To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia,a total of 120 patients with post-stroke dysphagia were randomly and evenly divided in...To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia,a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups：conventional swallowing therapy group,VitalStim therapy group,and VitalStim therapy plus conventional swallowing therapy group.Prior to and after the treatment,signals of surface electromyography（sEMG） of swallowing muscles were detected,swallowing function was evaluated by using the Standardized Swallowing Assessment（SSA） and Videofluoroscopic Swallowing Study（VFSS） tests,and swallowing-related quality of life（SWAL-QOL） was evaluated using the SWAL-QOL questionnaire.There were significant differences in sEMG value,SSA,VFSS,and SWAL-QOL scores in each group between prior to and after treatment.After 4-week treatment,sEMG value,SSA,VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group,but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group.It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.展开更多
Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to ...Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to our hospital, and randomly divided them into the Neuman group (n = 51) given nursing intervention based on Neuman systems model and a control group (n = 46) given routine nursing intervention. Both groups received nutritional support for 3 months. Nutritional indexes (serum total protein, plasma albumin, serum albumin, hemoglobin and transferrin levels) and immune indexes (immunoglobulin (Ig) A, IgG, IgM and total lymphocyte count (TLC) in both groups were recorded and compared. Pulmonary function recovery, video fluoroscopic swallowing study score, water swallowing test score, complication rate, and health knowledge mastery level were also compared between the two groups. Results: After the intervention, the Neuman group showed less decrease in the nutritional and immune index scores (serum total protein, plasma albumin, hemoglobin, serum albumin;IgA, IgG, IgM, and TLC;all P Conclusion: For patients with stroke and dysphagia, comprehensive nursing intervention (e.g., nutritional support) under theNeuman systems model can promote the recovery of immune, swallowing, and pulmonary function, reduce complication incidence and facilitate comprehensive rehabilitation, ensuring adequate nutritional intake.展开更多
Objective： To observe the effectiveness and safety of Tongyan Spray （通咽喷雾剂） composed of Chinese medicine for post-stroke dysphagia patients. Method： One hundred and twenty-two post-stroke dysphagia patients w...Objective： To observe the effectiveness and safety of Tongyan Spray （通咽喷雾剂） composed of Chinese medicine for post-stroke dysphagia patients. Method： One hundred and twenty-two post-stroke dysphagia patients were randomly assigned to the treatment group （61 cases） and the control group （61 cases）. Basic treatment was given to both groups, with Tongyan Spray additionally used in oropharynx for the treatment group, and the placebo used for the control group. After 28-day treatment, the clinical effect and safety were evaluated according to the standard swallowing assessment （SSA） scale. Results： One patient dropped out in each group, and 120 patients reached the final analysis of the study. The total effective rate for the treatment group was 71.7% （43/60）, higher than 46.7% （28/60） in the control group （P〈0.05）, and the improvement on SSA scores of the two groups were significantly different after treatment （P〈0.05）. For grade 1 dysphagia patients （completely depending on nasogastric tube）, the effective rate of the treatment group was 40.9% （9/22）, and 12.5% （2/16） of the control group, without significant difference （P〉0.05）, while the improvement of SSA score was significantly different between the two groups after treatment （P〈0.05）. For grade 2-3 dysphagia patients （oral and nasogastric tube feeding）, the total effective rate of the treatment group was 89.5% （34/38）, higher than 59.1% （26/44） in the control group （P〈0.05）, and also the improvement on SSA scores was significantly different between the two groups after treatment （P〈0.05）. Conclusion： Tongyan Spray was an effective and safe method for post-stroke dysphagia patients.展开更多
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 dy...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.展开更多
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...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.展开更多
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 wi...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.展开更多
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 pat...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.展开更多
基金supported by a grant from the Health Bureau of Hubei Province,China (No. JX5B36)
文摘To investigate the effects of VitalStim therapy coupled with conventional swallowing training on recovery of post-stroke dysphagia,a total of 120 patients with post-stroke dysphagia were randomly and evenly divided into three groups：conventional swallowing therapy group,VitalStim therapy group,and VitalStim therapy plus conventional swallowing therapy group.Prior to and after the treatment,signals of surface electromyography（sEMG） of swallowing muscles were detected,swallowing function was evaluated by using the Standardized Swallowing Assessment（SSA） and Videofluoroscopic Swallowing Study（VFSS） tests,and swallowing-related quality of life（SWAL-QOL） was evaluated using the SWAL-QOL questionnaire.There were significant differences in sEMG value,SSA,VFSS,and SWAL-QOL scores in each group between prior to and after treatment.After 4-week treatment,sEMG value,SSA,VFSS and SWAL-QOL scores were significantly greater in the VitalStim therapy plus conventional swallowing training group than in the conventional swallowing training group and VitalStim therapy group,but no significant difference existed between conventional swallowing therapy group and VitalStim therapy group.It was concluded that VitalStim therapy coupled with conventional swallowing training was conducive to recovery of post-stroke dysphagia.
文摘Objective: To explore nutritional support under the Neuman systems model in treating dysphagia in stroke patients. Methods: In this retrospective study, we enrolled 97 patients with dysphagia after stroke admitted to our hospital, and randomly divided them into the Neuman group (n = 51) given nursing intervention based on Neuman systems model and a control group (n = 46) given routine nursing intervention. Both groups received nutritional support for 3 months. Nutritional indexes (serum total protein, plasma albumin, serum albumin, hemoglobin and transferrin levels) and immune indexes (immunoglobulin (Ig) A, IgG, IgM and total lymphocyte count (TLC) in both groups were recorded and compared. Pulmonary function recovery, video fluoroscopic swallowing study score, water swallowing test score, complication rate, and health knowledge mastery level were also compared between the two groups. Results: After the intervention, the Neuman group showed less decrease in the nutritional and immune index scores (serum total protein, plasma albumin, hemoglobin, serum albumin;IgA, IgG, IgM, and TLC;all P Conclusion: For patients with stroke and dysphagia, comprehensive nursing intervention (e.g., nutritional support) under theNeuman systems model can promote the recovery of immune, swallowing, and pulmonary function, reduce complication incidence and facilitate comprehensive rehabilitation, ensuring adequate nutritional intake.
基金Supported by the Project of Beijing Traditional Chinese Medicine Scientific Program(No.JJ2007-010)
文摘Objective： To observe the effectiveness and safety of Tongyan Spray （通咽喷雾剂） composed of Chinese medicine for post-stroke dysphagia patients. Method： One hundred and twenty-two post-stroke dysphagia patients were randomly assigned to the treatment group （61 cases） and the control group （61 cases）. Basic treatment was given to both groups, with Tongyan Spray additionally used in oropharynx for the treatment group, and the placebo used for the control group. After 28-day treatment, the clinical effect and safety were evaluated according to the standard swallowing assessment （SSA） scale. Results： One patient dropped out in each group, and 120 patients reached the final analysis of the study. The total effective rate for the treatment group was 71.7% （43/60）, higher than 46.7% （28/60） in the control group （P〈0.05）, and the improvement on SSA scores of the two groups were significantly different after treatment （P〈0.05）. For grade 1 dysphagia patients （completely depending on nasogastric tube）, the effective rate of the treatment group was 40.9% （9/22）, and 12.5% （2/16） of the control group, without significant difference （P〉0.05）, while the improvement of SSA score was significantly different between the two groups after treatment （P〈0.05）. For grade 2-3 dysphagia patients （oral and nasogastric tube feeding）, the total effective rate of the treatment group was 89.5% （34/38）, higher than 59.1% （26/44） in the control group （P〈0.05）, and also the improvement on SSA scores was significantly different between the two groups after treatment （P〈0.05）. Conclusion： Tongyan Spray was an effective and safe method for post-stroke dysphagia patients.
基金Supported by the Gansu Province Health Department of China(No.GZK-2014-47)
文摘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.
基金Supported by the Science and Technology Department of Sichuan Province(No.2016SZ0039)the Sichuan Province Medical Association(No.S15063)
文摘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.
基金Supported by Youth Talent Program of Longyan Municipal Science and Technology Bureau:2017LY085
文摘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.
基金supported by a grant from the Construction of Traditional Chinese Medicine Prevention and Treatment of Apoplexy Comprehensive System,No.201007002
文摘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.
