摘要
目的 探讨针刺、神经肌肉电刺激联合冷刺激对病毒性脑炎后吞咽障碍患儿吞咽功能恢复的影响。 方法 选取病毒性脑炎恢复期伴吞咽障碍患儿322例，按照随机数字表法将其分为针刺组107例（针刺＋冷刺激）、电刺激组107例（电刺激＋冷刺激）和联合治疗组108例（针刺＋电刺激＋冷刺激），治疗14d为1个疗程，中间休息2d后再进行下个疗程治疗，共治疗2个疗程后。治疗前及治疗2个疗程后（治疗后），对3组总有效率、吸入性肺炎、营养不良发生率进行分析，评定其吞咽功能和吞咽障碍程度。 结果 治疗后，电刺激组总有效率（61.68%）低于针刺组（75.70%），差异有统计学意义（P〈0.05），联合治疗组总有效率（90.74%）高于针刺组（75.70%），差异有统计学意义（P〈0.05）。与电刺激组比较，联合治疗组总有效率显著较高（P〈0.05）。治疗前，3组患儿SSA、摄食-吞咽障碍程度评分比较，差异无统计学意义（P〉0.05）。治疗后，3组患儿SSA、摄食-吞咽障碍程度评分均较组内治疗前改善（P〈0.05）。与针刺组比较，电刺激组治疗后SSA评分［（30.58±1.93）分］较高（P〉0.05）、摄食-吞咽障碍程度评分［（5.08±1.23）分］降低（P〉0.05）。与针刺组及电刺激组比较，联合治疗组治疗后SSA评分［（20.31±1.29）分］较低（P〈0.05）、摄食-吞咽障碍程度评分［（7.05±1.27）分］增高（P〈0.05）。治疗后，针刺组与电刺激组吸入性肺炎、营养不良发生率比较，差异无统计学意义（P〉0.05）。联合治疗组吸入性肺炎（10.19%）、营养不良发生率（8.33%）显著低于针刺组和电刺激组（P〈0.05）。 结论 针刺、神经肌肉电刺激联合冷刺激能够明显改善病毒性脑炎后吞咽障碍患儿的吞咽功能，降低其吸入性肺炎及营养不良的发生率。
Objective To explore the effect of acupuncture plus neuromuscular electrical stimulation and cold stimulation on children with swallowing disorders caused by viral encephalitis. Methods A total of 322 children with dysphagia subsequent to viral encephalitis were randomly divided into an acupuncture ＋ cold stimulation group （group A, n=107）, an electrical stimulation ＋ cold stimulation group （group E, n=107） and an acupuncture ＋ electric stimulation ＋ cold stimulation group （group C, n=108） using a random number table. The treatments were applied in two courses each of 14 days with an interval of two days between the courses. Before and after the treatment, the total effectiveness rates and the incidence of aspiration pneumonia and malnutrition were analyzed. The children′s swallowing function was evaluated using a standardized swallowing assessment （SSA）, while the severity of dysphagia was assessed using dysphagia outcome and severity scale （DOSS） based on videofluorescopic imaging. Results There were no significant differences in any of the outcome measures before the treatment. Afterward the total effectiveness rate in group A was 76%, significantly higher than in group E （62%） but significantly lower than in group C （91%）. There was significant improvement in the average SSA and DOSS scores of all 3 groups. Compared with group A, the average SSA score of group E was higher while the average DOSS score was lower. For group C the relationship was the opposite, with the average SSA score significantly higher and the average DOSS score significantly lower. After the treatment there were no significant differences between groups A and E in the incidence of aspiration pneumonia or malnutrition, but the incidence of both in group C was significantly lower than in groups A and E. Conclusion Acupuncture administered together with electrical and cold stimulation can significantly improve dysphagia and lower the incidence of aspiration pneumonia and malnutrition for children with vi
作者
罗伟
刘春雷
王军英
黄超
刘青
Luo Wei;Liu Chunlei;Wang Junying;Huang Chao;Liu Qing(Hunan Children＇s Hospital, Changsha 410007, China)
出处
《中华物理医学与康复杂志》
CAS
CSCD
北大核心
2018年第6期431-435,共5页
Chinese Journal of Physical Medicine and Rehabilitation
关键词
病毒性脑炎
吞咽障碍
针刺
电刺激
冷刺激
Encephalitis Swallowing disorders Acupuncture Electrical stimulation Cold stimulation
