Observation on mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in the convalescent stage

Objective： To observe the clinical effect of mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus for deglutition disorder of stroke patients in convalescence stage. Methods： A total of 136 patients conforming to the inclusion criteria were randomized into three groups by the random number table, including group A of 46 cases, group B of 44 cases and group C of 46 cases. Patients in group A received swallowing disorder therapeutic apparatus treatment, patients in group B received mind-refreshing and orifice-opening needling method treatment, and patients in group C received mind-refreshing and orifice-opening needling method plus swallowing disorder therapeutic apparatus treatment. The treatment was given once a day for 10 d as a course, the whole treatment lasted for 4 courses. Therapeutic evaluation items including water-swallowing test （WST）, standardized swallowing assessment （SSA） and modified Barthel index （MBI） were measured before treatment, after treatment and at follow-up visit （2 months after treatment）. Results： After treatment, scores of WST and MBI in all three groups increased significantly （all P〈0.05）, while the SSA score dropped significantly （all P〈0.05）. After treatment and during follow-up visit period, score of WST in group C was significantly higher than that in group A and group B （both P〈0.05）, while the difference between group A and group B showed no statistical significance （P〉0.05）; the SSA score in group C was substantially lower than that in group A and group B （all P〈0.05）, the difference between group A and group B showed no statistical significance （P〉0.05）; the MBI scores in group B and group C were substantially higher than that in group A （all P〈0.05）, the difference between group B and group C showed no statistical significance （P〉0.05）. After treatment and during follow-up visit period, the differences in overall therapeutic effect between group A and group B showed no statistical significance （P〉0.05）, while the overall therapeutic effect in group C was substantially better than that in group A and group B （all P〈0.05）. Conclusion： Both mind-refreshing and orifice-opening needling method and swallowing disorder therapeutic apparatus can alleviate symptoms of deglutition disorder of stroke patients respectively, and the combination of two methods can improve the therapeutic effect.

Therapeutic observation of Gao's nape acupuncture plus swallowing training for pharyngeal deglutition disorder after stroke

Objective: To observe the clinical efficacy of Gao's nape acupuncture plus swallowing training in treating pharyngeal deglutition disorder after stroke. Methods: One hundred patients with post-stroke pharyngeal deglutition disorder were randomized into a treatment group and a control group, with 50 cases in each group. The two groups both received routine neurological intervention. In addition, the treatment group was given Gao's nape acupuncture plus swallowing training, while the control group was intervened by swallowing training alone. After eight-week treatment, the two groups were observed in terms of the changes in repetitive saliva swallowing test (RSST), modified water swallowing test (MWST), standardized swallowing assessment (SSA) and swallowing-related quality of life (SWAL-QOL). The clinical efficacies of the two groups were also compared. Results: After treatment, the RSST grading, and scores of MWST, SSA and SWAL-QOL changed significantly in both groups (P<0.05 or P<0.01). The RSST grading, and scores of MWSX SSA and SWAL-QOL in the treatment group were significantly different from those in the control group after treatment (P<0.05 or P<0.01). The total effective rate and markedly effective rate were respectively 100.0% and 72.3% in the treatment group, versus 97.9% and 34.0% in the control group. There was a significant differenee in the markedly effective rate between the two groups (P<0.01). The differenee in the clinical efficacy between the two groups was statistically significant (P<0.01). Con elusion: Gao's n ape acupu ncture plus swallowi ng training is an effective approach for post-stroke phary ngeal deglutiti on disorder. Its therapeutic efficacy is more significant than that of swallowing training alone.

Clinical Study on Acupuncture Effect for Spastic Paralysis Following Cerebrovascular Disease

Objective： To investigate the acupuncture effect for post-apoplectic spasticity. Methods： Modified Ashworth spasticity rating, Brunnstrom grades, Barthel ADL （Activity of Daily Living） indexes were employed to assess the spasticity, motor function and activities of daily living （ADL）, and thus observe the effect of combined scalp and body acupuncture for post-apoplectic hemiplegic patients. Results： Combined scalp and body acupuncture can obtain significantly better effects than body acupuncture alone in relieving spasticity and improving the patients＇ motor function and ADL （P〈0.01）. Conclusion： Combined scalp and body acupuncture has a distinct advantage in relieving spasticity and can improve the patients＇ motor function and ADL.

Clinical observation on acupuncture combined with Chinese medicine and rehabilitation training for subacute stroke patients

Objective： To observe the clinical effect of combining acupuncture, Chinese medicine and rehabilitation training for subacute stroke. Methods： A total of 120 subacute stroke cases were randomly allocated into a treatment group （n=60） and a control group （n=60）. Patients in the control group received standard rehabilitation therapy alone, whereas patients in the observation group received additional acupuncture and Chinese medicine. Before treatment, after 30-day and 60-day treatments, and 3 months after treatment, the neurologic deficit severity was evaluated using the National Institute of Health stroke scale （NIHSS）; the motor function was evaluated using the FugI-Meyer assessment scale （FMA）; the activities of daily living {ADL） was evaluated using the Barthel index （BI）; and the changes of traditional Chinese medicine （TCM） symptoms were evaluated according to TCM symptom scores. Results： After 30-day, 60-day treatments, and 3 months after treatment, the NIHSS, FMA, BI and TCM symptoms scores were statistically different from those before treatment in both groups （all P〈0.05）; and there were between-group statistical differences at same time points （all P〈0.05）. Conclusion： Combining acupuncture, Chinese medicine and rehabilitation training can improve neurologic deficit, motor function and ADL in subacute stroke patients and its efficacy is better than rehabilitation therapy alone.

Tuina along the meridians combined with Chinese medicine for motor functions and activities of daily living in patients with post-stroke upper limb spasticity

Objective： To observe the effect of combining Chinese medicine and tuina along the meridians on motor function and activities of daily living （ADL） in patient with post-stroke upper limb spasticity. Methods： A total of 220 patients with post-stroke upper limb spasticity were randomly allocated into a treatment group （n=120） and a control group （n=110）. Patients in the treatment group received tuina along the meridians combined with spasticity-alleviating and collateral-unblocking Chinese medicine, whereas patients in the control group received routine rehabilitation therapy. Patients in both groups were treated for 3 weeks. Then the patients＇ motor function, ADL and muscle tone were evaluated before and after treatment using the FugI-Meyer assessment scale （FMA）, modified Barthel index （MBI） and modified Ashworth scale （MAS）. Results： After treatment, the FMA scores, MBI scores, and muscle （shoulder intortor, elbow flexors and wrist flexors） tones were significantly improved （P〈0.05）, but the improvement was more significant in the treatment group than that in the control group （P〈0.05）. Conclusion： Tuina along the meridians combined with spasticity-alleviating and collateral-unblocking Chinese medicine can substantially alleviate muscle tone on the affected side and remarkably improve the patients＇ motor function and ADL.