[Post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation: a randomized controlled trial].

Xue Cao, Hong-Juan Zhang, Gang Xu, Xing-Xing Ma, Xiu-Ling Pu, Wen-Juan Ma, Di Zhang, Zhao-di Tian, Wei-Hua Zhang
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Abstract

Objective: To observe the clinical efficacy on post-stroke dysphagia treated with four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation.

Methods: Sixty patients with post-stroke dysphagia were randomly divided into an observation group and a control group, with 30 cases in each group. The neuromuscular electrical stimulation was adopted in the control group. Besides the treatment as the control group, in the observation group, the four-step acupuncture therapy for opening orifices and benefiting throat was supplemented. Step 1: the three areas of scalp acupuncture on the affected side were stimulated. Step 2: pricking method was operated on the posterior pharyngeal wall. Step 3: bleeding technique was operated at Jinjin (EX-HN 12) and Yuye (EX-HN 13). Step 4: deep insertion of needle was operated at three-pharynx points. The needles were retained for 30 min at the three areas of scalp acupuncture and the three-pharynx points. The intervention of each group was delivered once daily, 6 times a week, at the interval of 1 day. One course of treatment was 1 week and 4 successive courses were required. The rating of Kubota water swallow test, the score of standardized swallowing assessment (SSA) and the rating of Rosenbek penetration- aspiration scale (PAS) were observed before and after treatment in patients of the two groups. The incidence of clinical complications and clinical efficacy were compared between the two groups.

Results: Compared with those before treatment, the rating of Kubota water swallow test, the scores of SSA and the rating of PAS of patients in the two groups were decreased after treatment (P<0.01), and the values of the observation group were lower than those of the control group after treatment (P<0.05). The incidence of clinical complications in the observation group was 13.3% (4/30), lower than 36.7% (11/30) in the control group (P<0.05). The total effective rate in the observation group was 93.3% (28/30), which was better than 70.0% (21/30) in the control group (P<0.05).

Conclusion: The four-step acupuncture therapy for opening orifices and benefiting throat combined with neuromuscular electrical stimulation can improve the swallowing function of patients with post-stroke dysphagia and reduce the incidence of clinical complications.

[四步针刺开孔益喉联合神经肌肉电刺激治疗卒中后吞咽困难:一项随机对照试验]。
目的:观察针刺开孔益喉四步法联合神经肌肉电刺激治疗脑卒中后吞咽困难的临床疗效。方法:将60例脑卒中后吞咽困难患者随机分为观察组和对照组,每组各30例。对照组采用神经肌肉电刺激。观察组在对照组治疗的基础上,辅以开窍益喉四步针刺疗法。步骤一:刺激患侧头皮针刺的三个区域。第二步:咽后壁穿刺法。第三步:在金津穴(ex - hn12)和郁液穴(ex - hn13)处行出血术。第四步:在三咽穴处深插针。在头皮针刺的三个区域和三个咽穴上留针30分钟。各组干预措施每日1次,每周6次,间隔1天。1个疗程为1周,连续4个疗程。观察两组患者治疗前后Kubota水吞试验评分、标准化吞咽评定(SSA)评分和Rosenbek渗透-误吸量表(PAS)评分。比较两组患者的临床并发症发生率及临床疗效。结果:与治疗前比较,两组患者治疗后久保田水吞试验评分、SSA评分、PAS评分均下降(ppppp)。结论:开孔利喉四步针刺疗法联合神经肌肉电刺激可改善脑卒中后吞咽困难患者的吞咽功能,减少临床并发症的发生。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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