天津医药

天津医药 ›› 2025, Vol. 53 ›› Issue (7): 688-693.doi: 10.11958/20251362

• 临床研究 • 上一篇    下一篇

表面肌电生物反馈联合呼吸训练治疗脑卒中后吞咽障碍的疗效观察

金亮1(), 金爱2, 王苓3, 齐霄茹4, 代琰3, 苏海涛1   

  1. 1 沧州市人民医院肿瘤院区神经外科（邮编061000）
    2 沧州市人民医院肿瘤院区输血科（邮编061000）
    3 沧州市人民医院肿瘤院区康复科（邮编061000）
    4 沧州市人民医院肿瘤院区神经内科（邮编061000）
  • 收稿日期:2025-04-02 修回日期:2025-05-08 出版日期:2025-07-15 发布日期:2025-07-21
  • 作者简介:金亮（1981），男，副主任医师，主要从事神经外科方面研究。E-mail:jt4764@sina.com
  • 基金资助:
    沧州市科技计划自筹经费项目(222106045)

Observation on the therapeutic efficacy of surface electromyography biofeedback combined with respiratory training in the treatment of post-stroke dysphagia

JIN Liang1(), JIN Ai2, WANG Ling3, QI Xiaoru4, DAI Yan3, SU Haitao1   

  1. 1 Department of Neurosurgery, Cangzhou People's Hospital Cancer Branch, Cangzhou 061000, China
    2 Department of Transfusion, Cangzhou People's Hospital Cancer Branch, Cangzhou 061000, China
    3 Department of Rehabilitation, Cangzhou People's Hospital Cancer Branch, Cangzhou 061000, China
    4 Department of Neurology, Cangzhou People's Hospital Cancer Branch, Cangzhou 061000, China
  • Received:2025-04-02 Revised:2025-05-08 Published:2025-07-15 Online:2025-07-21

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摘要：

目的 探究表面肌电生物反馈联合呼吸训练治疗脑卒中后吞咽障碍的疗效及对血清神经元特异性烯醇化酶（NSE）、胰岛素样生长因子1（IGF-1）水平的影响。方法 纳入120例脑卒中后吞咽障碍患者并随机分为对照组和联合组，各60例，分别采用呼吸训练治疗及表面肌电生物反馈联合呼吸训练治疗。比较2组的临床疗效，血清NSE、中枢神经特异蛋白（S100β）、IGF-1，功能性经口摄食量表（FOIS）评分、标准吞咽功能评定量表（SSA）评分，呼吸功能，咽收缩率、咽收缩持续时间。结果 治疗后，联合组总有效率高于对照组（χ2=4.876，P<0.05）。与治疗前比较，治疗后2组NSE、S100β、SSA评分、咽收缩率降低（均P<0.05），联合组更低（t分别为5.193、9.000、8.976、10.614，P<0.05）；治疗后与治疗前比较，2组IGF-1、FOIS评分、肺活量（FVC）、第1秒用力呼气容积（FEV1）、呼气峰值流量（PEF）、咽收缩持续时间升高，联合组更高（t分别为4.212、6.220、3.765、6.935、5.020、4.249，P<0.05）。结论 表面肌电生物反馈联合呼吸训练可改善吞咽障碍患者神经元损伤，提高吞咽效率，降低血清NSE、S100β水平及咽部滞留时间，疗效显著。

关键词: 卒中, 吞咽障碍, 神经反馈, 表面肌电生物反馈, 呼吸训练

Abstract:

Objective To investigate the efficacy of surface electromyography biofeedback combined with respiratory training on post-stroke dysphagia and its impacts on serum neuron specific enolase (NSE) and insulin-like growth factor 1 (IGF-1) in patients. Methods Totally 120 patients with post-stroke dysphagia in our hospital were stochastically assigned into the control group and the combined group, with 60 patients in each group. Both groups were given conventional treatment first, while the control group received respiratory training treatment. The combined group received surface electromyography biofeedback treatment on the top of the control group. The efficacy, serum NSE, central nervous system specific protein (S100β), IGF-1, functional oral intake scale (FOIS) score, standard swallowing function assessment scale (SSA) score, respiratory function, pharyngeal contraction rate and duration of pharyngeal contraction were compared between the two groups. Results After treatment, the total effective rate was higher in the combined group (χ2=4.876, P<0.05). Compared with before treatment, NSE, S100β, SSA score and pharyngeal contraction rate decreased after treatment in both groups, and those were even lower in the combined group (t=5.193, 9.000, 8.976, 10.614, P<0.05). Compared with before treatment, IGF-1, FOIS score, force vital capacity (FVC), forced expiratory volume in one second (FEV1), peak expiratory flow rate (PEF) and duration of pharyngeal contraction increased after treatment in both groups, with even higher levels in the combined group (t=4.212, 6.220, 3.765, 6.935, 5.020, 4.249, P<0.05). Conclusion Surface electromyography biofeedback combined with respiratory training can improve neuronal damage in patients with dysphagia, enhance swallowing efficiency, reduce serum NSE, S100β levels and pharyngeal retention time, with significant curative effect.

Key words: stroke, deglutition disorders, neurofeedback, surface electromyography biofeedback, respiratory training

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