中国组织工程研究

中国组织工程研究 ›› 2026, Vol. 30 ›› Issue (11): 2736-2744.doi: 10.12307/2026.076

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腹部电刺激与核心稳定训练改善脑卒中假性延髓麻痹患者平衡及咳嗽能力

高世爱1，陈金慧1，曹新燕1，冷晓轩1，刘西花2   

  1. 1山东中医药大学康复医学院，山东省济南市   250355；2山东中医药大学附属医院康复科，山东省济南市   250014

  • 收稿日期:2025-02-25 接受日期:2025-05-16 出版日期:2026-04-18 发布日期:2025-09-05
  • 通讯作者: 刘西花，博士，主任医师，山东中医药大学附属医院康复科，山东省济南市 250014
  • 作者简介:高世爱，女，2001年生，山东省聊城市人，汉族，山东中医药大学在读硕士，主要从事神经与心肺疾病康复基础与临床研究。
  • 基金资助:
    国家自然科学基金青年基金项目(81802239)，项目负责人：刘西花；山东省中医药科技项目(M-2023142)，项目负责人：刘西花；山东省医务职工科技创新计划项目(SDYWZGKCJH2022024)，项目负责人：刘西花

Abdominal electrical stimulation combined with core stabilization training improves balance and cough function in patients with stroke pseudobulbar palsy

Gao Shiai1, Chen Jinhui1, Cao Xinyan1, Leng Xiaoxuan1, Liu Xihua2   

  1. 1School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China; 2Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • Received:2025-02-25 Accepted:2025-05-16 Online:2026-04-18 Published:2025-09-05
  • Contact: Liu Xihua, MD, Chief physician, Department of Rehabilitation, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan 250014, Shandong Province, China
  • About author:Gao Shiai, MS candidate, School of Rehabilitation Medicine, Shandong University of Traditional Chinese Medicine, Jinan 250355, Shandong Province, China
  • Supported by:
    National Natural Science Foundation of China for the Youth, No. 81802239 (to LXH); Shandong Provincial Traditional Chinese Medicine Science and Technology Project, No. M-2023142 (to LXH); Shandong Provincial Medical Staff Science and Technology Innovation Program, No. SDYWZGKCJH2022024 (to LXH)

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摘要：


文题释义：
假性延髓麻痹：是脑卒中后常见的并发症之一，主要由双侧上运动神经元损伤(如双侧皮质或皮质脑干束受损)引起，导致延髓运动神经核团失去上位神经支配，进而引发舌、软腭、咽喉、颜面及咀嚼肌的中枢性瘫痪，其典型临床表现为发音障碍、吞咽困难等症状。然而，目前针对此类患者的康复治疗多集中于吞咽和言语功能，对躯干肌群力量的关注相对不足，忽视了躯干肌在维持平衡和咳嗽功能中的重要作用。
核心稳定训练：是一种通过非稳定状态下的运动训练，激活人体深层小肌群，增强躯干控制力和协调性的康复方法，其目的是通过提高核心肌群的力量和稳定性，改善患者的平衡能力及整体运动功能，从而促进功能恢复。
腹部电刺激：是一种通过电流刺激腹部肌群以增强其功能的物理治疗方法。该方法能够针对性地强化腹外斜肌、腹内斜肌等腹部核心肌群的力量，促进更多肌纤维的募集，从而提升腹部肌群的整体功能，对改善平衡和咳嗽能力具有潜在作用。

背景：假性延髓麻痹是脑卒中患者的常见并发症，常伴有躯干核心肌群控制能力下降、自主咳嗽反射减弱等问题。而目前临床治疗假性延髓麻痹多集中于言语和吞咽功能的康复，往往忽视平衡运动能力以及咳嗽排痰功能的系统治疗。
目的：探究腹部电刺激联合核心稳定训练对脑卒中假性延髓麻痹患者平衡、运动及咳嗽功能的影响。
方法：选取山东中医药大学附属医院康复中心收治的脑卒中后假性延髓麻痹患者60例，随机分为对照组和试验组，每组30例。两组患者均接受基础治疗和常规康复训练，并同时进行核心稳定训练(30 min/次，1次/d，6 d/周，持续2周)；试验组患者在上述治疗和训练的基础上联合腹部电刺激治疗(30 min/次，1次/d，6 d/周，持续2周)。分别于治疗前及治疗2周后，评估2组患者的Berg平衡量表评分、Fugl-Meyer下肢运动功能评分、改良Barthel指数及半定量咳嗽强度评分；采用超声成像技术评估患者腹外斜肌、腹内斜肌及腹横肌的增厚率，并通过肺功能测试测定患者的咳嗽峰值流量。
结果与结论：①治疗2周后，2组患者Berg平衡量表评分、Fugl-Meyer下肢运动功能评分、改良Barthel指数、咳嗽峰值流量评分、半定量咳嗽强度评分及腹肌增厚率均较治疗前有所提高，且试验组改善幅度优于对照组(P < 0.05)。②结果表明，腹部电刺激联合核心稳定训练在改善患者平衡功能、下肢运动功能、日常生活能力、咳嗽能力及核心肌群激活方面均优于对照组，具有明显的临床疗效，这一联合干预措施为假性延髓麻痹患者的整体康复提供了有效的支持。
https://orcid.org/0009-0006-2294-061X (高世爱) 

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

关键词: 假性球麻痹, 脑卒中, 腹部电刺激, 核心稳定训练, 平衡, 咳嗽功能, 肌骨超声

Abstract: BACKGROUND: Pseudobulbar palsy is a common complication in stroke patients. Additionally, patients often experience reduced trunk core muscle control and weakened voluntary cough reflexes. Current clinical treatments for pseudobulbar palsy predominantly focus on speech and swallowing rehabilitation, often neglecting systematic interventions for balance, motor function, and cough expectoration.
OBJECTIVE: To investigate the effects of abdominal electrical stimulation combined with core stability training on balance, motor function, and cough ability in stroke patients with pseudobulbar palsy.
METHODS: Sixty patients with post-stroke pseudobulbar palsy from the Rehabilitation Center of the Affiliated Hospital of Shandong University of Traditional Chinese Medicine were randomly divided into a control group and an experimental group, with 30 patients in each group. Both groups received basic treatment and conventional rehabilitation training. The control group additionally underwent core stability training (30 minutes as a session, once a day, six sessions per week, for 2 weeks), while the experimental group received abdominal electrical stimulation (30 minutes as a session, once a day, six sessions per week, for 2 weeks) in addition to the control group’s treatment. Before and after 2 weeks of treatment, the Berg Balance Scale, Fugl-Meyer Assessment for Lower Extremity, Modified Barthel Index, and Semiquantitative Cough Strength Score were evaluated. Abdominal muscle thickness ratio of the external oblique, internal oblique and transversus abdominis muscles was assessed using ultrasound, and cough peak flow was measured via pulmonary function testing.
RESULTS AND CONCLUSION: After 2 weeks of treatment, both groups showed improvements in the Berg Balance Scale, Fugl-Meyer Assessment for Lower Extremity, Modified Barthel Index, and Semiquantitative Cough Strength scores, and abdominal muscle thickness ratio compared with pre-treatment levels, with the experimental group demonstrating significantly greater improvements than the control group (P < 0.05). These findings indicate that abdominal electrical stimulation combined with core stability training is superior to the control group in improving patients' balance function, lower limb motor function, activities of daily living, cough ability, and core muscle activation, demonstrating significant clinical efficacy. This combined intervention provides effective support for the overall rehabilitation of patients with pseudobulbar palsy.

Key words: pseudobulbar palsy, stroke, abdominal electrical stimulation, core stability training, balance, cough function, musculoskeletal ultrasound

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