Observation of Therapeutic Effect of Transcranial Direct Current Stimula-tion Combined with Intraoral Low-frequency Electrical Stimulation in the Treatment of Swallowing Dysfunction after Pontocerebral Infarction

HAO Pengna; CHENG Xiaona; LANG Xiaoguang; LIANG Zhijuan; LYU Xuehai

doi:10.3969/j.issn.1002-3429.2023.07.026

Abstract：Objective To investigate the clinical effect of transcranial direct current stimulation(tDCS)combined with intraoral low-frequency electrical stimulation on patients with swallowing dysfunction after pontocerebral infarction.Meth-ods A total of 96 patients with swallowing dysfunction after pontocerebral infarction from June 2018 to June 2021 were select-ed as the research subjects and divided into control group A(n =32),control group B(n =32)and observation group(n = 32)according to treatment methods.Control group A was given tDCS,control group B was given oral low-frequency electrical stimulation,and observation group was given tDCS combined with oral low-frequency electrical stimulation.The three groups were compared in terms of therapeutic effect,feeding status,nutritional status indicators[prealbumin(PAB),albumin(ALB),transferrin(TRF),hemoglobin(Hb)],surface electromyography,hyolaryngeal complex movement,modified Mann Swallowing Ability Assessment Scale(MMASA),Swallowing-related-Quality of Life(SWAL-QOL),National Institutes of Health Stroke Scale(NIHSS),Barthel Index(BI)score.Results The total effective rate of observation group was90.62%(29/32),which was higher than that of control group A[62.50%(20/32)]and control group B[65.62%(21/32)](P＜0.05).At 2 and4 weeks after treatment,the time of autonomous eating in observation group was longer than that in con-trol group A and control group B,the actual eating proportion,maximum amplitude of surface electromyography,ALB,PAB,Hb,TRF,MMASA,SWAL-QOL and BI scores were higher than those in control group A and control group B,and the swal-lowing time was shorter than that in control group A and control group B.The NIHSS score was lower than that of control group A and B,and the ascending and advancing distance of hyoid bone and thyroid cartilage was greater than that of control group A and control group B(P＜0.05).At 2 and 4 weeks after treatment,the NIHSS score of control group A was lower than that of control group B,and the BI score was higher than that of control group B(P＜0.05).Conclusion tDCS combined with intraoral low-frequency electrical stimulation in the treatment of swallowing dysfunction after pontocerebral infarction can im-prove the therapeutic effect,enhance the nutritional status and oral muscle function of patients,promote the improvement of neurological function,and thus improve the dysphagia,which is conducive to the recovery of disease and the improvement of quality of life.