A Preliminary Clinical Study Of Abnormal Gag Reflex

Objective:To comprehend the distribution of abnormal gag reflex in the relative health group,diabetes group,stroke group and stroke with diabetes group,explore the possibility of the relevant factors with abnormal gag reflex and assess the actual value of gag reflex in distinction between bulbar palsy and pseudobulbar palsy.Methods:Collected 146 cases hospitalized in the Department of Neurology or Endocrinology of the First Affiliated Hospital of Guangxi Medical University in February and March 2009,in line with the inclusion criteria of 52 cases of diabetes,74 cases of stroke,20 cases of stroke with diabetes.82 relative health cases were chosen from Physical Examination Center.Acquisitioned the medical history,applied the physical examination(another examiner participated in checking the gag reflex in relative health group in double-blind situation),and then assembled the auxiliary examination data of these cases.Results:①The results of the two examiners made no statistically significant difference:X~2=1.000,P=0.607,the results of the two examiners have a good consistency:Kappa=0.776,P＜0.001②The incidence of abnormal gag reflex in the relative health group,diabetes group,stroke group and stroke with diabetes group were 14.6%,25.0%,33.8%,40.0%.③There was statistically significant difference between the relative health group and the stroke group or the stroke with diabetes group,P=0.005,0.01.The stroke group and the stroke with diabetes group made no significant difference,P=0.605. The diabetes group and the relative health group made no statistically significant,so did the diabetes and the stroke with diabetes group,P=0.214, 0.151.④Run Logistic regression analysis base on the relevantive factors (hypertension,hyperlipidemia,body mass index,age,smoking and sex)with the gag reflex in the health group,P＞0.05 in all of the factors.Analyzed the relevantive factors(course of the stroke,lesions of stroke and whether or not pseudobulbar palsy) with the gag reflex in the stroke group by Logistic regression analysis,the pseudobulbar palsy resulting in P=0.033,OR=7.369, and the course of stroke,lesions of stroke P＞0.05.Conclusion:①The Moulton's gag reflex standard has a certain feasibility.②There are decreased or disappeared gag reflex in the relative health group.③The incidence of abnormal gag reflex in the stroke group and in the stroke with diabetes group is higher than that in the health group.④The high incidence of abnormal gag reflex with pseudobulbar palsy suggests that the distinction between bulbar palsy and pseudobulbar palsy with gag reflex is not reliable.⑤High blood pressure,high blood lipids,body mass index,age, smoking,sex,the course of stroke,the lesion of stroke have no correlation with abnormal gag reflex.