Treating medulla oblongata dorsolateral syndrome in patients with dysphagia by using transcranial magnetic stimulation of low frequency electric and positioning
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摘要: 目的 观察经颅磁刺激定位头电针配合低频电治疗瓦伦贝格综合征患者吞咽困难的临床疗效。 方法 采用随机数字表法将2013年5月-2014年5月沧州市中心医院神经内科、康复科就诊的30例瓦伦贝格综合征合并吞咽困难患者分为治疗组和对照组,治疗组16例,对照组14例。在吞咽康复训练的基础上,治疗组给予头电针配合低频电治疗仪治疗。电针选用断续波,频率为50 Hz,电流强度2 m A;低频采用三角形波脉冲,刺激波宽750 ms,波幅0~25 m A,频率为2 Hz,电流强度为7.0~10.0 m A,每次刺激时间为2~3 s,间歇时间为5~6 s。治疗2次/d,每次20 min,4周为1个疗程;对照组给予低频电治疗仪治疗,2次/d,每次20 min,4周为1个疗程。将治疗组与对照组患者分别在治疗前、治疗后4周进行洼田饮水试验评分与电视透视吞咽评估(VFSS)评分。所有数据采用SPSS 16.0统计学软件进行数据分析,计量资料中,组间比较采用独立t检验,组内比较采用配对t检验,P<0.05为差异有统计学意义。 结果 治疗4周后,经颅磁刺激定位头电针配合低频电治疗瓦伦贝格综合征患者吞咽困难的洼田饮水试验与VFSS评分明显优于低频电治疗组(P<0.05)。 结论 经颅磁刺激定位头电针配合低频电治疗瓦伦贝格综合征能进一步改善吞咽功能,避免误吸,继而提高患者的生存质量。Abstract: Objective To observe the curative effect of transcranial magnetic stimulation including positioning head together with the low frequency treatment on medulla oblongata dorsolateral syndrome in patients with dysphagia. Methods Thirty cases of medulla oblongata dorsolateral syndrome with dysphagia patients from May,2013 to May,2014 Cangzhou of neurology and rehabilitation center hospital were divided into treatment group and control group by using random numbers,16 cases of treatment group and control group in 14 cases.In swallowing rehabilitation training,the treatment group was given head cupping treatment together with the low frequency therapeutic apparatus.Electric acupuncture selects the discontinuous wave,frequency 50 Hz,current strength 2 m A;Low frequency using triangle wave pulse to stimulate wave width 750 ms,amplitude 0 to 25 m A,frequency of 2 Hz,the current strength of 7.0-10.0 m A,each time for2-3 s,intermittent time is 5-6 s.Treatment 2 times/d,20 min,at a time,4 weeks for 1 course of treatment;The control group given low frequency electric therapeutic treatment,2 times/d,20 min at a time,4 weeks for 1 course of treatment.Treatment group and control group respectively in both groups before treatment,4 weeks after treatment respectively for kubota drinking water test score and VFSS score.All the data with SPSS 16.0 statistical software for data analysis,the measurement data by chi-square test,measurement data,the comparison between groups using independent t test,group in comparison with paired t test,take a 95% confidence interval. Results After 4 weeks treatment,the patients with transcranial magnetic stimulation including positioning head together with the low frequency treatment of medulla oblongata dorsolateral syndrome in patients with dysphagia Kubota drinking water test and VFSS score is better than low frequency electric therapy group (P ﹤ 0.05). Conclusion Transcranial magnetic stimulation including positioning head together with the low frequency treatment of medulla oblongata dorsolateral syndrome can further improve swallowing function,avoid aspiration,and then improve the quality of life of patients.
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