低频电刺激联合呼吸训练对成人原发性帕金森病吞咽障碍患者吞咽功能及生活质量的影响
周 红 黄东明 黄 澄 陈映萍 汪丽文 林俊良 李 莹
广西壮族自治区江滨医院，广西 南宁 530021
通信作者：黄东明
【摘要】 目的 探讨低频电刺激联合呼吸训练对成人原发性帕金森病（PD）吞咽障碍患者吞咽功能和生活质量的影响。方法 按照随机抽签法将 2019-01—2021-12 广西壮族自治区江滨医院收治的 90 例成人原发性 PD 伴吞咽障碍患者，随机分为对照组 45 例和观察组 45 例。其中对照组施以常规的吞咽功能训练，观察组则采用低频电刺激联合呼吸训练，比较 2 组吞咽优良率、吞咽功能（VFSS 评分）以及生活质量（SWAL-QOF 评分）水平，对 2 组舌骨喉复合体动度指标（舌骨向前、舌骨上移、喉向前以及喉上移最大幅度）进行观察比较，评估 2 组肺功能（FVC、FEV1）水平。结果 观察组吞咽功能的优良率为 91.11%，明显优于对照组的 66.66%（P<0.05）；治疗后 2 组 VFSS、SWAL-QOF 评分均有所提高，且观察组 VFSS、SWAL-QOF 评分［（8.55±1.28 分）、（184.37±27.65）］分均明显高于对照组［（6.47±0.97）分、（169.41±25.41）分］（P<0.05）；治疗后 2 组舌骨喉复合体动度指标较治疗前均有所提高，治疗后观察组舌骨向前、舌骨上移、喉向前以及喉上移最大幅度依次为（11.18±1.67）mm、（16.87±2.53）mm、（18.72±2.80）mm、（28.44±4.26）mm，均明显高于对照组的（8.63±1.29）mm、（14.86±2.22）mm、（16.23±2.43）mm、（25.75±3.86）mm（P<0.05）；治疗后观察组 FVC、FEV1 水平（2.96±0.44、2.82±0.42）与对照组（2.31±0.34、2.25±0.33）相比较，差异有统计学意义（P<0.05）。结论 低频电刺激联合呼吸训练治疗 PD 吞咽障碍患者不仅有利于提高患者的吞咽功能，同时也能有效改善患者肺功能水平和生活质量。
【关键词】 帕金森病；吞咽障碍；呼吸训练；低频电刺激
【中图分类号】 R742.5【文献标识码】 A【文章编号】 1673-5110 （2022） 08-0953-06
基金项目：广西壮族自治区卫生和计划生育委员会自筹经费课题（编号：Z20201187）；广西医疗卫生适宜技术开发与推广应用项目（编号：S201626）
DOI：10.12083/SYSJ.220239
Effects of low-frequency electrical stimulation combined with respiratory training onswallowing function and quality of life in adult patients with Parkinson’s dysphagia
ZHOU Hong，HUANG Dongming，HUANG Cheng，CHEN Yingping，WANG Liwen，LIN Junliang，LI Ying
Jiangbin Hospital of Guangxi Zhuang Autonomous Region，Nanning 530021，China
Corresponding author：HUANG Dongming
【Abstract】 Objective To investigate the effects of low frequency electrical stimulation combined with respiratory training on swallowing function and quality of life in adult patients with primary Parkinson’s disease（PD） dysphagia. Methods According to the random drawing method，90 adult patients with primary PDcomplicated with dysphagia admitted to our hospital from January2019to December2021 were divided into control group（n=45） and observation group（n=45）. The control group received routine swallowing functiontraining，and the observation group received low frequency electrical stimulation combined with breathing training.The excellent and good swallowing rate，swallowing function（VFSS score）and quality of life（SWAL-QOF score）of the two groups were compared. The activity indexes of hyoid bone and larynx complex（hyoid bone forward，hyoid bone upward，larynx forward and larynx upward maximum）were observed and compared between the twogroups，and the lung function（FVC，FEV1）levels of the two groups were evaluated.Results The excellent andgood rate of swallowing function in the observation group was91.11%，which was significantly better than66.66%in the control group（P<0.05）. After treatment，the VFSS and SWAL-QOF scores of the two groups were improved，and the VFSS and SWAL-QOF scores of the observation group（8.55±1.28，184.37± 27.65）were significantlyhigher than those of the control group（6.47±0.97，169.41±25.41）（P<0.05）. After treatment，thehyoid-laryngolaryngopharyngeal complex motion indexes in both groups were improved compared with those beforetreatment，and after treatment，the maximum magnitudes of hyoid bone forward，hyoid bone upward movement，laryngeal forward movement and laryngeal upward movement in the observation group were（11.18±1.67）mm，（16.87±2.53）mm，（18.72±2.80）mm，（28.44±4.26）mm，which were significantly higher than those of the controlgroup（8.63±1.29）mm，（14.86±2.22）mm. Compared with the control group（2.31±0.34，2.25±0.33），the levels ofFVC and FEV1in the observation group after treatment（2.96±0.44，2.82±0.42）（P<0.05）.Conclusion Theapplication of low-frequency electrical stimulation combined with respiratory training in the treatment of PDpatients with dysphagia is not only beneficial to improve the patients’ swallowing function，but also can effectivelyimprove the patients’pulmonary function level and quality of life.
【Key words】Parkinson’s disease；Dysphagia；Breathing training；Low-frequency electrical stimulation
