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 Observation of Acupuncture in Treating Pseudobulbar Palsy

Objective： To observe the clinical efficacy of needling nape acupoints in the treatment of pseudobulbar palsy. Methods： One hundred and twenty cases of pseudobulbar palsy were randomized into two groups, a treatment group in which 60 cases were treated by needling nape acupoints and a control group in which 60 cases were treated by needling tongue acupoints; after one-month treatment, the clinical symptoms and signs were observed. Results： The cure rate and total effective rate were respectively 41.7% and 90.0% in the treatment group, and respectively 26.7% and 81.7% in the control group, with differences in the cure rate and total effective rate between the two groups （P〈0.01）. Conclusion： Needling nape acupoints is quite effective to treat pseudobulbar palsy in the relief of clinical symptoms and signs.

Brief introduction to Professor Gao Wei-bin's needling technique of ‘Ten Acupuncture Skills'

‘Ten Acupuncture Skills＇ refers to ten types of needling techniques for difficult and intractable neurological diseases. It has been summarized by Prof. Gao Wei-bin, a famous traditional Chinese medicine expert in China, based upon his clinical experience for years, including neck acupuncture for bulbar palsy, neck acupuncture for laryngeal muscular paralysis, stuck needling technique for ocular muscular paralysis, electric field therapy at Jiaji（EX-B 2） points for incomplete spinal paraplegia, electroacupuncture（EA） for urination disorder, electric neck acupuncture for waking up and treating various cerebral and nuchal diseases, EA at Jiaji（EX-B 2） points for intractable hiccup, EA at Jiaji（EX-B 2） points for cervical and lumbar spondylopathy, antagonistic EA for post-apoplectic hemiplegia, and EA for facial paralysis. The ten acupuncture skills are summarized in order to guide the clinical application.

Efficacy evaluation of acupuncture plus rehabilitation training for post-stroke deglutition disorders of qi-deficiency blood stasis pattern

Objective:To observe the clinical efficacy of acupuncture plus rehabilitation training in treating post-stroke deglutition disorders of qi-deficiency blood stasis pattern.Methods:Sixty-six patients with post-stroke deglutition disorders of qi-deficiency blood stasis patter were divided into an observation group and a rehabilitation group using the random number table method.The two groups both received conventional medications and supportive treatment for stroke.In addition,the observation group received acupuncture plus rehabilitation training while the rehabilitation group only received the same rehabilitation training.The interventions were conducted 3 times a week for a total of 4 weeks in both groups.They were evaluated using Kubota water swallowing test(KWST),Fujishima Ichiro food intake level scale(FILS)and symptoms score of traditional Chinese medicine(TCM)before and after treatment,and at the 1-month follow-up.The therapeutic efficacy was assessed at the 1-month follow-up.Results:The KWST grading and FILS result after treatment and at the follow-up were significantly different from those before treatment in both groups(all P<0.001);the results of these two items at the follow-up were not significantly different from those after treatment in the two groups(all P>0.05).There were significant differences in the KWST grading and FILS result between the two groups after treatment and at the follow-up(all P<0.05).The TCM symptoms score changed significantly after treatment and at the follow-up compared with that before treatment in both groups(all P<0.001).The TCM symptoms grading efficacy at the follow-up was significantly different from that after treatment in the observation group(P<0.05),while the difference was statistically insignificant in the rehabilitation group(P>0.05).The TCM symptoms grading efficacy in the observation group was significantly different from that in the rehabilitation group after treatment and at the follow-up(both P<0.05).Conclusion:Based on the conventional treatment for stroke,acupuncture plus rehabilitation training or use of rehabilitation training alone both can improve the clinical symptoms in post-stroke deglutition disorders of qi-deficiency blood stasis pattern,but acupuncture plus rehabilitation training can produce more significant efficacy and better long-term efficacy in improving TCM symptoms.

Clinical observation on acupoint massage plus Vitalstim electrical stimulation for deglutition disorder after stroke

Objective:To observe the effect of acupoint massage plus Vitalstim electrical stimulation on deglutition function and surface electromyography(SEMG)of deglutition muscle groups.Methods:A total of 60 patients with deglutition disorder after stroke were selected and divided into an electrical stimulation group,a massage group and an integrated group according to the random number table method,with 20 cases in each group.Patients in these three groups were given the same routine rehabilitation training for deglutition.In addition,patients in the electrical stimulation group were given extra Vitalstim electrical stimulation,patients in the massage group were given extra acupoint massage on the head,face and neck,and patients in the integrated group were given extra acupoint massage plus Vitalstim electrical stimulation.Fujishima Ichiro food intake level scale(FILS)was scored before and after treatment.The swallowing duration and maximal amplitude of masseter muscle in SEMG were evaluated before and after treatment.Results:After treatment,the FILS score and the maximal amplitude of recruitment potential generated by muscular contraction of masseter muscle group in the three groups were higher than those before treatment(all P<0.05),and the swallowing duration of masseter muscle group was shortened compared with that in the same group before treatment(all P<0.05).After treatment,the FILS score in the integrated group was higher than that in the electrical stimulation group and the massage group(both P<0.05).The swallowing duration of masseter muscle group measured by SEMG was lower than that in the electrical stimulation group and the massage group(both P<0.05),while the maximal amplitude was higher than that of the electrical stimulation group and the massage group(P<0.05).After treatment,there were no significant differences in the FILS score,swallowing duration and maximal amplitude of masseter muscle group between the electrical stimulation group and the massage group(all P>0.05).Conclusion:Both acupoint massage and electrical stimulation can improve the deglutition function in patients with deglutition disorder after stroke,and improve the coordination and flexibility of masseter muscle.The integration of the two is more effective.

Fire-needle therapy for deglutition disorders in post-stroke pseudobulbar palsy:a randomized controlled trial

Objective:To observe the clinical efficacy of fire-needle therapy in treating deglutition disorders due to pseudobulbar palsy in the remission stage of stroke.Methods:Sixty-two eligible subjects were divided into a fire-needle group and a rehabilitation group by a simple randomization method at a ratio of 1:1.The two groups received same basic intervention;in addition,the fire-needle group received fire-needle treatment,while the rehabilitation group received rehabilitation training.The two groups of subjects all received a 3-week treatment and were evaluated by the dysphagia severity rating scale (DSRS),modified Mann assessment of swallow ability (MMASA) and Kubota Toshio swallow test (KTST) before and after the intervention.The complications and adverse events occurred during the trial were recorded.The data were statistically analyzed.Results:At the third week,the DSRS,MMASA and KTST scores changed significantly compared with the baseline in both groups (P<0.05),and the changes in the fire-needle group were more significant than those in the rehabilitation group (P<0.05).The between-group comparison at the third week showed that the therapeutic efficacy in the fire-needle group was superior to that in the rehabilitation group (P<0.05).Conclusion:Fire-needle therapy can obviously change the DSRS,MMASA and KTST scores in pseudobulbar palsy in the remission stage of stroke,and significantly enhance the therapeutic efficacy of the treatment of deglutition disorders in this stage.