PDF(Pubmed)
Abstract：
Background: Swallowing is one of the most complex functions of the central nervous system (CNS), which is controlled by different parts of the brain. Oropharyngeal dysphagia (OD) is one of the most common complications after stroke. Despite a variety of behavioral, compensatory, and rehabilitative methods, many stroke patients still suffer from swallowing disorders that adversely affect their quality of life (QOL). The aim of this study was to evaluate the effect of pyridostigmine on patients with post-stroke dysphagia. Methods: A randomized, double-blind, placebo-controlled clinical trial was carried out on 40 patients suffering from post-stroke dysphagia. Patients were assigned randomly into two groups: intervention and control groups (20 in each group). The intervention group was treated with pyridostigmine (60 mg, three times a day, 30 minutes before each meal for three weeks), and the control group received placebo treatment in the same way. All patients (intervention and control) were evaluated according to National Institutes of Health Stroke Scale (NIHSS), modified Rankin Scale (mRS), and Functional Communication Measures (FCM)/American Speech-Language-Hearing Association (ASHA) criteria at baseline and after three weeks of intervention. Values of P < 0.05 were considered statistically significant. Results: In the intervention group, the mean values of NIHSS, mRS, and ASHA/FCM were significantly reduced following three weeks of treatment with pyridostigmine (P = 0.002, P = 0.003, and P < 0.001, respectively), but no significant differences were found in the mean NIHSS, mRS, and ASHA/FCM in the placebo group. Conclusion: Although pyridogestamine is somewhat effective in post-stroke dysphagia, it has not been shown to be more important in preventing aspiration pneumonia and length of hospital stay.
摘要：
背景：吞咽是中枢神经系统（CNS）最复杂的功能之一，由大脑的不同部分控制。口咽吞咽困难(OD)是脑卒中后最常见的并发症之一。尽管有各种各样的行为，补偿性,和康复方法，许多中风患者仍然患有吞咽障碍，这对他们的生活质量（QOL）产生不利影响。这项研究的目的是评估吡啶斯的明对中风后吞咽困难患者的影响。方法：随机，双盲,我们对40例卒中后吞咽困难患者进行了安慰剂对照临床试验.患者被随机分为两组：干预组和对照组（每组20例）。干预组给予吡啶斯的明(60mg,一天三次,每餐前30分钟，持续三周），对照组接受相同方式的安慰剂治疗。根据美国国立卫生研究院卒中量表（NIHSS）对所有患者（干预和对照）进行评估。改良的Rankin量表（MRS），和功能沟通措施（FCM）/美国言语-语言-听力协会（ASHA）标准在基线和干预后三周。P<0.05的值被认为具有统计学意义。结果:干预组,NIHSS的平均值，mRS,使用吡啶斯的明治疗三周后，ASHA/FCM显着降低（分别为P=0.002，P=0.003和P<0.001），但在平均NIHSS中没有发现显著差异，mRS,和ASHA/FCM在安慰剂组。结论：虽然吡格培明对卒中后吞咽困难有一定的疗效，它在预防吸入性肺炎和住院时间方面没有显示出更重要的作用。
