The Second Department of Rehabilitation, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Cardiovascular Medicine Combined with Traditional Chinese and Western Medicine, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Technol Health Care. 2023;31(1):11-19. doi: 10.3233/THC-213234.
Transcranial direct current stimulation (tDCS) has a considerable advantage in the rehabilitation treatment of dysphagia.
The purpose of this study was to explore the effect of tDCS combined with respiratory training on dysphagia in post-stroke patients.
From December 2017 to January 2019, 64 post-stroke patients who were hospitalized in the Department of Neurology of the Second Hospital of Hebei Medical University were enrolled in this study. They were randomly divided into control and treatment groups (n= 32). Patients in the two groups received routine swallowing rehabilitation training and respiratory training. On this basis, the patients in the treatment group received tDCS. The anode was placed in the movement area of the pharyngeal cortex on the unaffected side of the patients' bodies, and the cathode was placed in the upper orbital orbit on the opposite side. The current intensity was 1.5 mA, 20 min/time, 1 time/d, and 6 d/w. Before and after the treatment, the water swallow text, functional oral intake scale (FOIS), forced vital capacity (FVC) and peak expiratory flow (PEF) were assessed, and the correlation among them was evaluated.
There were no differences in all indexes before and after treatment. After treatment, water swallow text, FOIS, FVC and PEF were all better than before treatment, and the clinical efficacy in the treatment group was significantly better than that in the control group. FVC and PEF were positively correlated with water swallow text and FOIS.
tDCS combined with respiratory training may have a significant therapeutic effect on dysphagia in post-stroke patients.
经颅直流电刺激（tDCS）在吞咽障碍的康复治疗中具有相当大的优势。
本研究旨在探讨 tDCS 联合呼吸训练对脑卒中后吞咽障碍的疗效。
2017 年 12 月至 2019 年 1 月，河北医科大学第二医院神经内科收治的脑卒中后吞咽障碍患者 64 例，采用随机数字表法分为对照组和治疗组，每组 32 例。两组患者均接受常规吞咽康复训练和呼吸训练，在此基础上治疗组患者加用 tDCS 治疗，阳极置于患者健侧咽皮质运动区，阴极置于对侧眶上区，电流强度 1.5 mA，20 min/次，1 次/d，每周 6 次。治疗前后分别采用饮水试验、洼田饮水试验、用力肺活量（FVC）、呼气峰流速（PEF）评估吞咽功能，并分析其相关性。
治疗前后两组患者各指标比较差异均无统计学意义（P>0.05）。治疗后，两组患者饮水试验、洼田饮水试验、FVC、PEF 均优于治疗前，且治疗组患者上述指标改善程度均优于对照组（P<0.05），治疗组临床疗效明显优于对照组（P<0.05）。FVC 和 PEF 与饮水试验、洼田饮水试验呈正相关（r=0.674、0.721，P<0.05）。
tDCS 联合呼吸训练治疗脑卒中后吞咽障碍患者疗效显著。
