经颅直流电刺激改善卒中后共济失调型吞咽障碍的.pdf

2015年，第30卷，第8期 ·临床研究· 经颅直流电刺激改善卒中后共济失调型 吞咽障碍的疗效观察* 1 1 2，4 1 1 1 3 1 1 袁 英 汪 洁 吴东宇 宋为群 张大华 程亦男 陈 滟 赵钰婷 张甜甜 摘要 目的：研究经颅直流电刺激（tDCS ）改善卒中后共济失调型吞咽障碍的疗效。 方法：采用随机对照设计，将30 例卒中后共济失调型吞咽障碍患者随机分为tDCS 组和对照组，各15例。在外周经 皮电刺激治疗的基础上，tDCS 组进行小脑tDCS 治疗，而对照组进行小脑tDCS 假刺激治疗。比较两组患者治疗前、 后的改良吞咽障碍能力评价表和吞咽障碍严重程度的变化。 结果：治疗前，两组患者的改良Masa 吞咽能力评价和吞咽障碍严重程度分级的差异无显著性（P0.05 ）。治疗后， tDCS 组和对照组的改良吞咽障碍能力评价和吞咽障碍严重程度分级值均有显著改善（P0.05 ），而且tDCS 组的改 善程度明显优于对照组（P0.05 ）。 结论：小脑阳极tDCS 配合外周经皮电刺激治疗，可以更为明显地改善卒中后共济失调型吞咽障碍患者的吞咽功能， 为共济失调型吞咽障碍的治疗提供了新的手段。 关键词 经颅直流电刺激；卒中；共济失调；吞咽障碍 中图分类号：R454.1 R743.3 文献标识码：A 文章编号：1001-1242（2015 ）-08-0765-06 Effects of transcranial direct current stimulation on ataxic dysphagia after stroke/YUAN Ying, WANG Jie,WUDongyu,et al.//Chinese Journal of Rehabilitation Medicine，2015，30(8): 765—770 Abstract Objective: To investigate the effect of transcranial direct current stimulation (tDCS) on ataxic dysphagia after stroke. Method: Thirty patients after stroke were randomly divided into tDCS group (n= 15) and control group (n= 15). The tDCS group received anodal tDCS over bilateral cerebellum combined with transcutaneous electrical stimula- tion therapy, while control group received sham tDCS combined with transcutaneous electrical stimulation thera- py. Modified Mann assessment of swallowing ability (MMASA) and swallow severity scale(SSS) were com- pared between the two groups before and after treatment． Result: Before treatment, there was no significant difference in scores of MMASA and SSS between the two groups (P0.05). Compared with pre- treatment, scores of MMASA and SSS