摘要：

目的 探讨发声训练对改善帕金森病患者流涎严重程度的作用。方法 选择2018年8月至2019年7月共60例原发性帕金森病患者随机接受常规康复训练（对照组，30例）和常规康复训练联合发声训练（观察组，30例），分别于训练前和训练4周时采用标准吞咽功能评价量表（SSA）评价吞咽功能、最长发声时间和最大发声分贝评价喉功能和声带振动、统一帕金森病评价量表第二部分（UPDRSⅡ）流涎评分、流涎严重程度和频率量表（DSFS）评价流涎程度（DSFS-S）和频率（DSFS-F）。结果 与训练前相比，两组患者训练4周时最长发声时间延长（P=0.000），最大发声分贝增大（P=0.000），SSA评分（P=0.000）、UPDRSⅡ流涎评分（P=0.000）、DSFS-S评分（P=0.000）和DSFS-F评分（P=0.000）减少；与对照组相比，观察组患者最大发声时间延长（P=0.010），最大发声分贝增大（P=0.000），SSA评分（P=0.044）、UPDRSⅡ流涎评分（P=0.020）、DSFS-S评分（P=0.044）和DSFS-F评分（P=0.049）减少。结论 常规吞咽训练联合发声训练可通过提高吞咽功能而改善帕金森病患者流涎严重程度。

关键词: 帕金森病, 发声, 吞咽障碍, 流涎, 神经康复

Abstract:

Objective To investigate the effect of vocalization training in improving drooling in patients with Parkinson's disease (PD). Methods A total of 60 PD patients from August 2018 to July 2019 were randomly divided into control group (N=30) and observation group (N=30). The patients in control group received routine rehabilitation therapy and the observation group received routine rehabilitation therapy combined with vocalization training. All patients were treated for 4 weeks. Standardized Swallowing Assessment (SSA) was used to evaluate the swallowing function of 2 groups before and after 4-week training. Maximum phonation time (MPT) and maximum phonation decibel were used to evaluate the laryngeal function and vocal cord vibration. Drooling part of Unified Parkinson's Disease Rating Scale Ⅱ (UPDRS Ⅱ), Drooling Severity and Frequency Scale (DSFS) were used to evaluate drooling severity (DSFS-S) and frequency (DSFS-F). All the tests were carried out before and after 4-week training. Results After 4-week training, SSA score (P=0.000) was lower than the score before training in both groups. MPT (P=0.000) and maximum phonation decibel (P=0.000) were significantly increased, moreover, drooling part of UPDRS Ⅱ score (P=0.000), DSFS-S score (P=0.000) and DSFS-F score (P=0.000) were significantly decreased after 4-week training in both groups. Compared with control group, MPT (P=0.010) and maximum phonation decibel (P=0.000) were increased, and SSA score (P=0.044), drooling part of UPDRS Ⅱ score (P=0.020), DSFS-S score (P=0.044) and DSFS-F score (P=0.049) were decreased in the observation group. Conclusions Vocalization training could mitigate drooling severity and frequency of the patients with PD by improving the swallowing function.

Key words: Parkinson disease, Phonation, Deglutition disorders, Sialorrhea, Neurological rehabilitation