辣椒素联合重复经颅磁刺激用于脑卒中后吞咽障碍患者的疗效观察

doi:10.11958/20231579

天津医药 ›› 2024, Vol. 52 ›› Issue (9): 950-953.doi: 10.11958/20231579

辣椒素联合重复经颅磁刺激用于脑卒中后吞咽障碍患者的疗效观察

郑继青(), 龙耀斌^△(), 徐金

广西医科大学第二附属医院康复医学科（邮编530007）

收稿日期:2023-12-15 修回日期:2024-04-12 出版日期:2024-09-15 发布日期:2024-09-06
通讯作者: ^△E-mail：long232316@163.com
作者简介:郑继青（1996），女，初级治疗师，主要从事神经系统疾病机制与康复方面研究。E-mail：zhengjiqing@sr.gxmu.edu.cn
基金资助:
广西自然科学基金资助项目(2022GXNSFAA035511);广西壮族自治区医疗卫生重点学科建设项目(桂卫科教发〔2022〕4号)

Efficacy of capsaicin combined with repetitive transcranial magnetic stimulation in patients with dysphagia after stroke

ZHENG Jiqing(), LONG Yaobin^△(), XU Jin

Department of Rehabilitation, the Second Affiliated Hospital, Guangxi Medical University, Nanning 530007, China

Received:2023-12-15 Revised:2024-04-12 Published:2024-09-15 Online:2024-09-06
Contact: ^△E-mail：long232316@163.com

郑继青, 龙耀斌, 徐金. 辣椒素联合重复经颅磁刺激用于脑卒中后吞咽障碍患者的疗效观察[J]. 天津医药, 2024, 52(9): 950-953.

ZHENG Jiqing, LONG Yaobin, XU Jin. Efficacy of capsaicin combined with repetitive transcranial magnetic stimulation in patients with dysphagia after stroke[J]. Tianjin Medical Journal, 2024, 52(9): 950-953.

摘要/Abstract

摘要：

目的探讨辣椒素联合重复经颅磁刺激（rTMS）用于脑卒中后吞咽障碍患者的治疗效果。方法选取脑卒中后吞咽障碍且无真性球麻痹的患者85例，采用随机数字表法分为辣椒素组（28例）、rTMS组（29例）及辣椒素联合rTMS组（联合组，28例）。在常规康复治疗的基础上，辣椒素组给予辣椒素刺激患者口咽部，每日3次（餐前30 min），6 d/周；rTMS组给予健侧初级躯体感觉皮层S1热点磁刺激，1次/d，6 d/周；辣椒素联合rTMS组采用辣椒素结合S1热点磁刺激，3组疗程均为3周。治疗前后分别使用洼田饮水试验（WST）、标准化床边吞咽功能检查（SSA）、进食评估工具（EAT）-10、电视X线透视吞咽功能检查（VFSS）评估患者吞咽功能改善的程度。结果 3组患者WST、SSA、EAT-10、VFSS评分在治疗前差异均无统计学意义，治疗后3组上述指标较治疗前均改善，其中联合组改善较其余2组更明显（P<0.05）。结论辣椒素联合rTMS较单一使用辣椒素或rTMS能更明显改善脑卒中后吞咽障碍患者的吞咽功能。

关键词: 卒中, 辣椒辣素, 经颅磁刺激, 吞咽障碍, 口咽

Abstract:

Objective To investigate the efficacy of capsaicin combined with repetitive transcranial magnetic stimulation (rTMS) in the treatment of dysphagia after stroke. Methods A total of 85 stroke patients with dysphagia and no true bulbar palsy were included and divided into 3 groups by random number table method: the capsaicin group (28 cases), the rTMS group (29 cases) and the capsaicin combined with rTMS group (28 cases). On the basis of conventional rehabilitation treatment, patients of the capsaicin group were given capsaicin to stimulate oropharynx 3 times a day (30 min before breakfast, lunch and dinner) for 6 days/week. Patients of the rTMS group were given S1 hot spot magnetic stimulation of the primary somatosensory cortex on the healthy side, once a day, 6 times a week, and patients of the capsaicin combined with rTMS group were treated with capsaicin combined with S1 hot spot magnetic stimulation. The treatment course of the 3 groups was 3 weeks. Before and after treatment, patients were evaluated by WST, SSA, EAT-10 and VFSS, respectively, to determine the degree of improvement in their swallowing function. Results There were no significant differences in WST, SSA, EAT-10 and VFSS scores before treatment between the 3 groups, and the above indexes were improved after treatment in the 3 groups. The improvement in the capsaicin combined with rTMS group was more obvious than that of the other 2 groups (P<0.05). Conclusion Capsaicin combined with rTMS can significantly improve swallowing function of patients with swallowing disorder after stroke compared with capsaicin or rTMS alone.

Key words: stroke, capsaicin, transcranial magnetic stimulation, deglutition disorders, oropharynx

中图分类号:

R743.3

图/表 6

参考文献 21

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组别	n	性别（男/女）	年龄/岁	病程/d	MMSE 评分/分
辣椒素组	28	21/7	56.11±10.67	47.07±15.17	21.00±4.31
rTMS组	29	20/9	57.97±10.49	41.79±13.91	21.10±4.56
联合组	28	18/10	58.18±9.77	45.96±14.99	22.29±3.48
χ²或F		0.761	0.311	1.028	0.833

组别	n	性别（男/女）	年龄/岁	病程/d	MMSE 评分/分
辣椒素组	28	21/7	56.11±10.67	47.07±15.17	21.00±4.31
rTMS组	29	20/9	57.97±10.49	41.79±13.91	21.10±4.56
联合组	28	18/10	58.18±9.77	45.96±14.99	22.29±3.48
χ²或F		0.761	0.311	1.028	0.833

组别	n	治疗前	治疗后	t
辣椒素组	28	30.61±3.72	25.61±4.32	4.647^＊＊
rTMS组	29	30.37±3.53	25.20±4.45	4.683^＊＊
联合组	28	29.56±3.34	22.67±3.03^ab	8.174^＊＊

组别	n	治疗前	治疗后	t
辣椒素组	28	30.61±3.72	25.61±4.32	4.647^＊＊
rTMS组	29	30.37±3.53	25.20±4.45	4.683^＊＊
联合组	28	29.56±3.34	22.67±3.03^ab	8.174^＊＊

组别	n	治疗前	治疗后	t
辣椒素组	28	23.07±6.13	16.75±6.77	3.662^＊＊
rTMS组	29	23.17±4.78	15.83±5.65	5.086^＊＊
联合组	28	22.56±5.19	12.26±5.19^ab	7.677^＊＊

辣椒素联合重复经颅磁刺激用于脑卒中后吞咽障碍患者的疗效观察

Efficacy of capsaicin combined with repetitive transcranial magnetic stimulation in patients with dysphagia after stroke

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组别	n	治疗前	治疗后	t
辣椒素组	28	63.61±10.62	47.09±17.03	4.354^＊＊
rTMS组	29	65.43±9.07	45.85±16.92	5.259^＊＊
联合组	28	63.30±11.05	35.50±15.25^ab	8.011^＊＊

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