| BackgroundNearly 15 million people worldwide suffer from stroke each year,and this number continues to grow as a result of the aging population,stroke has become the leading cause of disability and death in our country,and the new stroke patients can be up to more than about 2million each year.Characterized by acute onset and severe condition,stroke can lead to a variety of clinical complications,according to statistics,about half of the people will be accompanied by dysphagia in the stroke of the hospitalized patients,however,as the development of medical science,there is still lack of effective intervention measures to prevent stroke and related diseases of stroke,such as motor dysfunction after stroke and dysphagia after stroke.Dysphagia is one of the most common symptoms of the pseudobulbar palsy after stroke,mainly due to he bilateral upper motor neurons lesions which dominated the trigeminal motor nucleus and medullary motor nerve nucleus,resulting in some regional muscles which innervated by nerves paralysis,such as lip,cheek,tongue muscle,soft palate and pharynx area.The patients of dysphagia after stroke often can not safely eat through the mouth because of aspiration causes a series of serious complications,such as aspiration pneumonia,malnutrition,affective disorder,which is not conducive to the recovery of neurological function,resulting in the total duration of hospitalization of patients in the hospital,which greatly reduce the patients quality of life,or even increase mortality,but also the independent risk factors of poor prognosis.Early some positive individualized interventions for stroke patients can significantly shorten the length of stay and decrease the mortality of stroke.Therefore,it has been one of the hot issues of modern medical research on swallowing disorders after stroke.The monosialotertrahexosyl ganglioside GM1 has been a focus of research investigations due to its function as a neurotrophic drug and its ability to penetrate the blood-brain barrier.Recent studies have found that the GM1 can improve the local blood perfusion of the damaged brain tissue and promote nerve growth,differentiation,regeneration and so on,but the drug for the treatment of post stroke patients with dysphagia has not been reported on the recovery of swallowing function.ObjectiveThe aim of this study was to analyze the effects of GM1 on the recovery of neurological function and swallowing function in patients with pseudobulbar palsy caused by acute recurrent stroke,to provide a new method for clinical treatment.Methods1.In total of 189 cases with swallowing dysfunction of PP induced by acute recurrent stroke were randomly divided into two groups.The two groups were both treated by conventional therapy and rehabilitation training.The treatment group was also given GM1 60 mg into 100 ml 0.9%sodium chloride solution with intravenous infusion,qd,for 21 days.2.The evaluation method of observation indexes included the evaluation of swallowing functionby water swallowing test;the evaluation of the neurological deficit by the National Institutes of Health Stroke scale(NIHSS);to evaluation of the recovery of swallowing by the clinical effect of swallowing function.3.The two groups were compared including the age,sex,the past medical history,the score of NIHSS,and the clinical efficacy4.Statistical analysis was carried out with SPSS 17 software.The measurement data were demonstrated by mean ± standard deviation(X±S),the measurement data with normal distribution by t test(groups of homogeneity of variance test,with 0.05 as the test standard,t test with Satterthwaite method for correction of homogeneity of variance),numeration data were demonstrated by χ2 test,the Ridit analysis was used to compare the clinical efficacy between the two groups,P<0.05 indicated the difference was statistically significant.Results1.There was no significant difference between the two groups in age,gender,and the past medical history(p>0.05).2.Before the treatment,two groups showed no statistically significant difference between the water swallowing test score and NIHSS score(p>0.05).3.After the treatment,the two groups of the water swallowing test score were lower than before treatment,the water swallowing test score in treatment group was(1.95 ± 1.42),and the water swallowing test score in treatment group was(2.3 8 ±1.33),the difference was statistically significant(P<0.05).4.After the treatment,the clinical efficacy of the two groups were analyzed by Ridit,the difference was statistically significant(P<0.05).5.After the treatment,the two groups of the NIHSS scores were lower than before treatment the NIHSS score of the treatment group was(11.45±4.36),and the NIHSS score of the control group was(14.23±6.19),the difference was statistically significant(P<0.05).ConclusionGM1 may be one of the effective drugs for the treatment of pp after stroke,which can significantly improve the neurological function and the recovery of swallowing function. |
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