ABSTRACT
Objective To observe the effect of acupuncture plus rehabilitation in treating deglutition disorders due to cerebral stroke and its effect on each link of the neural pathway of deglutition function. Method By adopting the prospective randomized controlled method, ninety-nine patients with deglutition disorders after cerebral stroke were recruited and divided into an acupuncture-rehabilitation group, a pharyngeal acupuncture group, and a control group, respectively 33 cases, 34 cases, and 32 cases in each group. The acupuncture-rehabilitation group was intervened by acupuncture respectively at scalp, pharyngeal, and the root of tongue plus basic treatment, the pharyngeal acupuncture group was by acupuncture at the deglutition point (Extra) plus basic treatment, while the control group was by the basic treatment alone, once a day, 4 weeks in total. The Functional Oral Intake Scale (FOIS) and Clinical Nursing Swallowing Assessment Tool (CNSAT) were evaluated and statistically analyzed before and after intervention. Result The component scores of CNSAT were significantly improved after intervention in the acupuncture-rehabilitation group (P<0.01); the component scores of CNSAT were significantly changed after intervention in the pharyngeal acupuncture group (P<0.05);the CNSAT component scores in the acupuncture-rehabilitation group were significantly different from that in the pharyngeal acupuncture group and control group after intervention (P<0.01); the CNSAT component scores in the pharyngeal acupuncture group were significantly different from that in the control group after intervention (P<0.05). The FOIS scores were enhanced in the three groups after treatment; the FOIS score was significantly changed in the acupuncture-rehabilitation group after intervention (P<0.01);the FOIS score was markedly changed in the pharyngeal acupuncture group after intervention (P<0.05);the FOIS scores in the acupuncture-rehabilitation group and pharyngeal acupuncture group were both significantly higher than that in the control group (P<0.01,P<0.05). Conclusion The scalp-pharyngeal-root of tongue sequential-acupuncture plus rehabilitation can effectively mitigate the deglutition problems after cerebral stroke, improve the food-intake ability of the patients, and reduce the risk of mistake inhalation.
ABSTRACT
<p><b>OBJECTIVE</b>To explore the efficacy of local acupuncture therapy on post-stroke pseudo-bulbar palsy and the clinical advantageous protocol of local acupuncture therapy.</p><p><b>METHODS</b>Eighty patients of post-stroke pseudo-bulbar palsy were randomized into a quick needle insertion group and a routine acupuncture group, 40 cases in each one. The western medicine, such as thrombolysis, lipid regulation, antiplatelet aggregation, antihypertension and hypoglycemic therapy method was all used in the two groups. On the basis of the treatment of western medicine, in the quick needle insertion group, the perpendicular needle insertion was used atpoint, about 8 to 12 mm in depth. When the emptiness feeling presented under the needle, the needle went slowly for 2 mm more depth till cough occurred, and removed afterward. The treatment was given once every day, and totally 20 treatments were required. In the routine acupuncture group, Lianquan (CV 23) was stimulated. The needle was inserted toward the tongue root, about 40 mm in depth. The needle was rotated till the patient felt soreness and distention at the tongue root, and then retained for 30 min. The treatment was given once a day, and totally 20 treatments were required. The water swallow test score and clinical efficacy were evaluated before and after treatment.</p><p><b>RESULTS</b>The curative rate was 80.0% (32/40) in the quick needle insertion group, better than 55.0% (22/40) in the routine acupuncture group (<0.05). The total effective rate was 97.5% (39/40) in the quick needle insertion group and was 90.0% (36/40) in the routine acupuncture group, indicating no significant difference in comparison (>0.05). The water swallow test scores decreased after treatment as compared with those before treatment in the two groups (both<0.01), and the water swallow test scores after treatment of the two groups had no significant difference (>0.05).</p><p><b>CONCLUSIONS</b>Acupuncture at local point is effective for post-stroke pseudo-bulbar palsy.The curative rate of quick needle insertion atpoint is better than routine acupuncture at Lianquan (CV 23).</p>
ABSTRACT
Objective To explore the effect of acupuncture at Yanglingquan (GB 34) on white matter structure of stroke patients. Meth-ods 6 stroke patients with left hemiplegia in recovery stage were recruited. The sham acupoint was as control, the diffusion tensor imaging (DTI) data in a 1.5 T SIEMENS scanner before and after acupuncture at Yanglingquan point was collected. Differences between the two con-ditions were compared with the Tract-Based Spatial Statistics (TBSS), which is one of FSL tools. Results The brain areas included left pre-central gyrus, postcentral gyrus, middle temporal gyrus, inferior temporal gyrus, supplementary motor area, inferior frontal gyrus, internal capsule, fornix and bilateral inferior parietal gyrus, in which the verum acupuncture had stronger effect on fractional anisotropy (FA) than the sham acupuncture. White matter tract such as pyramidal tract, arcuate fasciculus, corpus callosum and other inter-cortex association fi-bers passed these brain areas. The fiber tracts and brain areas were found to be involved with multiple brain networks of motor compensa-tion, somatosensory, language and cognition. Conclusion Compared with the sham point, acupuncture at Yanglingquan point can change the microstructure of stroke patients' white matter, mainly in the inaffected side and related to multiple functional networks.