Deglutition Disorders ; diagnosis ; etiology ; Humans ; Inhalation

Deglutition Disorders ; etiology ; Humans ; Male ; Middle Aged ; Respiration Disorders ; etiology ; Speech Disorders ; etiology ; Thyroglossal Cyst ; complications

Cerebral Palsy/complications* ; Child ; Deglutition Disorders/etiology* ; Humans

Acupuncture Therapy ; Deglutition Disorders ; etiology ; therapy ; Humans ; Stroke ; complications

Aged ; Deglutition Disorders ; etiology ; Humans ; Male ; Zenker Diverticulum ; complications ; pathology

Cervical Vertebrae ; Deglutition Disorders ; diagnosis ; etiology ; Female ; Humans ; Middle Aged ; Spinal Osteophytosis ; complications ; etiology

OBJECTIVETo explore the therapeutic effect of dysphagia after stroke treated with different depth of Chonggu (EX-HN 27) by electroacupuncture.

METHODSTwo hundreds and eighty-three cases of dysphagia after stroke were randomly divided into Chonggu (EX-HN 27) deep insertion group (99 cases), Chonggu (EX-HN 27) shallow insertion group (94 cases) and traditional acupuncture group (90 cases) based on multi-central randomized control and blinding methods. Besides routine therapy, Chonggu (EX-HN 27) and Lianquan (CV 23) were selected in the Chonggu (EX-HN 27) deep insertion group and the Chonggu (EX-HN 27) shallow insertion group; the needles were inserted for 60-75 mm and 30 mm respectively and the electroacupuncture was applied in both groups; in traditional acupuncture group, Fengchi (GB 20), Yifeng (TE 17), Wangu (GB 12) and Lianquan (CV 23), etc. were selected. The needles were retained for 30 min, twice a day and 30 treatments totally in 3 groups. The clinical therapeutic effects were evaluated by Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke.

RESULTSThe total effective rate was 97.0% (96/99) in the Chonggu (EX-HN 27) deep insertion group, superior to that of 64.9% (61/94) in Chonggu (EX-HN 27) shallow insertion group and 70.0% (63/90) in traditional acupuncture group (both P < 0.05). Compared with the scores before and after treatment, significant differences were presented statistically in score reduction of TCM Scale in Chonggu (EX-HN 27) shallow insertion group (P < 0.01); the scores of Kubota's Water Drinking Test Scale, Standard Swallowing Function Scale and TCM Scale of Dysphagia After Stroke were obviously reduced in Chonggu (EX-HN 27) deep insertion group and traditional acupuncture group (all P < 0.01); compared with the scores between groups after treatment, the reduction of scores in Chonggu (EX-HN 27) deep insertion group was superior to those in Chonggu (EX-HN 27) shallow insertion group and traditional acupuncture group ( P < 0.05, P < 0.01) respectively.

CONCLUSIONPuncture at Chonggu (EX-HN 27) can improve the dysfunction of swallowing after stroke; it is safe and effective, and the needle should be inserted deeply.

Acupuncture Points ; Adult ; Aged ; Deglutition ; Deglutition Disorders ; etiology ; physiopathology ; therapy ; Electroacupuncture ; Female ; Humans ; Male ; Middle Aged ; Stroke ; classification

OBJECTIVE: To observe the effect on swallowing function in patients with post-stroke dysphagia treated with nape cluster acupuncture and the immediate effect of acupuncture at Fengchi (GB 20). METHODS: A total of 60 patients with post-stroke dysphagia were randomized into an observation group and a control group, 30 cases in each one.On the basis of conventional western medication treatment, swallowing function training was applied in the control group, once a day.On the base of the treatment as the control group, nape cluster acupuncture was applied at Fengchi (GB 20), Tianzhu (BL 10), Wangu (GB 12), Lianquan (CV 23), Panglianquan (Extra), Jinjin (EX-HN 12) and Yuye (EX-HN 13) in the observation group, once a day. Additionally, pricking blood was applied at Jinjin (EX-HN 12) and Yuye (EX-HN 13), 2 times a week. The treatment was given 30 min each time, a week as one course and 4 courses were required. Before and after treatment, the standardized swallowing assessment (SSA) score and video fluoroscopic swallowing study (VFSS) score were compared in the two groups. The ultrasonic diagnostic device of swallowing and surface electromyography were used to observe the immediate effect on swallowing related muscles of acupuncture at Fengchi (GB 20). RESULTS: Compared before treatment, the SSA scores were reduced after treatment in the two groups (<0.05), and the change of the observation group was larger than the control group (<0.05). Compared before treatment, the VFSS scores were increased after treatment in the two groups (<0.05), and the change of the observation group was larger than the control group (<0.05). Acupuncture at Fengchi (GB 20) immediately increased the amplitude of submental muscles and infrahyoid muscles in the observation group (<0.05), the geniohyoid muscle movement time was reduced and geniohyoid muscle displacement was increased (<0.05). CONCLUSION On the base of the routine treatment, nape cluster acupuncture could improve swallowing function in patients with post-stroke dysphagia. Acupuncture at Fengchi (GB 20) could immediately affect swallowing related muscles, improve muscle amplitude and reduce swallowing time.
Acupuncture Points ; Acupuncture Therapy ; Deglutition ; Deglutition Disorders ; etiology ; therapy ; Humans ; Stroke ; complications ; therapy ; Stroke Rehabilitation ; Treatment Outcome

OBJECTIVETo verify the clinical efficacy on post-stroke dysphagia treated with acupuncture at Lianquan (CV 23).

METHODSOne hundred and eighty patients were randomized into an acupuncture A group, an acupuncture B group and a rehabilitation group, 60 cases in each one. On the basis of the conventional medication, in the acupuncture A group, acupuncture was applied at Lianquan (CV 23); in the acupuncture B group, acupuncture was applied at Hegu (LI 4) and Neiguan (PC 6) and in the rehabilitation group, the swallowing rehabilitation training was adopted. The treatment was given once a day, 5 times a week, and the 4 weeks of treatment was required in all of the groups. The national institute of health stroke scale (NIHSS) and TV X-ray fluoroscope swallowing scale (VFSS) were used to evaluate neurologic deficit and swallowing function before and after treatment in the patients of each group. The morbidity of pneumonia and clinical efficacy were compared among the groups.

RESULTSThe scores of NIHSS and VFSS were improved apparently after treatment in the patients of the three groups (all P < 0.05) and the results in the acupuncture A group were superior to those in the other two groups (all P < 0.05). The morbidity of pneumonia in the acupuncture A group was lower than that in the acupuncture B group and the rehabilitation group [3.3% (2/60) vs 6.7% (4/60), 8.3% (5/60), both P < 0.05]. The effective rate in the acupuncture A group was better than that in either of the other two groups [95.0% (57/60) vs 81.7% (49/ 60), 75.0% (45/60), both P < 0.05].

CONCLUSIONOn the basis of the conventional medication, acupuncture at Lianquan (CV 23) effectively improves the swallowing function, relieves neurological deficit and reduces the morbidity of pneumonia in the patients of post-stroke dysphagia.

Acupuncture Therapy ; Aged ; Deglutition ; Deglutition Disorders ; etiology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged ; Quality of Life ; Stroke ; complications ; Treatment Outcome

OBJECTIVETo optimize primarily acupuncture program for dysphagia after cerebral infarction.

METHODSSixty-three patients with pseudobulbar palsy dysphasia after cerebral infarction were selected as the subjects. Water swallow test was adopted for observation index. Orthogonal design was used to study the different combinations of treatment programs among four factors and three levels, named acupuncture opportunity (factor A: A1: 1-10 d, A2: 11-20 d, A3: 21-40 d), point combination (factor B: B1: points in the neck, B2: points in the neck + points in the glossopharyngeal part, B3: points in the neck + points in the glossopharyngeal part + differentiating point), needling depth (factor C: C1: shallow puncture, C2: moderate puncture, C3: deep puncture), and treatment session (factor D: D1: 2 sessions, D2: 4 sessions, D3: 6 sessions); as well as the influences on pseudobulbar palsy dysphagia after cerebral infarction so as to determine primarily the optimized acupuncture program for dysphagia after cerebral infarction.

RESULTSThe direct analysis of orthogonal design indicated that the best level and the combination of four factors and three levels were A1 (or A2), B3, C3 and D3. It meant that for the patients less than 20 days for sickness, the points in the neck, points in the glossopharyngeal part and points selected according to syndrome differentiation were selected for deep puncture and the treatment lasted for 6 sessions. This program achieved the best improvement in water swallow test. The comparison between the primary effect and secondary effect among four factors (variance analysis) showed that factor A and C were the significant factors (P < 0.05), factor B and D were not significant (P > 0.05). It was suggested that acupuncture opportunity and needling depth played the significant roles in clinical efficacy. The comparison among different levels in terms of the significant factors A and C (multiple comparison) presented that A1 and A2 were superiorly significant than A3 (P < 0.001), A1 was not different in significance from A2 (P > 0.05). C3 was superiorly significant than C2 and C1 (P < 0.001, P < 0.01) and C2 was superiorly significant than C1 (P < 0.05).

CONCLUSIONBy the comprehensive summarization of direct analysis, variance analysis and multiple comparison combined with actual clinical situation, the optimal program of acupuncture treatment for pseudobulbar palsy dysphasia after cerebral infarction is that in terms of the four factors and three levels, for the patients within 1 to 20 days for sickness, acupuncture is applied to the points in the neck or combined with points in the glossopbaryngeal part or the points se-i lected according to syndrome differentiation, with deep puncture, for 4 to 6 sessions of treatment.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Cerebral Infarction ; complications ; Deglutition ; Deglutition Disorders ; etiology ; physiopathology ; therapy ; Female ; Humans ; Male ; Middle Aged