ABSTRACT
Acupoint selection rules of neurogenic dysphagia treated with acupuncture and moxibustion from pre-Qin to late Qing Dynasty in were analyzed based on data mining. The literature regarding acupuncture and moxibustion for neurogenic dysphagia was searched and screened according to the inclusion and exclusion criteria in (5th Edition), the prescriptions were extracted according to the principle of acupoint extraction.The SPSS 21.0 and Clementine 12.0 were used to perform the cluster analysis and association rule analysis.A total of 191 acupuncture and moxibustion prescriptions were screened and extracted，including 45 acupoints. The top 5 acupoints of acupuncture and moxibustion for neurogenic dysphagia in frequency were Jiache (ST 6), Dicang (ST 4), Lieque (LU 7), Lianquan (CV 23), Shuigou (GV 26). The most involved meridians were the stomach meridian, the governor vessel and the conception vessel. The main acupoints were distributed in the scalp face neck and upper limbs. The most frequently used specific acupoints was crossing points,next was eight confluence points. There were 11 acupoint combinations with strong association according to the association rule analysis, and the top one acupoint combination was Hegu (LI 4)-Jiache (ST 6). There were 9 acupoint cluster groups according to the cluster analysis. Hegu (LI 4), Jiache (ST 6), Dicang (ST 4), Shuigou (GV 26) and Chengjiang (CV 24) were core acupoints for neurogenic dysphagia treated with acupuncture and moxibustion in ancient times, besides，selecting proximal and distal acupoints and selecting acupoints according to symptoms were emphasized.
ABSTRACT
Objective To explore the best treatment program for neurogenic dysphagia (ND) by observing the efficacy of three different rehabilitation programs.Methods Eighty-two dysphagic patients were randomly divi-ded into a swallowing training group (which received mouth,facial,and tongue function training along with cold sti-mulation of the pharynx,Mendelson's swallowing training,and swallowing behavior coordination training) and a group which received neuromuscular electrical stimulation (NMES) only.Low-frequency NMES was applied at the location of the swallowing obstacle using a biphase square wave 700ms long at 30-80 Hz with a current intensity of 0-15 mA.There was also a combined treatments group which received swallowing behavior therapy combined with NMES.All three groups were treated for 30 min daily for 20 days.Videofluoroscopy (VFSS) was conducted before and after treatment to assess swallowing function.Results After 20 days of treatment,swallowing function had improved in all three groups.The effectiveness rate was 73% in the swallowing training group,83% in the NMES group and 94% in the combined treatment group.The average VFSS score in the combined therapy group was significantly higher than that of either the swallowing training or NMES group.Conclusions NMES combined with swallowing behavior the-rapy can greatly improve swallowing function in patients with neurogenic dysphagia,especially those with pseudosupranuclear paralysis.
ABSTRACT
OBJECTIVE: The purpose of this study is to find the proper feeding posture for the safe liquid meal in the patients with neurogenic dysphagia. METHOD: Fifty patients of neurogenic dysphagia with tracheal aspiration diagnosed with the videofluoroscopic swallowing test (VFST) were evaluated. VFST using 5 cc of barium solution was done for each patient in the sitting and supine position. The results of VFST of supine position were analyzed and compared with those of sitting position for the tracheal aspiration, laryngeal penetration, premature leakage, and laryngeal spillage. RESULTS: The incidence of premature leakage, tracheal aspiration, and laryngeal penetration is significantly decreased in the supine position (56%, 14% and 46%) compared to the sitting position (96%, 100% and 100%) (p<0.001). The incidence of laryngeal penetration referable to the swallowing reflex is significantly decreased in the supine position (0%, 46%, 0%) compared to the sitting position (14%, 96%, 44%) (p<0.001). The incidence of nasal regurgitation is 2% in the sitting position and 30% in the supine position. CONCLUSION: The incidence of tracheal aspiration of liquid diet is significantly decreased in the supine position compared to the sitting position. The supine position would be safer than the sitting position in the feeding of liquid diet.