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目的：探讨脑卒中后吞咽障碍给予不同频次经颅直流电刺激（tDCS）治疗的临床疗效，旨在为脑卒中后吞咽障碍的治疗提供临床指导。方法：选取2022年1月至2023年6月我院收治的脑卒中后吞咽障碍患者共计96例，以随机数字表法分成低强度组（32例）、中强度组（32例）、高强度组（32例），低强度组给予1.0mA的tDCS治疗，中强度组给予1.5mA的tDCS治疗，高强度组给予2.0mA的tDCS治疗，比较三组洼田饮水试验评级、吞咽能力、摄食能力、营养状况、生活质量的改变。结果：三组治疗后洼田饮水试验评级改善（P<0.05），高强度组优于低强度组、中强度组（P<0.05），低强度组、中强度组比较无差异（P>0.05）；三组治疗后标准吞咽功能评价量表（SSA）评分下降（P<0.05），功能性经口摄食量表（FOIS）评分升高（P<0.05），高强度组SSA评分较低强度组、中强度组更低（P<0.05），FOIS评分更高（P<0.05），低强度组、中强度组比较无差异（P>0.05）；三组治疗后血红蛋白（HGB）、前白蛋白（PA）、总蛋白（TP）、转铁蛋白（TFN）水平升高（P<0.05），高强度组较低强度组、中强度组更高（P<0.05），低强度组、中强度组比较无差异（P>0.05）；三组治疗后日常生活能力量表（ADL）、吞咽障碍特异性生活质量评估量表（SWAL-QOL）评分升高（P<0.05），高强度组较低强度组、中强度组更高（P<0.05），低强度组、中强度组比较无差异（P>0.05）。结论：高强度tDCS治疗脑卒中后吞咽障碍的效果较好，能够促进吞咽功能改善，提升患者吞咽能力、摄食能力，改善营养状况，提高生活质量。

英文摘要:

Objective:To explore the efficacy of different frequencies of Transcranial direct current stimulation (tDCS) treatment on swallowing disorders after stroke,to provide clinical guidance for the treatment of swallowing disorders after stroke.Methods:A total of 96 patients with swallowing disorders after stroke from January 2022 to June 2023 who were admitted in our hospital were selected, and divided into the low intensity group (n=32), the moderate intensity group (n=32), and the high intensity group (n=32) by random number table method.The low intensity group was received 1.0mA tDCS treatment, the moderate intensity group was received 1.5mA tDCS treatment, and the high intensity group was received 2.0mA tDCS treatment.The changes in wada drinking water test rating,swallowing ability and feeding ability, nutritional status,and quality of life in three groups were compared.Results:After treatment,the wada drinking water test rating in three groups were improved (P<0.05),and compared with the low and moderate intensity group,the high intensity group was better (P<0.05),while no significant difference in the low and moderate intensity group(P>0.05). After treatment,the standardized swallowing assessment(SSA) scores in three groups were decreased (P<0.05), the Functional Oral Intake Scale (FOIS) scores were increased (P<0.05),in comparision of the low and moderate intensity group, the SSA score in the high intensity group was lower (P<0.05), and the FOIS score was higher (P<0.05),while no significant difference in the low and moderate intensity group(P>0.05).After treatment,Hemoglobin(HGB), Prealbumin(PA),Total protein(TP),and Treansferrin (TFN) levels in three groups were increased(P<0.05),in comparision of the low and moderate intensity group, the high intensity group was higher (P<0.05),while no significant difference in the low and moderate intensity group (P>0.05). After treatment, Activity of Daily Living Scale (ADL) and Swallowing Quality of Life (SWAL-QOL) scores in three groups were improved (P<0.05),and compared with the low and moderate intensity group,the high intensity group was higher(P<0.05),while no significant difference in the low and medium intensity group (P>0.05).Conclusion:High intensity tDCS has good therapeutic effect on swallowing disorders after stroke,which can promote improvement of swallowing function,enhance swallowing and feeding abilities,improve nutritional status,and improve quality of life.

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