Clinical Observation Of Tongue Three-needle Combined With Repetitive Transcranial Magnetic Stimulation In The Treatment Of Dysphagia After Stroke

Objective:On the basis of clinical routine treatment,this study observed and compared the difference of clinical efficacy between tongue three needle combined with repetitive transcranial magnetic stimulation(r TMS)and r TMS alone in the treatment of dysphagia after stroke(DAS),further providing clinical trial basis for the feasibility and effectiveness of this new combined rehabilitation method of traditional Chinese and western medicine,standardizing the specific operation method of tongue three needle combined with r TMS in the treatment of DAS,and further providing theoretical basis for the research and use of this treatment method.Method:Select 60 patients with DAS who meet the criteria for this enrollment,and randomly divide them into treatment group and control group according to the method of random number table,with 30 patients in both groups.On the basis of receiving secondary prevention medication and routine rehabilitation treatment for stroke,all the patients in the treatment group were treated with r TMS+tongue three-needle and routine treatment,while the control group was only treated with r TMS and routine treatment.Before and after treatment for 4 weeks,the Water Swallow Test(WST),the Standardized Swallowing Assessment(SSA),the Functional Dysphagia Scale(FDS)and the surface electromyography(s EMG)signal(maximum amplitude and duration)of the submental muscle group were evaluated and compared between the two groups of patients.Results:(1)Before treatment,the general information of patients in the two groups,including gender,age,course of disease,disease classification were comparable(P>0.05).(2)After treatment,the Water Swallow Test,the Standardized Swallowing Assessment,the Functional Dysphagia Scale of the two groups were improved,and the improvement degree of the treatment group was more significant than that of the control group(P<0.05).(3)After treatment,the maximum amplitude of surface EMG signal of submental muscle group during swallowing was higher than that before treatment,and the duration was lower than that before treatment(P<0.01);The maximum amplitude and duration of s EMG in the treatment group were significantly better than those in the control group(P<0.05).(4)There were 2 cases in this study.In the treatment group,1 case fell off,and the patient fell down in the ward,with slight recurrent cerebral hemorrhage.One case fell off in the control group,and the patient gave up halfway.One patient in the treatment group developed slight dizziness after transcranial magnetic stimulation treatment and disappeared after 10 minutes of rest.There was no complaint of discomfort during the treatment.Other patients did not have other adverse reactions such as needle sickness and severe subcutaneous hemorrhage.Conclusion:(1)The combination tongue three-needle with r TMS and r TMS alone can improve the WST,the SSA,and the FDS of the two groups of patients,indicating that the two groups of methods can improve the clinical symptoms of patients with dysphagia after stroke,but the former is more obvious.(2)The combination of tongue three-needles and repetitive transcranial magnetic stimulation alone can affect the maximum amplitude and duration of surface electromyography,and the former has a greater impact,indicating that both of them can improve the cortical excitability of patients,and the former has a significant increase.