Professor 's experience for post-stroke dysphagia treated with penetrating-needling and swallowing technique of acupuncture is summarized in this paper. The key pathogenesis of this disease is dysfunction of organs, impairment of the house of mental activity and dysfunction of meridian sinew. Innovatively, the anatomic structure related to swallowing is divided into three zones. Based on the distributions of heart, kidney and stomach meridians on the neck, three lines are determined. Hence, the theory of "three-zone and three-line" as well as the penetrating-needling and swallowing technique of acupuncture are put forward. In this paper, the theoretic evidences of penetrating-needling and swallowing technique of acupuncture, point selection and manipulation in treatment of post-stroke dysphagia are introduced.
Acupuncture Therapy ; Deglutition ; Deglutition Disorders ; therapy ; Humans ; Stroke ; complications

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

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

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

OBJECTIVE: To observe the effect of lateral needling at Lianquan (CV 23) for post-stroke dysphagia, and explore its mechanism. METHODS: A total of 64 patients with post-stroke dysphagia were randomly divided into an observation group and a control group, 32 cases in each group. Both groups were treated with conventional basic treatment. The observation group was treated with lateral needling at CV 23, without needle retaining, once a day. The control group was treated with swallowing rehabilitation training, once a day. Both groups were treated for 5 days a week, with 2 days interval, 1 week as one course and 4 courses were required. Before and after treatment, the Kubota water swallowing test grade and standardized swallowing assessment (SSA) score were compared in the two groups. Before and after treatment, the video fluoroscopic swallowing study (VFSS) was used to measure the hyoid bone movement displacement and pharyngeal delivery time in the observation group. RESULTS: Compared before treatment, the Kubota water swallowing test grade after treatment was improved in the two groups (P<0.05), and the observation group was superior to the control group (P<0.05); the SSA scores after treatment were decreased in the two groups (P<0.05), and the observation group was lower than the control group (P<0.05). Compared before treatment, the hyoid bone movement displacement was increased and pharyngeal delivery time was shortened after treatment in the observation group (P<0.05). CONCLUSION Lateral needling at CV 23 could improve dysphagia symptoms in patients with post-stroke dysphagia, its mechanism may be related to the increasing of hyoid bone movement displacement and shortening of pharyngeal delivery time.
Deglutition ; Deglutition Disorders/therapy* ; Humans ; Stroke/complications* ; Vascular Surgical Procedures ; Water

OBJECTIVE: To observe the effect of acupuncture combined with regular treatment and swallowing function training on pharyngeal motor, sensory function and penetration-aspiration function in patients with dysphagia after stroke. METHODS: A total of 60 patients with dysphagia after stroke were randomly divided into a control group and an observation group, 30 patients in each group. Both groups were treated with conventional treatment and swallowing function training; in addition, the observation group was treated with acupuncture at Lianquan (CV 23), Fengfu (GV 16), Yifeng (TE 17). All the treatments were given once a day, 5 days a week, for totally 4 weeks. In the two groups, the pharyngeal motor and sensory function, penetration-aspiration scores were evaluated by fiberoptic endoscopic evaluation of swallowing (FEES), and the Kubota water swallowing test scores were assessed before and after treatment, and the clinical effects were compared. RESULTS: After treatment, the pharyngeal motor and sensory function in the two groups were all higher than those before treatment (P<0.05), and those in the observation group were better than the control group (P<0.05). After treatment, the penetration-aspiration scores and Kubota water swallowing test scores in the two groups were all lower than those before treatment (P<0.05), and those in the observation group were lower than the control group (P<0.05). The total effective rate was 93.3% (28/30) in the observation group, which was better than 73.3% (22/30) in the control group (P<0.05). CONCLUSION Acupuncture combined with regular treatment and swallowing training could improve the pharyngeal motor and sensory function, and penetration-aspiration scores in patients with dysphagia after stroke.
Acupuncture Points ; Acupuncture Therapy ; Deglutition ; Deglutition Disorders/therapy* ; Humans ; Stroke/complications* ; Treatment Outcome ; Water

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

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

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

BACKGROUND AND OBJECTIVES: Some use age 70 as a cut-off point for supraglottic laryngectomy because of postoperative aspiration and deglutition complications. But the relationship between age and postoperative aspiration and deglutition complications has not been adequately reported. Therefore, we reviewed postoperative aspiration and deglutition complications of supraglottic laryngectomy in patients older than 70 years old and investigated whether age was one of the factors influencing functional outcome in supraglottic laryngectomy. Patients and Method: From 1994 to 2001, the decannulation day and the postoperative day when oral feeding was started were retrospectively investigated on seven patients who underwent supraglottic partial laryngectomies among early (T1, T2) supraglottic squamous cell carcinoma patients elder than 70 years old. RESULTS: There were no cases requiring either a persistent tube feeding and a gastrostomy. Decannulation could be performed in all cases. The average decannulation day was postoperative 20.6 days and the average oral feeding day was 16.3 days. There were no postoperative complications such as aspiration, fistula and dysphagia. There were no differences according to age. CONCLUSION: No differences were found regarding age in the functional outcomes of supraglottic laryngectomy. So, one's chronological age does not necessarily reflect his or her physiological age and therefore cannot be a contraindication of supraglottic laryngectomy.
Aged* ; Carcinoma, Squamous Cell ; Deglutition ; Deglutition Disorders ; Enteral Nutrition ; Fistula ; Gastrostomy ; Humans ; Laryngectomy* ; Postoperative Complications ; Retrospective Studies