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

BACKGROUND: Dysphagia is a common complication in stroke patients. This study aimed to investigate the effects of the tongue-holding maneuver over an 8-week period on the swallowing function in stroke patients. METHODS: Twenty-eight stroke patients with dysphagia diagnosed within 1 year were randomly allocated to the experimental or control groups. The experimental (n=15) and control groups (n=13) performed the tongue-holding and Mendelsohn maneuver, respectively. And both groups additionally participated in traditional dysphagia therapy. The maneuvers were conducted for thirty minutes a day, five days a week, for six weeks, totaling forty sessions. Swallowing function with the functional dysphagia scale and swallowing pain with the visual analogue scale between the 2 groups were tested by chi-square tests, Mann-whitney testes, and Wilcoxon signed rank tests. RESULTS: The general characteristics, including age, sex, and disease history, between the two groups did not differ. After 8 weeks of intervention, swallowing function at the oral phase and the pharyngeal phase and the total score was significantly improved in both experimental and control groups. Also, swallowing pain decreased significantly in both groups. However, the change to swallowing function and pain between the groups were not different. CONCLUSIONS: The tongue-holding maneuver practiced over an eight-week period improved the swallowing function in stroke patients.
Deglutition Disorders ; Deglutition* ; Humans ; Occupational Therapy ; Stroke* ; Testis

OBJECTIVE: To determine the cutoff value of the pharyngeal residue for predicting reduction of aspiration, by measuring the residue of valleculae and pyriformis sinuses through videofluoroscopic swallowing studies (VFSS) after treatment with neuromuscular electrical stimulator (VitalStim) in stroke patients with dysphagia. METHODS: VFSS was conducted on first-time stroke patients before and after the VitalStim therapy. The results were analyzed for comparison of the pharyngeal residue in the improved group and the non-improved group. RESULTS: A total of 59 patients concluded the test, in which 42 patients improved well enough to change the dietary methods while 17 did not improve sufficiently. Remnant area to total area (R/T) ratios of the valleculae before treatment in the improved group were 0.120, 0.177, and 0.101 for solid, soft, and liquid foods, respectively, whereas the ratios for the non-improved group were 0.365, 0.396, and 0.281, respectively. The ratios of the pyriformis sinuses were 0.126, 0.159, and 0.121 for the improved group and 0.315, 0.338, and 0.244 for the non-improved group. The R/T ratios of valleculae and pyriformis sinus were significantly lower in the improved group than the non-improved group in all food types before treatment. The R/T ratio cutoff values were 0.267, 0.250, and 0.185 at valleculae and 0.228, 0.218, and 0.185 at pyriformis sinuses. CONCLUSION: In dysphagia after stroke, less pharyngeal residue before treatment serves as a factor for predicting greater improvement after VitalStim treatment.
Deglutition ; Deglutition Disorders* ; Electric Stimulation Therapy* ; Humans ; Prognosis* ; Stroke*

OBJECTIVETo assess the therapeutic effect and potential adverse effect of acupuncture in treatment of dysphagia after stroke.

METHODSA systematic review including all the relevant randomized controlled trials (RCTs) or quasi-RCTs of acupuncture and moxibustion for treatment of dysphagia after stroke were performed using the method recommended by the cochrane collaboration.

RESULTSSeven papers including 506 cases met the enrolled criteria. All of the trials were of lower methodological quality. Meta-analysis of enrolled 6 trials showed that the acupuncture group had a better therapeutic effect on dysphagia after stroke than the control group (RR 1.17, 95% CI 1.08, 1.27, Z=3.78, P=0.0002). The mortality and the occurrence of pneumonia were similar between acupuncture and control groups (RR 0.25, 95% CI 0.03, 2.18 and RR 3.02, 95% CI 0.093, 23.10, respectively). The treatment group significantly reduced in time of the thick barium through pharynx examined by videofluorography (WMD -7.23, 95% CI -13.18,-1.28).

CONCLUSIONA reliable conclusion can not be drawn from the present data because of the defects in methodological quality, especially no long-term terminal outcome events, although it appears a tendency that acupuncture can improve dysphagia after stroke in short-term with no adverse effect. Therefore, it is necessary to perform more multi central randomized controlled trials in good internal validity and high quality in future.

OBJECTIVE: To observe the effects of acupuncture on swallowing function and quality of life for patients with dysphagia in Parkinson's disease (PD). METHODS: A total of 60 patients of PD with dysphagia were randomly divided into an observation group (30 cases, 2 cases dropped off) and a control group (30 cases, 3 cases dropped off). The control group was given conventional medication therapy and rehabilitation training. On the basis of the treatment as the control group, the observation group was given acupuncture at Fengfu (GV 16), Baihui (GV 20), Shenting (GV 24), Yintang (GV 24⁺), Yansanzhen and bilateral Fengchi (GB 20), 30 min each time, once a day, 6 times a week for 4 weeks. Before and after treatment, the Kubota water swallowing test, standardized swallowing assessment (SSA) and swallowing quality of life (SWAL-QOL) were used to evaluate the swallowing function and quality of life of the two groups. RESULTS: After treatment, the Kubota water swallowing test grade, SSA scores in the two groups were decreased compared with those before treatment (P<0.05, P<0.001)，the SWAL-QOL scores were increased compared with those before treatment (P<0.001); in the observation group，the Kubota water swallowing test grade and SSA score were lower than those in the control group (P<0.05)，the SWAL-QOL score was higher than that in the control group (P<0.001). CONCLUSION On the basis of conventional medication therapy and rehabilitation training，acupuncture could improve the swallowing function and quality of life for patients of PD with dysphagia.
Humans ; Deglutition Disorders/therapy* ; Deglutition ; Quality of Life ; Parkinson Disease/therapy* ; Acupuncture Therapy ; Water

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

The paper summarizes professor LIN Guo-hua's clinical experience in staging treatment for post-stroke dysphagia. Professor LIN Guo-hua adheres to "essence and marrow deficiency and primary yang decline" as the pathogenesis and "conducting yin from yang " as the treating principle. By regulating the conception vessel and the governor vessel and focusing on yang meridians, in association with meridian differentiation and the location differentiation, professor LIN provides the staging treatment for post-stroke dysphagia. At the oral phase, yangming is dysfunction, manifested as facial paralysis and flaccid tongue. In treatment, reducing method is predominated at yangming meridian specially. At the pharyngeal phase, shaoyang is invaded by pathogens, manifested as pivoting dysfunction. The treatment focuses on communicating the exterior with the interior and promoting shaoyang meridian. At the esophageal phase, yangming meridian is deficiency and the turbid qi fails to descend, thus the reinforcing method is dominated to promote and tonify yangming. Additionally, the kinesiotherapy of acupuncture is assisted and the Lingnan fire needling therapy is used particularly. All of the summaries above provide the reference for the clinical treatment of post-stroke dysphagia.
Acupuncture ; Acupuncture Points ; Acupuncture Therapy ; Deglutition Disorders/therapy* ; Humans ; Meridians

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

OBJECTIVE: To observe the clinical efficacy of acupoint injection combined with Vitalstim electrical stimulation for post-stroke dysphagia. METHODS: A total of 98 patients with dysphagia after first stroke were randomized into an acupoint injection group (35 cases, 2 cases dropped off), an electrical stimulation group (31 cases, 3 cases dropped off) and a combination group (32 cases, 3 cases dropped off). Injection of mecobalamin into Tunyan point, Vitalstim electrical stimulation and the combination of injection of mecobalamin into Tunyan point and Vitalstim electrical stimulation were applied respectively in the 3 groups, once a day, 10 times as one course, 2 courses were required. Before and after treatment, the tongue muscle thickness and video fluoroscopic swallowing study (VFSS) score were observed in the 3 groups. RESULTS: After treatment, the tongue muscle thickness was decreased (P<0.05), the VFSS scores were increased (P<0.05) compared with before treatment in the 3 groups, and the variation of tongue muscle thickness and VFSS score in the combination group was greater than the acupoint injection group and the electrical stimulation group (P<0.05). CONCLUSION Both acupoint injection of mecobalamin and Vitalstim electrical stimulation have therapeutic effect on dysphagia after stroke, and the two have synergistic effect.
Acupuncture Points ; Acupuncture Therapy ; Deglutition ; Deglutition Disorders/therapy* ; Electric Stimulation ; Humans ; Treatment Outcome

OBJECTIVE: To observe the effect of nape cluster acupuncture on swallowing function and respiratory function in patients with post-stroke dysphagia, and to explore its relationship to cerebral arterial flow and neurotrophic factors. METHODS: A total of 120 patients with post-stroke dysphagia were randomized into an observation group and a control group, 60 patients in each one. The conventional swallowing rehabilitation therapy and respiratory function training were adopted in the control group. On the basis of treatment in the control group, nape cluster acupuncture was applied at Fengchi (GB 20), Tianzhu (BL 10), Wangu (GB 12), Lianquan (CV 23), Panglianquan (Extra), once a day; pricking blood was applied at Jinjin (EX-HN 12) and Yuye (EX-HN 13), once every 2 days. Both groups were treated for 2 weeks. The therapeutic efficacy was compared between the two groups, and the swallowing function (scores of Kubota water swallowing test, standardized swallowing assessment [SSA] and video fluoroscopic swallowing study [VFSS]), the respiratory function indexes (forced vital capacity [FVC], maximal voluntary ventilation [MVV] and maximal expiratory time), the bilateral cerebral arterial hemodynamics parameters (systolic peak velocity [Vs], mean flow velocity [Vm] and vascular resistance index [RI]) and the serology indexes (brain-derived neurotrophic factor [BDNF], nerve growth factor [NGF] and insulin-like growth factors-1 [IGF-1]) before and after treatment were observed in the both groups. RESULTS: The total effective rate was 80.0% (48/60) in the observation group, which was superior to 60.0% (36/60) in the control group ( CONCLUSION On the basis of the conventional rehabilitation training, nape cluster acupuncture can effectively improve the swallowing function and respiratory function in patients with post-stroke dysphagia, its mechanism may be related to the improvement of cerebral hemodynamics and the regulation of neurotrophic factors.
Acupuncture Points ; Acupuncture Therapy ; Deglutition ; Deglutition Disorders/therapy* ; Humans ; Treatment Outcome