| 梁娜,李雪薇,乔晋,潘齐,薛阳.开窍利咽四步针法联合tDCS治疗脑卒中吞咽障碍的疗效[J].中国康复,2026,41(8):462-467 |
| 开窍利咽四步针法联合tDCS治疗脑卒中吞咽障碍的疗效 |
| Efficacy of four-step acupuncture technique for promoting qi circulation and relieving sore throat combined with tDCS in the treatment of dysphagia due to stroke |
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| DOI：10.3870/zgkf.2026.08.003 |
| 中文关键词: 开窍利咽四步针法 经颅直流电刺激 脑卒中 吞咽障碍 皮质功能 |
| 英文关键词: Kaiqiao Liyan four-step acupuncture method transcranial direct current stimulation stroke dysphagia cortical function |
| 基金项目:陕西省重点研发计划项目（S2024-YF-YBSF-1776） |
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| 中文摘要: |
| 目的：探究开窍利咽四步针法联合tDCS治疗脑卒中吞咽障碍的疗效。方法：选择西安市第三医院118例脑卒中吞咽障碍患者，随机分为电刺激组59例（tDCS）和研究组59例（开窍利咽四步针法+tDCS）。比较2组治疗前后的吞咽功能［（饮水吞咽测试（WST）、安德森吞咽困难量表（MDADI）、改良曼恩吞咽能力评估量表（MASA）］、表面肌电图（舌骨上下肌群吞咽时程及最大波幅值）、皮质功能［运动诱发电位（MEP）、静息运动阈值（RMT）］和生活质量［吞咽障碍特异性生活质量量表（SWAL-QOL）］，比较2组治疗后的临床疗效。结果：治疗后，相较于治疗前，2组WST分级降低（P＜0.01），研究组低于电刺激组（P＜0.05）；2组MASA、MDADI评分升高（P＜0.01），研究组高于电刺激组（P＜0.05，0.01）；2组舌骨上下肌群吞咽时程缩短，研究组短于电刺激组（P＜0.01），2组最大波幅值升高，研究组高于电刺激组（P＜0.01）；2组MEP振幅、RMT水平升高，研究组高于电刺激组（P＜0.01）；2组SWAL-QOL评分升高，研究组高于电刺激组（P＜0.01）。研究组的临床总有效率明显高于对照组（P＜0.05）。结论：开窍利咽四步针法联合tDCS治疗脑卒中吞咽障碍，能提升临床疗效，有效改善患者吞咽功能及吞咽相关肌肉电生理活动，调节大脑皮质功能状态，提高患者生活质量。 |
| 英文摘要: |
| Objective: To explore the efficacy of the four-step acupuncture technique for promoting qi circulation and clearing the throat combined with tDCS in the treatment of dysphagia due to stroke. Methods: Totally, 118 patients in our hospital were selected and randomly separated into the electrical stimulation group of 59 cases (tDCS) and the experimental group of 59 cases (Kaiqiao Liyan four-step acupuncture + tDCS). Swallowing function before and after treatment ［using the water swallowing test (WST), MD Anderson dysphagia inventory (MDADI), modified Mann swallowing ability assessment (MASA)］, surface electromyography (swallowing time and maximum amplitude of the upper and lower hyoid muscles), cortical function ［motor evoked potential (MEP), resting movement threshold (RMT)］, and quality of life ［swallowing disorder specific quality of life scale (SWAL-QOL)］ were evaluated. The clinical efficacy of two groups was compared. Results: The efficacy of the experimental group was better (P<0.05). After treatment, the WST grades of both groups decreased (P<0.01), with the experimental group being lower than the electrical stimulation group (P<0.05). The MASA and MDADI scores of both groups increased (P<0.01), with the experimental group being higher than the electrical stimulation group (P<0.05 for the former, P<0.01 for the latter). The swallowing duration of the suprahyoid and infrahyoid muscle groups of both groups was shortened, with the experimental group being shorter than the electrical stimulation group. The maximum amplitude values of both groups increased, with the experimental group being higher than the electrical stimulation group. The MEP amplitudes and RMT levels of both groups increased, with the experimental group be-ing higher than the electrical stimulation group. The SWAL-QOL scores of both groups increased, with the experimental group being higher than the electrical stimulation group (P<0.01).Conclusion: The combination of the four step acupuncture method of opening the orifice and clearing the throat with tDCS can impr-ove the clinical efficacy of swallowing disorders in stroke patients and effectively improve their swallowing function. Swallowing related muscle electrophysiological activities regulate the functional status of the cerebral cortex and improve patients' quality of life. |
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