摘要
目的探讨阿托伐他汀联合重复经颅磁刺激(rTMS)作用于健侧半球吞咽皮质代表区对脑卒中恢复期患者吞咽功能和生活质量的影响。方法选取江苏省苏北人民医院2021年10月至2023年10月收治的脑卒中恢复期患者118例,按治疗方案的不同分为药物组(56例)和联合组(62例)。两组患者均予常规治疗,药物组患者加用阿托伐他汀治疗,联合组患者在药物组治疗基础上加用rTMS,均持续治疗8周。结果联合组的总有效率为95.16%,显著高于药物组的71.43%(P<0.05)。治疗后,两组患者的洼田氏饮水试验评分、标准吞咽功能评价量表(SSA)评分均显著降低(P<0.05),功能性经口摄食量表(FOIS)评分均显著升高(P<0.05),且联合组均显著优于药物组(P<0.05);两组患者的美国国立卫生院神经功能缺损评分量表(NIHSS)评分均显著降低(P<0.05),肢体运动功能量表(FMA)、Berg平衡量表(BBS)评分均显著升高(P<0.05),且联合组均显著优于药物组(P<0.05);两组患者的吞咽障碍特异性生活质量量表(SWAL-QOL)、生活质量评分表(SF-36)评分均显著升高(P<0.05),且联合组均显著高于药物组(P<0.05)。治疗期间,所有患者均未出现明显失眠、消化不良、腹胀等不良反应;仅联合组出现2例轻度头痛,休息后可缓解。结论阿托伐他汀联合rTMS作用于健侧半球吞咽皮质代表区的临床疗效良好,可有效改善脑卒中恢复期患者的神经功能、肢体运动功能,促进吞咽功能的恢复,提高预后的生活质量,且安全性良好。
Objective To investigate the effect of atorvastatin combined with repetitive transcranial magnetic stimulation(rTMS)on the swallowing function and quality of life in patients with stroke recovery by acting on the representative area of swallowing cortex in the healthy hemisphere.Methods A total of 118 patients with stroke recovery admitted to the Jiangsu Subei People′s Hospital from October 2021 to October 2023 were selected and divided into the medication group(56 cases)and the combination group(62 cases)according to different treatment plans.The patients in the two groups received routine treatment,on this basis,the patients in the medication group received atorvastatin,and the combination group received rTMS in addition to the medication group.Both groups were treated for eight weeks.Results The total effective rate in the combination group was 95.16%,which was significantly higher than 71.43%in the medication group(P<0.05).After treatment,the Kubota′s Drinking Water Test scores,the Standard Swallowing Function Assessment(SSA)scores significantly decreased(P<0.05),while the Functional Oral the Intake Scale(FOIS)scores in the two groups significantly increased(P<0.05),and those in the combination group were significantly better than those the medication group(P<0.05);the National Institutes of Health Stroke Scale(NIHSS)scores in the two groups significantly decreased(P<0.05),while the Fugl-Meyer Assessment(FMA)scores and the Berg Balance Scale(BBS)scores in the two groups significantly increased(P<0.05),and those in the combination group were significantly better than those the medication group(P<0.05);the Dysphagia-Specific Quality of Life Scale(SWAL-QOL)scores and the Quality of Life Score Scale(SF-36)scores in the two groups significantly increased(P<0.05),and those in the combination group were significantly higher than those the medication group(P<0.05).During the treatment period,no obvious adverse reactions such as insomnia,dyspepsia or abdominal distension were found in patients.There were only two cases of mild headache in the combination group,which could be relieved after rest.Conclusion Atorvastatin combined with rTMS acting on the representative area of the swallowing cortex in the healthy hemisphere has good clinical efficacy and good safety,which can effectively improve the neurological and limb motor functions in patients with stroke recovery,promote the recovery of swallowing function,and improve the quality of life prognosis.
作者
张丽华
郭晓娟
吉莉
张敏杰
ZHANG Lihua;GUO Xiaojuan;JI Li;ZHANG Minjie(Jiangsu Subei People′s Hospital,Yangzhou,Jiangsu,China 225000;Yangzhou University,Yangzhou,Jiangsu,China 225000)
出处
《中国药业》
CAS
2024年第21期101-104,共4页
China Pharmaceuticals
基金
江苏省苏北人民医院院级课题项目[SBHL22020]
江苏省人兽共患病学重点实验室“护馨基金”项目[HX2207]。
关键词
阿托伐他汀
重复经颅磁刺激
健侧半球吞咽皮质代表区
脑卒中恢复期
吞咽功能
生活质量
atorvastatin
repetitive transcranial magnetic stimulation
representative area of swallowing cortex in the healthy hemisphere
stroke recovery period
swallowing function
quality of life 2024年11月5日第33卷第21期Vol.33,No.21,November 5,2024
