Tongguan Liqiao acupuncture therapy improves dysphagia after brainstem stroke

Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.

Effect of scalp acupuncture combined with language rehabilitation training in treating post-stroke motor aphasia:A systematic review and meta-analysis

Objective:To evaluate the efficacy of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia.Methods:CNKI,VIP,Wan Fang Database,MEDLINE,Embase,Web of Science and Cochrane Library were searched for published researches up to March,2021.Randomized controlled trials RCTs that focused on scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia were included.We managed the data analysis with RevMan 5.3 software.Results:A total of 16 RCTs with 1323 patients were involved.The results of meta-analysis showed that:①The effective rate of scalp acupuncture combined with language rehabilitation training in the treatment of motor aphasia after stroke was significantly better than that of simple language rehabilitation training[OR=3.94,95%CI(2.73,5.68),P<0.00001];②In the evaluation of language function,compared with the language rehabilitation training,the scalp acupuncture combined with language rehabilitation training can significantly improve the reading ability of the patients with motor aphasia after stroke[MD=7.22,95%CI(3.55,10.89),P=0.0001],writing ability[MD=6.51,95%CI(3.61,9.41),P<0.0001],expressive ability[MD=4.13,95%CI(2.37,5.89),P<0.0001],retelling ability[MD=5.00,95%CI(2.38,7.63),P=0.0002],listening comprehension ability[MD=5.36,95%CI(3.12,7.61),P<0.00001]and naming ability[MD=5.60,95%CI(4.20,7.00),P<0.00001];③Compared with simple language rehabilitation training,scalp acupuncture combined with language rehabilitation can significantly improve the daily life language communication ability of patients with motor aphasia,and the difference was statistically significant[MD=30.01,95%CI(11.30,48.72),P=0.002].Conclusion:Scalp acupuncture combined with language rehabilitation training has a significant effect on motor aphasia.However,due to the small sample size,more RCTs are needed to confirm that.

Clinical observation of body acupuncture combined with FANG’s scalp acupuncture for limb dysfunction in the remission stage of stroke

Objective:To observe the clinical efficacy of body acupuncture combined with FANG’s scalp acupuncture in treating limb dysfunction in the remission stage of stroke and explore the mechanism.Methods:Sixty patients in the remission stage of stroke with limb dysfunction were divided into a control group and a treatment group using the random number table method,with 30 cases in each group.The control group was treated with ordinary acupuncture based on the conventional rehabilitation treatment,and the treatment group was additionally offered FANG’s scalp acupuncture.The interventions were conducted once daily with 10 sessions as 1 course.The Fugl-Meyer assessment(FMA)and Barthel index(BI)scores and serum malondialdehyde(MDA)and superoxide dismutase(SOD)levels were compared after 2 treatment courses,and the clinical efficacy was evaluated.Results:After treatment,the FMA and BI scores increased in both groups(P<0.05)and were higher in the treatment group than in the control group(P<0.05).Both groups showed a decreased MDA level and an increased SOD level after the intervention,all showing statistical significance(P<0.05);there were significant differences between the two groups(P<0.05).Conclusion:Based on the conventional rehabilitation treatment,ordinary acupuncture used alone or in combination with FANG’s scalp acupuncture can lower the oxidative stress level and improve limb function in treating limb dysfunction in the remission stage of stroke;body acupuncture plus FANG’s scalp acupuncture can produce better results.

Therapeutic efficacy of swallowing neuromuscular electrical stimulation combined with acupuncture for post-stroke dysphagia

Objective To seek a better therapy for treating post-stroke dysphagia. Methods Patients with stroke and swallowing disorders were randomly divided into ordinary acupuncture group （group A, 58 cases） and swallowing neuromuscular electrical stimulation combined with acupuncture group （group B, 62 cases）. Two-group patients were given the same basic internal medical treatment. In addition, group A was given normal acupuncture treatment with the choice of local points： Junjin （金津 EX-HN 12）, Yuye（玉液 EX-HN 23）, Fengchi （风池 GB 20）, Yifeng （翳风 TE 17）, Lianquan （廉泉 CV 23）, Wangu （完骨 GB 12）. Group B was given swallowing neuromuscular electrical stimulation combined with acupuncture： GB 20, Fengfu （风夜 GV 16）, TE 17, Yiming （翳明 EX-HN 14）, Yamen （哑门 GV 15）, Tianrong（天容 SI 17）, Tianchuang （天窗 SI 16）, CV 23, the uniform reinforcing-reducing manipulation was used; EX- HN 12, EX-HN 13, the piercing and blood-letting method （1-2 mL blood） was used; at the same time, the swallowing neuromuscular electrical stimulation therapy device was used to electrically stimulate the nerves and muscles in the throat and neck at specific output pulse current （50-100 Hz）. Treatment was made twice a day, 30 minutes each time. Two weeks after the treatment, the patients were assessed in symptoms improvement and clinical efficacy. Results The total effective rate in group B was 91.4% and 75.8% in group A; in the total efficiency comparison in both groups, χ^2=5.232, P〈0.05. The difference in improvement of symptoms with post-stroke dysphagia treated with above mentioned combination treatment was statistically significant between both groups （P〈0.05）. Conclusion The above mentioned swallowing neuromuscular electrical stimulation combined with acupuncture treatment has a better clinical effect when compared with ordinary acupuncture.

Meta analysis on ischemic stroke treated with scalp acupuncture

Objective To evaluate the efficacy and safety of scalp acupuncture in the treatment of ischemic stroke. Methods The method recommended in the Cochrane Collaboration was used for the systematic evaluation of the randomized controlled trials （RCTs） of scalp acupuncture in the treatment of ischemic stroke. Results One thousand three hundred and ninety-five cases from 13 papers in Chinese version were in compliance with the inclusive criteria and all of them were the low-quality trials. The results of the included 5 trials in Meta analysis indicated that the efficacy of scalp acupuncture was superior to medication in the treatment of ischemic stroke （RR=1.27, 95% CI 1.06, 1.51）. The results of 3 trials in Meta analysis suggested that the recovery in the nerve function defect of the patients with ischemic stroke treated with scalp acupuncture was apparent as compared with medication （WMD = -2.96, 95% C1-4.00, -1.92）. The results of 5 trials in Meta analysis showed that the efficacy of scalp acupuncture on ischemic stroke was potentially superior to body acupuncture （RR=I.10, 95% CI 0.93, 1.28）. Conclusion It is seen in the Meta analysis results of the included 13 RCTs that scalp acupuncture achieves the definite efficacy on ischemic stroke. Due to the limitation of the inclusive numbers and quality of the research, especially the lack of long-term indices, the conclusion reliability of this research is relatively low. Hence, it is required much more evidences for a further confirmation from the large scale and multiple central RCTs with high quality and intrinsic authenticity.

Efficacy observation of long-retaining scalp acupuncture plus interactive training for upper-extremity dysfunction after cerebral stroke

Objective:To observe the efficacy of long-retaining scalp acupuncture plus interactive training in improving upper-extremity dysfunction in cerebral stroke patients.Methods:Ninety-five patients with upper-extremity dysfunction after cerebral stroke were randomized into two groups,with 48 cases in the treatment group and 47 cases in the control group.Conventional internal medicine treatment was offered to both groups.In both groups,Anterior Oblique Line of Vertex-temporal(MS 6,the middle 2/5)and Posterior Oblique Line of Vertex-temporal(MS 7,the middle 2/5)were selected from the same side of the brain lesion(the side apposing to the hemiplegic limb)for scalp acupuncture treatment.In the treatment group,the scalp acupuncture needles were retained for 7 h,in combination with interactive training,while the needles were also retained for 7 h in the control group but without interactive training.Prior to treatment and at 2-week and 4-week treatment,the two groups were scored using the functional test for the hemiplegic upper extremity-Hong Kong(FTHUE-HK)and simplified Fugl-Meyer assessment-upper extremity(FMA-UE).Results:The total effective rate was 97.9%in the treatment group,higher than 74.5%in the control group(P<0.01).The FTHUE-HK score was higher at 2-week and 4-week treatment than before treatment in both groups,presenting statistically significant intra-group differences(all P<0.001);the FTHUE-HK score was higher at 4-week treatment than at 2-week treatment in both groups,presenting statistically significant intra-group differences(both P<0.001).At 2-week and 4-week treatment,the FTHUE-HK score was higher in the treatment group than in the control group,showing significant between-group differences(both P<0.05).During the whole treatment process,the treatment group had higher FTHUE-HK scores compared with the control group,but there was no statistical significance comparing the change of the score between the two groups at 2-week treatment(P>0.05),while the between-group difference in the change of the score was statistically significant at 4-week treatment(P<0.05).The FMA-UE score was higher at 2-week and 4-weeks treatment than before treatment in both groups,presenting statistically significant intra-group differences(all P<0.001);the FMA-UE score was higher at 4-week treatment than at 2-week treatment in both groups,presenting statistically significant intra-group differences(both P<0.001).At 2-week and 4-week treatment,the FMA-UE was higher in the treatment group than in the control group,and the between-group differences were statistically significant(both P<0.01).The FMA-UE score rose gradually with the increase of treatment session,and there was statistical significance comparing the change of the score between the two groups at 2-week and 4-week treatment,respectively(both P<0.05).Conclusion:Long-retaining scalp acupuncture plus interactive training results in more significant efficacy than long-retaining scalp acupuncture alone in improving the upper-limb dysfunction after cerebral stroke and the advantage becomes more notable after 2-week consecutive treatment.

Acupuncture Treatment for Post-Stroke Dysphagia: An Update Meta-Analysis of Randomized Controlled Trials

Objective： To explore the effectiveness and safety of acupuncture in patients with post-stroke dysphagia by an update meta-analysis. Methods： Potentially eligible RCTs aimed to evaluate the effects of acupuncture vs. non-acupuncture treatments, such as rehabilitation training or routine medication on the swallowing difficulty after stroke were searched from PubMed, Cochrane Library, China National Knowledge Infrastructure, and other database from the earliest record to June 2016. Patient demographics, regimens for acupuncture, type of controls, methods of randomization, and measurements of the clinical symptoms of dysphagia were retrieved. The relative risk （RR） and 95% confidence interval （CI） of effective rate of dysphagia was calculated after intervention performed following admission. Subgroup analyses and a meta- regression analysis were performed to describe the heterogeneity. Results： Twenty-nine RCTs comprising 2,190 patients were included. The included studies had a medium quality grade based on the Consolidated Standards of Reporting Trials （CONSORT） and Standards for Reporting Interventions in Clinical Trials of Acupuncture （STRICTA） checklist. Acupuncture therapy provided a higher effective rate compared with non- acupuncture treatments [RR=1.33, 95% confidence interval （CI）, 1.25 to 1.43]. Subgroup and meta-regression analyses suggested that acupuncture intensity and measurement method were main sources of heterogeneity and resulted in a significant difference for pooled effect size. No severe adverse events were documented in these RCTs. Conclusions： Our meta-analysis provides a new evidence supporting the efficacy and safety of acupuncture in treatment to post-stroke dysphagia in short-term compared with rehabilitation or medication. More high-quality and large-scale research studies are needed.

Therapeutic Effect of Acupuncture Combining Standard Swallowing Training for Post-stroke Dysphagia:A Prospective Cohort Study

Objective： To assess the therapeutic effect of acupuncture combining standard swallowing training for patients with dysphagia after stroke. Methods： A total of 105 consecutively admitted patients with post-stroke dysphagia in the Affiliated Hospital of Gansu University of Chinese Medicine were included： 50 patients from the Department of Neurology and Rehabilitation received standard swallowing training and acupuncture treatment （acupuncture group）; 55 patients from the Department of Neurology received standard swallowing training only （control group）. Participants in both groups received 5-day therapy per week for a 4-week period. The primary outcome measures included the scores of Videofluoroscopic Swallow Study （VFSS） and the Standardized Swallowing Assessment （SSA）; the secondary outcome measure was the Royal Brisbane Hospital Outcome Measure for Swallowing （RBHOMS）, all of which were assessed before and after the 4-week treatment. Results： A total of 98 subjects completed the study （45 in the acupuncture group and 53 in the control group）. Significant differences were seen in VFSS, SSA and RBHOMS scores in each group after 4-week treatment as compared with before treatment （P〈0.01）. Comparison between the groups after 4-week treatment showed that the VFSS （P=0.007） and SSA scores （P=0.000） were more significantly improved in the acupuncture group than the control group. However, there was no statistical difference （P=0.710） between the acupuncture and the control groups in RBHOMS scores. Conclusions： Acupuncture combined with the standard swallowing training was an effective therapy for post-stroke dysphagia, and acupuncture therapy is worth further investigation in the treatment of post-stroke dysphagia.

Clinical observation of scalp acupuncture plus speech rehabilitation for Broca's aphasia after cerebral stroke

Objective：To explore the clinical efficacy of scalp acupuncture plus speech rehabilitation in treating Broca＆#39;s aphasia after cerebral stroke, for providing novel evidences for the treatment. Methods：Ninety-one eligible patients with Broca＆#39;s aphasia after cerebral stroke were randomized into an observation group and a control group. Forty-six cases in the observation group were intervened by scalp acupuncture plus speech rehabilitation, while 45 cases in the control group were treated by speech rehabilitation alone. The aphasia battery of Chinese （ABC） and Boston diagnostic aphasia examination （BDAE） were adopted to evaluate the clinical efficacy. Results：After the treatment, the scores of oral expression, reading and writing and global score in the observation group were significantly higher than those in the control group （allP〈0.05）. There was a significant difference in comparing the BDAE grading between the two groups after the treatment （P〈0.05）. After intervention, the basically-recovered plus markedly-effective rate was 45.7% in the observation group versus 24.4% in the control group, and the between-group difference was statistically significant （P〈0.05）. Conclusion：Scalp acupuncture plus speech rehabilitation is effective in treating Broca＆#39;s aphasia after cerebral stroke, and worth promoting.

Clinical Observation on Scalp Acupuncture Combined with Rehabilitation Training for Hemiplegia After Stroke

Objective:To observe the clinical efficacy of the scalp acupuncture combined with rehabilitation training for hemiplegia. Methods:One hundred and thirty-six cases with hemiplegia after stroke who met the inclusion criteria were randomly divided into three groups according to visiting sequence. Forty-eight cases in the observation group were treated by scalp acupuncture combined with rehabilitation training, 35 cases in the medicine group were treated by Chinese and Western medicines, and 53 cases in the medicine plus rehabilitation group were treated by Western medicine and rehabilitation training. Patients' consciousness, speech and limb functions were scored before and after treatment, and the results were compared. Results:After treatment, the scores of consciousness, speech and limb functions after treatment were lower than those before treatment. And their decrease in the observation group were more statically significant than that in the medicine group and the medicine plus rehabilitation group (P<0.01 or P<0.05). The total effective rates of the three groups were significantly different (P<0.01 or P<0.05). The total effective rate of the observation group was better than that of the other two groups (both P<0.01). Conclusion:Scalp acupuncture combined with rehabilitation therapy has better effect for stroke hemiplegia.

Effect of Interactive Dynamic Scalp Acupuncture on Post-Stroke Cognitive Function,Depression,and Anxiety:A Multicenter,Randomized,Controlled Trial

Objective:To compare the clinical effects of interactive dynamic scalp acupuncture(IDSA),simple combination therapy(SCT),and traditional scalp acupuncture(TSA)on cognitive function,depression and anxiety in patients with post-stroke cognitive impairment.Methods:A total of 660 patients with post-stroke cognitive impairment who were admitted to 3 hospitals in Shenzhen City between May 2017 and May 2020 were recruited and randomly assigned to the IDSA(218 cases),SCT(222 cases)and TSA groups(220 cases)according to a random number table.All the patients received conventional drug therapy for cerebral stroke and exercise rehabilitation training.Scalp acupuncture and computer-based cognitive training(CBCT)were performed simultaneously in the IDSA group,but separately in the morning and in the afternoon in the SCT group.The patients in the TSA group underwent scalp acupuncture only.The course of treatment was 8 weeks.Before treatment(M0),1(M1)and 2 months(M2)after treatment,as well as follow-up at 1(M3)and 2 months(M4),the cognitive function of patients was assessed using the Mini-Mental State Examination(MMSE)and Montreal Cognitive Assessment Scale(MoCA)Scales;depression,anxiety,sleep quality,and self-care ability of patients were assessed using Hamilton Depression Rating Scale(HAMD),Hamilton Anxiety Rating Scale(HAMA),Pittsburgh Sleep Quality Index(PSQI),and Modified Barthel Index(MBI),respectively.During this trial,all adverse events(AEs)were accurately recorded.Results:There were no significant differences in the MMSE,MoCA,HAMD,HAMA,PSQI,and MBI scores among the 3 groups at M0(all P>0.05).In the IDSA group,the MMSE,MoCA and MBI scores from M2 to M4 were significantly higher than those in the SCT and TSA groups,while the HAMD,HAMA and PSQI scores were significantly reduced(all P<0.01).The changes of all above scores(M2–M0,M4–M0)were significantly superior to those in the SCT and TSA groups(all P<0.01,except M4–M0 of HAMD).At M2,the severity of MMSE,HAMD,HAMA,PSQI and MBI in the IDSA group was significantly lower than that in the SCT and TSA groups(all P<0.01).There was no serious AE during this trial.Conclusions:IDSA can not only significantly improve cognitive function,but also reduce depression,anxiety,which finally improves the patient's self-care ability.The effect of IDSA was significantly better than SCT and TSA。

Effects of Interactive Dynamic Scalp Acupuncture on Motor Function and Gait of Lower Limbs after Stroke:A Multicenter,Randomized,Controlled Clinical Trial

Objective:To evaluate the effects of interactive dynamic scalp acupuncture(IDSA),simple combination therapy(SCT),and traditional scalp acupuncture(TSA)on motor function and gait of the lower limbs in post-stroke hemiplegia patients.Methods:A total of 231 patients with post-stroke hemiplegia was randomly divided into IDSA(78 cases),SCT(78 cases),and TSA(75 cases)groups by a random number table.Scalp acupuncture(SA)and lower-limb robot training(LLRT)were both performed in the IDSA and SCT groups.The patients in the TSA group underwent SA and did not receive LLRT.The treatment was administered once daily and 6 times weekly for 8 continuous weeks,each session lasted for 30 min.The primary outcome measures included Fugl-Meyer Assessment of the Lower Extremity(FMA-LE),Berg Balance Scale(BBS),Modified Barthel Index(MBI),and 6-min walking test(6 MWT).The secondary outcome measures included stride frequency(SF),stride length(SL),stride width(SW),affected side foot angle(ASFA),passive range of motion(PROM)of the affected hip(PROM-H),knee(PROM-K)and ankle(PROM-A)joints.The patients were evaluated before treatment,at 1-and 2-month treatment,and 1-,and 2-month follow-up visits,respectively.Adverse events during 2-month treatment were observed.Results:Nineteen patients withdrew from the trial,with 8 in the IDSA group,5 in the SCT group,and 6 in the TSA group.The FMA-LE,BBS,6 MWT and MBI scores in the IDSA group were significantly increased after 8-week treatment and2 follow-up visits compared with the SCT and TSA groups(P<0.05 or P<0.01).Compared with pre-treatment,the grade distribution of BBS and MBI scores in the 3 groups were significantly improved at 1,2-month treatment and 2 follow-up visits(P<0.05 or P<0.01).The SF,PROM-H,PFOM-K and PROM-A in the IDSA group was significantly increased compared with the SCT and TSA groups after 8-week of treatment(P<0.05 or P<0.01).Compared with the SCT group,ASFA of the IDSA group was significantly reduced after 8-week of treatment(P<0.05).SF,SL,PROM-K and PROM-A were significantly increased at the 2 nd follow-up visit whereas the ASFA was significantly reduced in the IDSA group compared with the SCT groups at 1 st follow-up visit(P<0.05 or P<0.01).The SF was significantly increased in the SCT group compared with the TSA group after 8-week treatment(P<0.05).Compared with the TSA group,PROM-K,PROM-A were significantly increased at the 2 nd follow-up visit(P<0.05).Conclusions:The effects of IDSA on lower-limb motor function and walking ability of post-stroke patients were superior to SCT and TSA.The SCT was comparable to TSA treatment,and appeared to be superior in improving the motion range of the lower extremities.(Registration No.ChiCTR1900027206)

Effect of Parallel Scalp Acupuncture Therapy on Hemodynamic Function of Cerebral Circulation in Post-stroke Patients

Objective： To evaluate the effect of parallel scalp acupuncture therapy on hemodynamic function of cerebral circulation in post-stroke patients. Methods： Twenty post-stroke patients were taken as our objects. The cerebral circulation indices before and after parallel acupuncture therapy, were detected with KF-3000 Brain Circulation Analyze, to compare the change of hemodynamics indexes before and after parallel scalp acupuncture. Results： After the therapy, minimum and mean blood velocity of carotid artery （Vmin and Vmean） increased significantly （P〈0.001）; peripheral resistance （Rc） decreased significantly （P〈0.001）. And the other indices had no significant differences. Conclusion： Parallel Scalp Acupuncture can improve the state of cerebrovascular autoregulation, raise the velocity of blood, decrease the peripheral resistance, and increase the steady energy, total energy and the ratio of kinetic energy to total energy, decrease the ratio of oscillatory kinetic energy to total kinetic energy.

Effect of electro-scalp acupuncture on acute ischemic stroke: a randomized, single blind, trial

OBJECTIVE： To determine the clinical efficacy and safety of electro-scalp acupuncture in the treatment of patients with acute ischemic stroke. METHODS： Totally 74 patients with acute ischemic stroke were enrolled and divided into either body acupuncture （Control） or electro-scalp acupuncture （ESA） groups according to randomized controlled principle. The patients in the control group were given body acupuncture treatment once daily for 28 d, whereas except for the body acupuncture, electro-scalp acupuncture was additional treatment given to the ESA group. Neurological deficits, everyday motor function and muscle strength were evaluated at baseline and the 28th d by NIH Stroke Scale （NIHSS）, FugI-Meyer Assessment （FMA） and Modified Barthel Index Score （MBI）, respectively. RESULTS： There were not obvious between-group differences in the baseline efficacy parameters （NI- HSS, FMA and MBI） （all P 〉 0.05）, whereas signifi- cant between-group differences were found in post-treatment NIHSS, FMA-UE and MBI scores （all P 〈 0.05）. After acupuncture treatment, systematic within-group improvements were found in the two groups for any of the efficacy parameters assessed （all P 〈 0.01）, and the ESA group showed higher significant improvements in NIHSS, FMA-UE and MBI scores （all P 〈 0.05）. CONCLUSION： Electro-scalp acupuncture was efficacious in the treatment of acute ischemic stroke, which resulted in meaningful improvements in neurologic function, motor function and activities of daily living of patients.

Relieving throat and opening orifice acupuncture therapy for the post-stroke dysphagia

Objectives: To observe the effectiveness of acupuncture therapy for relieving throat and opening orifice on dysphagia due to different brain infarct sites.Methods: According to the random number table, 128 patients with post-stroke dysphagia were divided into group A(63 cases, intervention with deglutition training and acupuncture) and group B(65 cases,intervention with simple deglutition training). The conventional treatment and deglutition rehabilitation training in neurology department were used in the two groups. In group B, according to patient's condition, the rehabilitation trainings, such as respiration and neck movement range were used selectively.In group A, on the base of deglutition training, acupuncture therapy for relieving throat and opening orifice was supplemented. The acupoints included Sìshéncōng(四神聪EX HN 1),Bāihuì(百会GV 20), Tàiyang(太阳EX-HN5) bilateral, Fēngchi(风池GB 20) bilateral and Shésānzhēn(舌三针).Electrostimulator was attached on EX-HN 1, bilateral GB 20 and Shesanzhen(舌三针). Needles were retained for 30 min in each treatment. The treatment was given once a day, 5 treatments a week and the treatment for 3 weeks as 1 course. After 6 weeks of treatment, the deglutition ability scale developed by Fujishima Ichiro was adopted to determine the therapeutic effects and observe the score increase for dysphagia related to brain infarct sites before and after treatment.Results: In assessment after 6-week treatment, the improvements of deglutition ability were different corresponding to different brain infarct sites in group A. Specially, the improvements in the patients with dysphagia related to cerebral hemisphere infarction in group A were better than group B(8.68 ±1.12 vs7.32 ±0.91, P<0.05), followed by the improvements in the patients with dysphagia related to internal capsule/basal ganglia/diencephalon infarction(6.53 ±0.65 vs 6.36 ±0.84, P>0.05). Regarding the therapeutic effects in comparison of the two groups, the total effective rates in dysphagia related to cerebral hemisphere infarction were different between the two groups significantly(96.67% vs 82.75%, P< 0.05), as well as in the patients related to internal capsule/basal ganglia/diencephalon infarction(88.89% vs 66.67%,P<0.05). The therapeutic effects were not different in the patients related to cerebral stem and cerebella infarction between the two groups(P>0.05).Conclusion: The acupuncture therapy for relieving throat and opening orifice combined with deglutition training achieves the satisfactory therapeutic effects on dysphagia induced by cortical infarction in stroke.However, a large sample and multicentral clinical trial with this therapy is needed for a further argument so that this therapy is likely promoted in clinical practice in future.

Treatment of 85 patients with dysphagia after stroke with deep needling at local glossopharyngeum

Objective To observe the clinical efficacy of deep needling at local glossopharyngeum in treatment of dysphagia after stroke. Methods Deep needling at local glossopharyngeum was applied in 85 patients with dysphagia after stroke. Firstly, quick prick was conducted on lingual surface（mainly at the side of paralysis lingualis）, Jīnjīn（金津 EX-HN 12） and Yùyè（玉液 EX-HN 13） under the tongue; secondly, filiform needle with the length of 75 mm was used to perform quick prick at posterior wall of pharynx at the affected side about three or four times, and then the needle was removed rapidly. Filiform needle with the length of 75 mm was inserted perpendicularly at Liánquán（廉泉 CV 23） towards root of tongue; after deqi, the needle was pushed towards root of tongue in the depth of 60–70 mm, and the needle was retained for 30 min. Meanwhile, the patient was asked to swallow, and the feeling of abnormal deglutition without pain was considered as most appropriate. During needle retention, twirling for reinforcement was applied for two times. The manipulation was conducted once daily, and six days was considered as one course of treatment. Between two courses, one day was free of treatment; and there were four courses in total. Kubota＇s drinking water test evaluation scale was applied to assess the efficacy after the treatment for two weeks and four weeks. Results The score of Kubota＇s drinking water test at the early stage of treatment was 5.08 ± 2.28, the score of evaluation of treatment with deep needling at local glossopharyngeum after treatment for two weeks was 4.56 ± 2.32, and the total effective rate was 89.4%; the score of evaluation after treatment for four weeks was 2.80 ± 2.12, and the total effective rate was 95.3%. Compare before the treatment, the score of Kubota＇s drinking water test was reduced after treatment for two and four weeks（P〈0.05, P〈0.01）. Conclusion Deep needling at local glossopharyngeum in treatment of dysphagia after stroke has good effect.

OBSERVATION ON THE THERAPEUTIC EFFECT OF CT-AIDED SURROUNDING NEEDLING TREATMENT OF ISCHEMIC STROKE

121 cases of ischemic stroke were randomly divided into CT-aided surrounding needling group (CTASN, 61 cases) and scalp Acupuncture group (SA, 60 cases). After 30 sessions of treatment the therapeutic results of the two groups are significantly different (P ＜ 0.05), the therapeutic effect of CTASN group is better than that of SA group. The plasma contents of TXB2 and 6-keto-PGF1a of the two groups change considerably after acupuncture treatment, the change in CTASN group is more obvious.

OBSERVATION ON THE THERAPEUTIC EFFECT OF CT-AIDED SURROUNDING NEEDLING IN THE TREATMENT OF ISCHEMIC STROKE AND CHANGES OF PLASMA CATECHOLAMINE LEVEL

In this study, 61 cases of ischemic stroke patients are randomly divided into surrounding needling group (n=31) and scalp acupuncture group (n=30). The ischemic focus of the brain is determined by CT examination. For patients of the surrounding needling group, Gauge 29-30 stainless steel filiform needles are inserted into the surrounding scalp of the focal projection region one by one, with the needle tips toward the center of the focal projection area, and combined with other body acupoints according to syndrome differentiation. For patients of scalp acupuncture group, Motor Area (MS 6) and Sensory Area (MS 7) of the contralateral side of the focus are used. The treatment is performed once daily in both groups, with 30 sessions being a therapeutic course. After one course of treatment, in surrounding needling and scalp acupuncture groups, 20 and 11 cases are cured basically, 10 and 15 have a marked improvement, 1 and 4 are effective, the therapeutic effect of the former group is significantly superior to that of scalp acupuncture group. After treatment, plasma epinephrine (E) and norepinephrine (NE) levels of the two groups decrease considerably compared with pre treatment of each group (P<0.01), and the effects of surrounding needling on E and NE are more evidently than those of scalp acupuncture (P<0.05). Results suggest that the therapeutic effect of acupuncture may be related to the decline of plasma E and NE levels.

Study on Mechanism of Scalp Electro-acupuncture in Treating Ischemic Stroke Based on CT Localization

Objective： To investigate an effective method of treating ischemic stroke. Methods： The scalp area corresponding to the ischemic focus was electro-acupunctured by craniocerebral CT localization. Cerebral blood flow and blood rheology were measured. Results： The curative effect and changes in cerebral blood flow and hemorheologic indices were better in the observation group than in the control group （P〈0.05）. Conclusion： Scalp electro-acupuncture based on CT localization is an effective method of treating ischemic stroke.

Clinical Observation on the Application of Scalp and Body Acupuncture in Treating Post-stroke Hiccups

Hiccups are a common complication following stroke,characterized by gastric air reflux,causing an involuntarily frequent short"hic"sound.We adopted scalp and body acupuncture to treat78cases of post-stroke hiccups during August2007and December2008,and compared it with traditional body acupuncture.The report is now given as follows.