| Objective :To investigate the effect of transcranial direct current stimulation(tDCS)combined with respiratory training on dysphagia in post-stroke patientsMethod:A total of 64 patients with dysphagia after stroke admitted to the second hospital of hebei medical university from December 2017 to February 2019 were selected.Patients were randomly divided into two groups(32 cases by each group): the observed group given by transcranial direct current stimulation(tDCS)combined with respiratory training and the control group given by respiratory training.There was no statistical difference in age,sex,lesion location,lesion side,course of disease and days of treatment between the observed group and the control group(P>0.05).All patients received traditional swallowing rehabilitation training including neuromuscular electrical stimulation,oral muscle trainer,mendelsohn,ice stimulation,supractglottic swallowing training,direct ingestion training and posture training.The control group received respiratory training besides the above training including balloon blowing,toilet paper blowing and respiratory resistance training.Each time for 15 min,once per day,6d/w,at least 7 days of treatment,up to 14 days of treatment,with an average of 10.75 days of treatment.The observed group was treated with transcranial direct current stimulation(tDCS)electrode anodes based on interventions in the control group,which were placed in the motor area of the pharyngeal cortex at the unaffected side.The electricity was 1.2mA,20 min at a time,once a day,6d/w,at least 7 days of treatment,and at most 14 days of treatment,with an average of 11.5 days of treatment.There was no statistical difference on days of treatment between two groups.The results of both groups were assessed by the Eating assessment tool-10(eat-10),the Intake of drinking water from the low-lying area,the Functional Oral Intake Scale(FOIS)for assessment of swallowing function,and the Forced vital capacity(FVC),peak expiratory flow(PEF)for observing the pulmonary function.SPSS21.0 software was used for statistical analysis and processing of the results where t-test was conducted for the results conforming to the homogeneity of variance and normal distribution,while rank-sum test was conducted for the results not conforming to the normal distribution or the heterogeneity of variance.The linear correlation among the results of FVC and PEF with the results of eat-10,water swallow text and FOIS was conducted.Results:1.Eat-10: There was no significant difference between the two groups before treatment(P>0.05).The eat-10 score of the two groups after treatment was lower than before treatment,and the difference was statistically significant(P<0.05),while the eat-10 score of the observation group was much lower than that of the control group,and the difference was statistically significant(P<0.05).2.Water Swallow Text: There was no statistical difference between two groups before the treatment(P>0.05).The ratings of both groups after treatment were significantly lower than before treatment respectively(P<0.05),meanwhile the rating of the observed group was much lower than that of the control group(P<0.05).3.FOIS: There was no statistical difference between two groups before the treatment(P>0.05).FOIS ratings of both groups after treatment were significantly lower than before treatment respectively(P<0.05),meanwhile the rating of the observed group was much lower than that of the control group(P<0.05).4.FVC: There was no statistical difference between two groups before the treatment(P>0.05).FVC values of both groups after treatment were significantly higher than before treatment respectively(P<0.05),meanwhile the FVC value of the observed group was much higher than that of the control group(P<0.05).5.PEF: There was no statistical difference between two groups before the treatment(P>0.05).PEF values of both groups after treatment were significantly higher than before treatment respectively(P<0.05),meanwhile the PEF value of the observed group was much higher than that of the control group(P<0.05).6.Linear correlation: The results of EAT-10,water swallow text and FOIS were correlated with those of FVC and PEF.It was concluded that EAT-10,water swallow text and FOIS had linear relationship with FVC and PEF respectively,and the results had statistical significance(P<0.05).7.Clinical efficacy:According to the curative effect standard of drinking water experiment in low-lying land,there were 4 cases cured,15 cases better improved and 10 cases improved in the experimental group with an improvement rate of 90.6%.In the control group,there were 2 cases cured,7 cases better improved and 12 cases improved with an improvement rate of 65.6%.The chi-square analysis of the two groups showed a statistically significant difference(P<0.05).It could be concluded that the treatment effect of the observation group was more obvious than that of the control group.Conclusion: Respiratory training is effective in the treatment of stroke dysphagia,but tDCS combined with respiratory training is more effective in the treatment of stroke dysphagia. |
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