Clinical study of scalp acupuncture combined with repeated transcranial magnetic stimulation in the treatment of dysphagia after ischemic stroke
10.3760/cma.j.cn115398-20220707-00086
- VernacularTitle:头颅针法联合重复经颅磁刺激治疗缺血性卒中后吞咽障碍的临床研究
- Author:
Shuang LIU
1
;
Jinsong CHEN
;
Jiajie XIE
;
Sijie ZHANG
;
Jihong WEI
Author Information
1. 电子科技大学医学院附属绵阳医院 绵阳市中心医院康复医学科，绵阳 621000
- Keywords:
Ischemic stroke;
Deglutition disorders;
Sequela of apoplexy;
Scalp acupuncture;
Diffusion tensor imaging
- From:
International Journal of Traditional Chinese Medicine
2023;45(2):148-153
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the effect of scalp acupuncture combined with repeated transcranial magnetic stimulation (rTMS) on dysphagia after ischemic stroke.Methods:Prospective cohort study. A total of 94 patients with dysphagia after ischemic stroke in our hospital who met the inclusion criteria from December 2020 to February 2022 were randomly divided into two groups with 47 patients in each group. The control group was treated with rTMS and conventional acupuncture, while the scalp acupuncture group was treated with rTMS and scalp acupuncture (scalp acupuncture+seven points at the skull base). Both groups were treated for 4 weeks. Before and after treatment, Traditional Chinese Medicine (TCM) symptoms were scored, and the morphology, movement and food swallowing process of the patient's swallowing anatomy were observed with fiber optic endoscopy (FEES), and assessed by the leakage aspiration scale (PAS). The Yilang Fujishima swallowing efficacy evaluation and standard swallowing assessment (SSA) were used to evaluate swallowing function. The dysphagia quality of life scale (SWAL-QOL) were used to evaluate patients' quality of life. Magnetic resonance diffusion tensor imaging (DTI) scanning was performed to observe the anisotropy fraction (FA value) of the selected region of interest (ROI).Results:During the treatment period, each group dropped off 1 patient, and 92 patients entered the statistics. After treatment, the scores of salivation, food retention, eating and drinking cough in the scalp acupuncture group were significantly lower than those in the control group ( t values were 6.87, 4.90, 5.01, respectively, P<0.01), and the PAS grading was significantly better than that in the control group ( χ2=7.80, P=0.025), the swallowing efficacy evaluation and SWAL-QOL score of Yilang Fujishima were significantly higher than those of the control group ( t=6.81, 5.98, P<0.01), and the SSA score was significantly lower than that of the control group ( t=5.68, P<0.01). The FA values of parieto occipital cortex (0.47 ± 0.06 vs. 0.42 ± 0.04, t=3.16), insular cortex (0.44 ± 0.07 vs. 0.40 ± 0.05, t=3.00) and posterior limb of internal capsule (0.58 ± 0.04 vs. 0.54 ± 0.05, t=2.80) of ROI in the head acupuncture group after treatment were significantly higher than those in the control group ( P<0.05). Conclusion:The scalp acupuncture combined with rTMS can improve the swallowing function of patients with dysphagia after ischemic stroke and improve their quality of life.
