丁苯酞聯(lián)合高頻重復(fù)經(jīng)顱磁刺激對腦梗死后 吞咽障礙的影響

Effect of Butylphthalide Combined with High-frequency Repetitive Transcranial Magnetic StimulationonDysphagiaafter Cerebral Infarction/LIMingyu，LONGChuangang.//Medical Innovation of China，2025，22（20）：116-120

[Abstract]Objective： To evaluate the effcts of Butylphthalide combined with high-frequency repetitive transcranial magnetic stimulation （HF-rTMS）onpatients with dysphagiaafter incerebral infarction.Method：A total of 100 patients withdysphagiaafterincerebral infarctionadmited toJiujiangNO.1People's HospitalfromDecember 2022 to December 2O24 were retrospectively selected.According to diferent treatment plans，they were divided nto control group of 5O cases and observation group of 5O cases.The control group was treated with Butylphthalide，and the observation group was treated with HF-rTMS in addition to the treatment provided by the control group.The treatment efficacy，swallowing function [video fluoroscopic swallowing study （VFS），modified Mann assessmentof swallowing ability （MMASA）]，oral feeding ability[function oral intake scale （FOIS）]， and qualityof life[swallowingquality of life （SWAL-QOL）] between the two groups were compared.Result： The treatment effcacy rate in the observation group was higher than thatof the control group，after treatment，the VFSS，MMASA，F(xiàn)OISand SWALQOL scores of both groups were higher than those before treatment，and the VFSS，MMASA，F(xiàn)OIS and SWAL-QOL scores of the observation group were higher than those of the control group （ P lt;0.05）.Conclusion：Butylphthalide combined with HF-rTMS caneffctively treat patients with dysphagia after cerebral infarction can improve swallowing function and transoral feeding ability，and enhance their quality of life.

[KeyWords] ButylphthalideHigh-frequency repetitive transcranial magnetic stimulation Dysphagia 'erebral infarction Swallowing function

First-author's addres： Department of Neurology，Jiujiang NO.1 People's Hospital， Jiujiang 332000， China

doi： 10.3969/j.issn.1674-4985.2025.20.027

腦梗死是全球范圍內(nèi)導致死亡和殘疾的主要病因之一[]。隨著年齡的增長和生活方式的改變，腦梗死的發(fā)生率持續(xù)上升。腦梗死不僅給患者帶來了生命威脅，也嚴重影響了患者的生活質(zhì)量[。吞咽障礙是腦梗死患者中常見且嚴重的并發(fā)癥，有30%～50% 的腦梗死患者會出現(xiàn)不同程度的吞咽困難。這種癥狀不僅增加了患者的室息風險，還可能導致營養(yǎng)不良、肺炎及生活自理能力下降，嚴重影響患者的康復(fù)和生存質(zhì)量。丁苯酞作為一種常用的神經(jīng)營養(yǎng)藥物，具有改善神經(jīng)功能、促進腦血流和增強神經(jīng)保護作用，已被廣泛應(yīng)用于腦梗死后的康復(fù)治療[3]。研究表明，丁苯酞在改善吞咽功能方面具有一定的效果，能夠在一定程度上緩解吞咽困難[4。然而，單一藥物治療往往效果有限，且吞咽功能的恢復(fù)仍面臨較大挑戰(zhàn)。高瀕重復(fù)經(jīng)顱磁刺激（high-frequency repetitive transcranial magneticstimulation，HF-rTMS）是一種非侵入性腦部刺激技術(shù)，近年來被應(yīng)用于神經(jīng)康復(fù)領(lǐng)域[5。HF-rTMS在改善語言、運動等功能方面具有積極效果。越來越多的研究表明，HF-rTMS能夠有效改善吞咽障礙，促進吞咽功能的恢復(fù)，尤其是在與其他治療方法聯(lián)合應(yīng)用時，效果更加顯著[6-7]。本研究通過對比藥物治療和聯(lián)合治療的效果，希望為臨床治療腦梗死后吞咽障礙提供新的思路和方法，從而為改善患者的生活質(zhì)量和促進其康復(fù)提供更加有效的治療方案。

1資料與方法

1.1一般資料

回顧性選擇2022年12月—2024年12月九江市第一人民醫(yī)院收治的100例腦梗死后吞咽障礙患者。……