Effect of "Tongdu Tiaoshen" needling combined with swallowing training on dysphagia, cerebral blood flow and serum BDNF and NGF levels in ischemic stroke patients / 针刺研究

OBJECTIVE: To observe the efficacy of Tongdu Tiaoshen (dredging Governor Vessel and regulating mind) needling combined with swallowing training in the treatment of ischemic stroke (IS) with dysphagia, and to investigate its effect on cerebral blood flow and serum levels of brain-derived neurotrophic factor (BDNF) and nerve growth factor (NGF). METHODS: A total of 100 IS inpatients with dysphagia were enrolled in the present study, and randomly and equally divided into control group and treatment group by using a random number table. The patients of the control group received routine swallowing training including tongue extending and retracting, cheek-muscle training, breathing exercise, and laryngopharyngeal exercise, beginning from the 2nd day after hospitalization. The patients of the treatment group received manual acupuncture stimulation of Dazhui (GV14), Fengfu (GV16), Shenting (GV24), Shendao (GV11), Baihui (GV20), Shuigou (GV26), etc., on the basic treatment as those mentioned in the control group. The treatment was conducted once daily, 5 times per week and for 4 successive weeks. The swallowing ability was tested by using video fluoroscopic swallowing study (VFSS), Kubota water swallowing test, and the standard swallowing function assessment (SSA) scale, separately, and patients' daily life quality was assessed by using swallowing related quality of life questionnaire (SWAL-QOL). The cerebral hemodynamics including mean blood flow velocity (Vm), maximum peak flow speed (Vs), and vascular resistance index (RI) of the bilateral cerebral arteries was detected by transcranial color Doppler ultrasound tests, and serum BDNF and NGF contents were assayed by enzyme linked immunosorbent assay. The therapeutic effect of swallowing ability was evaluated after the treatment. RESULTS: After 4 weeks' treatment, the scores of Kubata water swallowing test, SSA, and SWAL-QOL and RI were considerably decreased (P<0.01), and the VFSS scores, Vs and Vm levels as well as serum BDNF and NGF contents were significantly increased (P<0.01) in both groups compared with their own pre-treatment. Of the 48 and 49 cases in the control and treatment groups, 4 (8.33%) and 8(16.33%) were cured, 26 (54.17%) and 33 (67.35%) effective, 18 (37.50%) and 8 (16.33%) failed, with the effective rate being 62.50% and 83.67%, respectively. The therapeutic effect of the treatment group was significantly superior to that of the control group in the effective rate (P<0.05), and in lowering the scores of Kubota water swallowing test, SWAL-QOL, SSA, RI, and in up-regulating the scores of VFSS, Vs and Vm, and serum BDNF and NGF levels (P<0.01). CONCLUSION: Tongdu Tiaoshen needling combined with swallowing training is effective in improving swallowing ability, promoting cerebral blood flow and in up-regulating serum neurotrophic factor levels in patients with dysphagia after ischemic stroke.

Short-term and long-term efficacy of PGLA thread-embedding therapy in treatment of stage Ⅰ post-stroke shoulder-hand syndrome / 针刺研究

OBJECTIVE: To investigate short-term and long-term efficacy of PGLA thread-embedding therapy in the treatment of stage Ⅰ post-stroke shoulder-hand syndrome. METHODS: A total of 60 patients with stage Ⅰ post-stroke shoulder-hand syndrome were randomly divided into control group and treatment group, with 30 patients in each group. The patients in the control group were given acupuncture combined with rehabilitation training, and those in the treatment group were given PGLA thread-embedding therapy combined with rehabilitation training. Conventional acupuncture was performed once a day, and thread-embedding therapy was performed once every 5 days. Both groups were treated for 30 days. Clinical outcome, Visual Analogue Scale (VAS) score, hand edema score, and Fugl-Meyer Assessment (FMA) score were compared within and between groups immediately and at 1 month after treatment. RESULTS: The treatment group had a significantly higher overall response rate than the control group immediately and at 1 month after treatment (93.33%/86.67% vs 73.33%/56.67%, P<0.05). Both groups had significant reductions in VAS score and hand edema score and a significant increase in FMA score immediately and at 1 month after treatment (P<0.05), and the treatment group had significantly greater improvements than the control group (P<0.05). CONCLUSION: PGLA thread-embedding therapy has a better clinical effect than conventional acupuncture in the treatment of stage Ⅰ post-stroke shoulder-hand syndrome.

Analysis on the adverse events of cupping therapy in the application / 中国针灸

The deep analysis has been done on the cases of adverse events and common injury of cupping therapy encountered in recent years in terms of manipulation and patient's constitution. The adverse events of cupping therapy are commonly caused by improper manipulation of medical practitioners, ignoring contraindication and patient's constitution. Clinical practitioners should use cupping therapy cautiously, follow strictly the rules of standard manipulation and medical core system, pay attention to the contraindication and take strict precautions against the occurrence of adverse events.