【目的】观察舌项针联合经颅直流电刺激治疗脑卒中后吞咽障碍的临床疗效。 【方法】将70例脑卒中后吞咽障碍患者随机分为观察组和对照组，每组各35例。2组患者均给予常规治疗及康复训练。对照组给予经颅直流电刺激治疗，观察组在对照组治疗的基础上，给予舌项针治疗。共治疗4周。治疗1个月后，评价2组临床疗效，观察2组患者治疗前后洼田饮水试验分级 （WST） 与电视透视吞咽功能检查 （VFSS） 评分的变化情况，以及功能性经口摄食量表 （FOIS） 评分的情况。比较2组患者治疗前后吞咽障碍特异性生活质量量表 （SWAL-QOL） 评分的变化情况，并评价2组的安全性及不良反应的发生情况。【结果】（1） 观察组失访2例 （1例转院、1例病情加重） ，对照组失访3例 （自行退出1例、中途出院1例、合并其它疾病1例） 。最终观察组33例、对照组32例纳入疗效统计。 （2） 治疗后，2组患者的WST、VFSS评分明显改善 （P＜0.05） ，且观察组在改善WST、VFSS评分方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （3） 治疗后，2组患者FOIS、SWAL-QOL评分均明显改善 （P＜0.05） ；且观察组在改善FOIS、SWAL-QOL评分方面明显优于对照组，差异有统计学意义 （P＜0.05） 。 （4） 观察组总有效率为90.90% （30/33） ，对照组为71.87% （23/32） 。观察组疗效优于对照组，差异有统计学意义 （P＜0.05） 。 （5） 观察组与对照组的不良反应发生率比较，差异无统计学意义 （P＞0.05） 。 【结论】舌项针联合经颅直流电刺激治疗脑卒中后吞咽障碍，能有效改善患者的吞咽功能，提高患者的摄食能力，从而提高患者的生活质量，降低并发症发生率，临床疗效显著。

Objective To observe the clinical efficacy of tongue-nape acupuncture combined with transcranial direct current stimulation （tDCS） in the treatment of post-stroke dysphagia. Methods A total of 70 patients with post-stroke dysphagia were randomly divided into observation group and control group，35 patients in each group. Both groups were given conventional treatment and rehabilitation training. The control group was treated with tDCS，and the observation group was treated with tongue-nape acupuncture on the basis of the control group. The course of treatment covered four weeks. After one month of treatment，the clinical efficacy of the two groups was evaluated，and the changes in the scores of the Kubota Water Swallowing Test （WST） and Video Fluoroscopy Swallowing Study （VFSS） ，as well as the scores of the Functional Oral Intake Scale （FOIS） of the patients in the two groups before and after the treatment were observed. We compared the changes in Swallowing Disorder Specific Quality of Life Scale （SWAL-QOL） scores before and after treatment in the two groups，the safety and the occurrence of adverse reactions in the two groups were evaluated. Results （1） There were two cases failed to follow-up in the observation group （one case was transferred to another hospital，one case was aggravated） ，and three cases failed to follow-up in the control group （one case withdrew on his own，one case was discharged in the middle of the treatment，and one case was combined with other diseases during treatment） . Finally，33 cases in the observation group and 32 cases in the control group were included in the efficacy statistics. （2） After treatment，the WST and VFSS scores of patients in the two groups were improved significantly （P＜0.05），and the improvement in the observation group was significantly superior to that in the control group，with statistically significant differences （P＜0.05） . （3） After treatment，the FOIS and SWAL-QOL scores of patients in the two groups were improved significantly 0.05 and the improvement in the observation group was significantly superior to that in the control group，with statistically significant differences （P＜0.05） . （4） The total effective rate was 90.90% （30/33） in the observation group and 71.87%（23/32） in the control group. The efficacy of the observation group was superior to that of the control group，and the difference was statistically significant （P＜0.05） . （5） Comparison of the incidence of adverse reactions between the observation group and the control group showed that the difference was not statistically significant（P＞0.05） . Conclusion Tongue-nape acupuncture combined with tDCS for the treatment of post-stroke dysphagia can improve the swallowing function of patients effectively，and improve the ability to ingest food of patients，so as to improve the patients’quality of life and reduce the incidence of complications，the clinical efficacy of which is remarkable.

R246.9

陕西省重点研发计划资助项目 （编号：2024SF-YBXM-686）；西安创新能力支撑计划-医学研究资助项目 （编号：23YXYJ0139）