经颅直流电刺激调节迷走神经兴奋性对脑卒中后吞咽障碍的效果

doi:10.3969/j.issn.1006-9771.2021.09.012

摘要/Abstract

摘要：

目的研究经颅直流电刺激(tDCS)调节迷走神经兴奋性对卒中后吞咽功能障碍的疗效。方法 2020年9月至2021年2月,本院康复科卒中后吞咽障碍患者28例随机分为对照组和tDCS组,各14例。两组均行吞咽功能训练,tDCS组行迷走神经tDCS,对照组行迷走神经假刺激。治疗前后,采用改良曼恩吞咽能力评估量表(MMASA)和澳大利亚治疗结局量表(AusTOMs)吞咽功能评分进行评定。结果治疗后,两组MMASA评分(|t| > 5.593, P < 0.001)和AusTOMs吞咽功能评分(|Z| > 2.121, P < 0.05)均提高,tDCS组优于对照组(|t| = 2.439, |Z| = 2.079, P < 0.05)。结论 tDCS调节迷走神经兴奋性可促进卒中后吞咽功能障碍恢复。

关键词: 脑卒中, 吞咽障碍, 经颅直流电刺激, 迷走神经

Abstract:

Objective To study the effect of transcranial direct current stimulation (tDCS) regulating excitability of the vagus nerve on dysphagia after stroke.Methods From September, 2020 to February, 2021, 28 patients with dysphagia after stroke were randomly divided into control group (n = 14) and tDCS group (n = 14). Both groups accepted swallowing function training, and tDCS group received anodal tDCS over vagus nerve, while the control group received sham tDCS. They were assessed with modified Mann Assessment of Swallowing Ability (MMASA) and Australian Therapy Outcome Measures (AusTOMs)-swallowing scale before and after treatment.Results The scores of MMASA (|t| > 5.593, P < 0.001) and AusTOMs swallowing scale (|Z| > 2.121, P < 0.05) increased in both groups after treatment, and were higher in tDCS group than in the control group (|t| = 2.439, |Z| = 2.079, P < 0.05).Conclusion Anodal tDCS over vagus nerve may further release dysphagia after stroke.

Key words: stroke, dysphagia, transcranial direct current stimulation, vagus nerve

陈佳君,吴登宠,邵湘芝,蒲新宇,毛燕舞,陈炳. 经颅直流电刺激调节迷走神经兴奋性对脑卒中后吞咽障碍的效果[J]. 《中国康复理论与实践》, 2021, 27(9): 1078-1081.

CHEN Jia-jun,WU Deng-chong,SHAO Xiang-zhi,PU Xin-yu,MAO Yan-wu,CHEN Bing. Effects of Transcranial Direct Current Stimulation over Vagus Nerve on Dysphagia after Stroke[J]. 《Chinese Journal of Rehabilitation Theory and Practice》, 2021, 27(9): 1078-1081.

图/表 3

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组别	n	性别(男/女, n)	年龄(岁)	病程(d)	病变性质(出血/梗死, n)
对照组	14	12/2	63±12.1	98±9.1	2/12
tDCS组	14	13/1	65±9.5	102±15.5	0/14
t值			0.610	0.635
P值		1.000^a	0.553	0.536	0.481^a

组别	n	治疗前	治疗后	t值	P值
对照组	14	65.5±8.8	70.9±7.8	-5.593	< 0.001
tDCS组	14	66.3±6.7	76.8±4.5	-6.623	< 0.001
t值		0.267	2.439
P值		0.792	0.022

组别	n	治疗前	治疗后	Z值	P值
对照组	14	1.64±1.01	2.07±0.83	-2.121	0.034
tDCS组	14	1.79±1.25	3.07±1.21	-3.145	0.002
Z值		-0.048	-2.079
P值		0.962	0.038