control group and observation group,with 40 patients in each group.The patients in the control group were treated with TDCSVN alone,while those in the observation group were treated with three-dimensional cervical acupuncture combined with TDCSVN,once a day for 5 days a week,followed by 2 days of rest,for 4 consecutive weeks.The two groups were compared in terms of water swallowing test(WST)ratings,swallo-wing-related quality of life(SWAL-QOL)score,standardized swallowing assessment(SSA)score,video fluoroscopic swallo-wing study(VFSS),electromyographic amplitude(AEMG)of submental and infrahyoid muscle groups,and mean swallow time before treatment and after 2 and 4 weeks of treatment.Compared the clinical outcomes and adverse reactions of the two groups.Results After 4 weeks of treatment,both groups had a significant improvement in WST ratings(P＜0.05),and the observation group had a significantly better improvement than the control group(P＜0.05).After 2 weeks of treatment,both groups had a significant increase in SWAL-QOL score(P＜0.05),a significant reduction in SSA score(P＜0.05),significant reductions in oral transit time(OTT),soft palate elevation time(SET)and hyoidbone movement time(HMT)(P＜0.05),sig-nificant increases in AEMG of submental and infrahyoid muscle groups(P＜0.05),and a significant reduction in mean swallow time(P＜0.05);compared with the values after 2 weeks of treatment,both groups had a significant increase in SWAL-QOL score(P＜0.05),a significant reduction in SSA score(P＜0.05),significant reductions in OTT,SET,and HMT(P＜0.05),significant increases in AEMG of submental and infrahyoid muscle groups(P＜0.05),and a significant reduction in mean swallow time(P＜0.05)after 4 weeks of treatment;the observation group had significantly greater improvements in these indicators compared with the control group(P＜0.05).The observation group had a significantly better clinical outcome than the control group(P＜0.05).No serious adverse events were observed in either group during treatment.Conclusion Three-dimensional cervical acupuncture combined with TDCSVN can effectively enhance swallowing function and improve quality of life in the treatment of patients with PSD,with better clinical efficacy than TDCSVN alone.