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.
Humans ; Pharynx ; Deglutition Disorders/therapy* ; Acupuncture Therapy ; Stroke/complications* ; Water ; Electric Stimulation

OBJECTIVE: To analyze the report status of outcomes and measurement instruments of randomized controlled trials (RCTs) of acupuncture for post-stroke dysphagia, so as to provide a basis for designing clinical trials and developing the core outcome set in acupuncture for post-stroke dysphagia. METHODS: RCTs of acupuncture for post-stroke dysphagia were searched in databases i.e. CNKI, SinoMed, Wanfang, PubMed, EMbase, Web of Science and clinical trial registries i.e. ClinicalTrials.gov and Chinese Clinical Trial Registry (ChiCTR), from January 1st, 2012 to October 30th, 2021. By literature screening and data extraction, outcomes and measurement instruments were summarized and analyzed. RESULTS: A total of 172 trials (including 165 RCTs and 7 ongoing trials registrations) were included, involving 91 outcomes. The outcomes could be classified into 7 domains according to functional attributes, namely clinical manifestation, physical and chemical examination, quality of life, TCM symptoms/syndromes, long-term prognosis, safety assessment and economic evaluation. It was found that there were various measurements instruments with large differences, inconsistent measurement time point and without discriminatively reporting primary or secondary outcomes. CONCLUSION The status quo of outcomes and measurement instruments of RCTs of acupuncture for post-stroke dysphagia is not conducive to the summary and comparison of each trial's results. Thus, it is suggested to develop a core outcome set for acupuncture for post-stroke dysphagia to improve the normative and research quality of their clinical trial design.
Humans ; Deglutition Disorders/therapy* ; Randomized Controlled Trials as Topic ; Acupuncture Therapy ; Databases, Factual ; Physical Examination ; Stroke/complications*

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

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

Objective To investigate the clinical characteristics and genetic mutations in Kindler syndrome(KS)and provide a theoretical basis for the diagnosis and treatment of KS. Methods The clinical data of one case of KS from Peking Union Medical College Hospital and 185 cases reported in literature were collected. The gene mutation types,patient clinical data,and tumor characteristics were statistically analyzed. Results A total of 186 cases were enrolled,including 110 males and 76 females,with the mean age of(28±16)years. The data of gene mutation and specific clinical manifestations were available in 151 and 94 patients,respectively. The main clinical manifestations of KS included poikiloderma,occurrence of blister in childhood,and photosensitivity,and the secondary clinical manifestations included oral inflammation,palmoplantar keratoderma,webbing/pseudoainhum,dysphagia,urethral stricture and so on.Oral inflammation(r=0.234,P=0.023),palmoplantar keratoderma(r=0.325,P=0.001),webbing/pseudoainhum(r=0.247,P=0.016),dysphagia(r=0.333,P=0.001),urethral stricture(r=0.280,P=0.006)were significantly correlated with age,showing significantly higher incidence in the patients over 32 years old.Urethral stricture(χ²=11.292,P=0.001)and anal stenosis(χ²=4.014,P=0.045)were significantly correlated with sex,with higher incidence in males.Eighty different mutations were found in 151 patients,and the most common gene mutation was c.676C>T.Forty-one tumors occurred in 27 patients,among which squamous cell carcinoma accounted for 92.7%. The gene mutation site had no significant correlation with squamous cell carcinoma or patient country. Conclusions The c.676C>T in FERMT1 gene is the most common mutation in KS.The patients are prone to squamous cell carcinoma and mainly attacked at the exposure sites(hand and mouth).
Adolescent ; Adult ; Ainhum ; Blister ; Carcinoma, Squamous Cell ; Child ; Constriction, Pathologic ; Deglutition Disorders/complications* ; Epidermolysis Bullosa ; Female ; Humans ; Inflammation ; Keratoderma, Palmoplantar/complications* ; Male ; Membrane Proteins ; Mutation ; Neoplasm Proteins/genetics* ; Periodontal Diseases ; Photosensitivity Disorders ; Urethral Stricture/complications* ; Young Adult

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 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

OBJECTIVE: To observe the effect of acupuncture combined with conventional symptomatic and supportive treatments on swallowing function and nutritional status in children with severe hand foot and mouth disease complicated with dysphagia. METHODS: A total of 68 children with severe hand foot and mouth disease complicated with dysphagia were randomized into an observation group and a control group, 34 cases in each one. Symptomatic and supportive treatments such as lowering temperature, tranquilizing and mechanical ventilation were adopted in the control group. On the basis of the treatments in the control group, acupuncture was applied at Lianquan (CV 23), Jialianquan (Extra), cervical Jiaji (EX-B 2), Fengfu (GV 16), Fengchi (GB 20), Yamen (GV 15), scalp motor and sensory areas in the observation group, once a day, 6 times a week, one month as a course and totally 3 courses were required. Time spent on restoring swallowing function was observed in both groups. Besides, score of dysphagia disorder survey (DDS) and nutritional status were evaluated before and after treatment, and the clinical effects were compared. RESULTS: The total effective rate was 91.2% (31/34) in the observation group, which was superior to 73.5% (25/34) in the control group (<0.05). The time of restoring swallowing function in the observation group was advanced than the control group (<0.05). Compared before treatment, the DDS scores after treatment were decreased in both groups, and the reduction in the observation group was larger than the control group (all <0.05). After the treatment, the normal rate of nutritional status was 61.8% (21/34) in the observation group, which was superior to 32.4% (11/34) in the control group (<0.05). CONCLUSION On the basis of conventional treatment, acupuncture can effectively treat the severe hand foot and mouth disease complicated with dysphagia, improve the swallowing function and nutritional status.
Acupuncture Points ; Acupuncture Therapy ; Child ; Deglutition Disorders ; etiology ; therapy ; Hand, Foot and Mouth Disease ; complications ; therapy ; Humans ; Treatment Outcome

OBJECTIVE: To observe the clinical effect of fire needling on dysphagia due to pseudobulbar paralysis after stroke and to compare the difference in clinical effect between fire needling and swallowing function rehabilitation training. METHODS: A total of 76 patients with dysphagia due to pseudobulbar paralysis after stroke were randomly divided into an observation group and a control group, 38 cases in each group (1 case dropped out in the control group). The both groups were based on conventional western medication treatment. Fire needle pricking was exerted at Lianquan (CV 23), Fengchi (GB 20), Wangu (GB 12), Shuigou (GV 26), Neiguan (PC 6) and Zusanli (ST 36) without needle retaining every other day in the observation group. The control group was treated with the swallowing function rehabilitation training. In both groups, treatment for 2 weeks was as one course and 2 courses of treatment with 2-day interval were required. After treatment, swallowing scores of Fujishima Ichiro and swallow quality of life questionnaire (SWAL-QOL) scores were observed in both groups, and the clinical effect was compared. Follow-up of swallowing scores of Fujishima Ichiro in 4 weeks after treatment was completed to evaluate the clinical effect. RESULTS: The clinical effective rates after treatment and follow-up were 92.1% (35/38) and 94.7% (36/38) in the observation group, higher than 75.7% (28/37) and 83.8% (31/37) in the control group (<0.05). After treatment, the swallowing scores of Fujishima Ichiro and SWAL-QOL scores were increased in the two groups (<0.05), and those in the observation group were higher than the control group (<0.05). The swallowing scores of Fujishima Ichiro were increased during follow-up in the two groups (<0.05). CONCLUSION Fire needling has a better effect than conventional rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke, which can obviously improve the swallowing function and quality of life in patients with dysphagia.
Acupuncture Points ; Acupuncture Therapy ; methods ; Deglutition Disorders ; etiology ; therapy ; Humans ; Pseudobulbar Palsy ; etiology ; therapy ; Quality of Life ; Stroke ; complications ; Treatment Outcome

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