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Objective:To investigate the clinical efficacy of different enteral nutrition methods combined with swallowing rehabilitation training in the treatment of Alzheimer's disease complicated by dysphagia.Methods:A total of 120 patients with Alzheimer's disease and dysphagia who received treatment in the Department of Geriatric Medicine, the Second Hospital of Jinhua from October 2019 to March 2021 were included in this study. They were randomly and evenly divided into four groups: A, B, C, and D. Patients in groups A, B, C, and D were given nasogastric tube feeding, naso-intestinal tube feeding, nasogastric tube feeding + swallowing rehabilitation training, and naso-intestinal tube feeding + swallowing rehabilitation training, respectively. After 12 weeks of treatment, total response rate, nutritional status, and complications were compared between the four groups.Results:After 12 weeks of treatment, total response rate in group D was the highest (100.0%), which was significantly higher than that in the other three groups (group A: 13.3%; group B: 40.0%; group C: 73.3%; χ2 = 45.88, 25.71, 9.23, all P < 0.05). After treatment, the nutritional status [body mass index (BMI): (21.42 ± 1.85) kg/m 2, (23.17 ± 2.03) kg/m 2] and patient satisfaction (60.0%, 100.0%) in groups C and D were significantly superior to those in group A [BMI: (19.01 ± 1.72) kg/m 2; patient satisfaction: 10.0%) and group B [BMI: (19.86 ± 1.69) kg/m 2; patient satisfaction: 33.3%]. Group D had the best nutritional status ( t = 7.01, 5.14, 1.78, all P < 0.05) and the highest patient satisfaction ( χ2 = 49.09, 30.00, 15.00, all P < 0.001). Conclusion:Naso-intestinal tube feeding combined with swallowing rehabilitation training is the best treatment for Alzheimer's disease complicated by dysphagia among the studied enteral nutrition feeding methods and therefore deserves clinical promotion.
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OBJECTIVE: To observe the effect of deep acupuncture of Tiantu (CV22), etc. in combination with rehabilitation training on swallowing function of patients with post-stroke dysphasia. METHODS: A total of 70 patients suffering from post-stroke dysphagia were randomly divided into control group (conventional acupuncture＋ swallowing rehabilitation training) and treatment group (deep acupuncture of CV22 ＋ rehabilitation training, n＝ 35 cases in each group). The swallowing rehabilitation procedure was conducted 30 min every time, twice daily, 5 times a week for 3 weeks. In patients of the treatment group, after deep insertion (about 80 mm) along the posterior margin of the manubrium sterna, the filiform needle in CV22 was lifted and thrusted repeatedly 9 times till the patient experienced a feeling of foreign matter blocking, followed by retaining the needle for 30 min. For patients of the control group, Lianquan (CV23) was punctured with 3 acupuncture needles (one vertical needling and bilateral slope needling toward the tongue root), and Fengfu (GV16), bilateral Bailao (EX-NH23), bilateral Renying (ST9) and bilateral Jialianquan (Extra) were punctured vertically with filiform needles. The treatment was conducted once daily, 5 times a week for 3 weeks. The swallowing function was evaluated by using Kubota water swallowing test (KWST) scale (0－5 points), Fujishima Ichiro rating scale (FIRS, 0－10 points), and video fluoroscopic swallowing study (VFSS, 0－10 points), separately. The therapeutic effect was also assessed according to the clinical scale scores and VFSS results. RESULTS: Following the treatment, of the two 35 cases in the control and treatment groups, 4 (11.43%) and 8 (22.86%) experienced marked improvement in their symptoms, 22 (62.86%) and 23 (65.71%) were effective, and 9 (25.71%) and 4 (11.43%) were failed, with the effective rates being 74.29% and 88.57%, respectively. After the treatment, the KWST score of the two groups were significantly decreased in comparison with their own pre-treatment (P<0.05), while the FIRS and VFSS scores of the two groups were considerably increased in comparison with their own pre-treatment (P<0.05). The therapeutic effects of the treatment group were obviously superior to those of the control group in the effective rate, lowering KWST score and in raising FIRS and VFSS scores (P<0.05)．. CONCLUSION: Acupuncture plus swallowing rehabilitation training is effective in improving the swallowing function of stroke patients with dysphagia, and the deep acupuncture stimulation of CV22 is apparently better than conventional acupuncture in the therapeutic effect.
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<p><b>OBJECTIVE</b>To observe the effects of's neck acupuncture combined with swallowing rehabilitation on swallowing function and quality of life in patients with post-stroke pseudobulbar palsy.</p><p><b>METHODS</b>One hundred patients were randomly assigned in to an observation group and a control group, 50 cases in each one. The patients in the control group were treated with basic pharmaceutical treatment, including neurotrophy medication and free radical scavenging medication as well as swallowing rehabilitation; the patients in the observation group, on the basis of those in the control group, were treated with's neck acupuncture at Fengchi (GB 20), Yiming (EX-HN 14), Gongxue (Extra), Lianquan (CV 23), Wai Jinjin Yuye (Extra), Tunyan (Extra), Zhiqiang (Extra), Fayin (Extra), once a day, five times a week for continuous eight weeks. The Repetitive saliva-swallowing test (RSST), standardized swallowing assessment (SSA) and swallow quality-of-life questionnaire (SWAL-QOL) before and after treatment in the two groups were observed; the relationship between disease location and frequency and efficacy of's neck acupuncture was explored in the observation group.</p><p><b>RESULTS</b>After treatment, the RSST, SSA and SWAL-QOL were superior to those before treatment (all<0.01), with more significant results in the observation group (all<0.01). The total effective rate was 91.7% (44/48) in the observation group, which was superior to 75.5% (37/49) in the control group (<0.01). The frequency of disease onset was one in 11 patients and 2 and above in 37 patients in the observation group, and the efficacy of one onset of disease was 100.0% (11/11), which was superior to two and above of onset 89.2% (33/37,<0.01). The number of patients with disease location at cortex and subcortex was 21, while that at capsula interna and basal ganglia was 27 in the observation group, the efficacy of two was similar (>0.05).</p><p><b>CONCLUSIONS</b> 's neck acupuncture combined with swallowing rehabilitation could effectively improve dysphagia and quality of life in patients with post-stroke pseudobulbar palsy. No correlation of lesion locations on acupuncture efficacy is observed, while onset frequency is inversely proportional to efficacy.</p>
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Objective To evaluate the clinical effect of deep acupuncture at Lianquan (CV23) combined with swallowing rehabilitation training in the treatment of dysphagia after stroke.Methods A total of 84 patients with dysphagia after stroke who met the inclusion criteria were divided into 2 groups, 42 in each. The control group received swallowing rehabilitation training, and the observation group was treated with acupuncture therapy based on deep acupuncture atLianquan (CV23) combined with swallowing rehabilitation training. The VFSS score and clinical efficacy were compared between the 2 groups before and after treatment.Results The cure rate of observation group was 69.1% (29/42), the total effective rate 85.7% (36/42), while the control group were 42.86% (18/42) and 66.67% (28/42). The comparison of cure rate and total efficiency rate between the two group had statistically significant differences (χ2=5.845, 4.200,P=0.016, 0.040). After treatment, the VFSS score of the observation group was significantly higher than that of the control group (7.43 ± 2.27vs.4.31 ± 1.53;t=5.433, P<0.05). The recovery time of the 29 cured patients in the observation group was (12.0 ± 3.0) d, while the recovery time of the 18 cured patients in the control group was (17.8 ± 2.2) d. There was statistically significant difference between the 2 groups (t=7.094,P=0.001).Conclusions Deep acupuncture at Lianquan (CV23) combined with swallowing rehabilitation training can improve the swallowing function of patients with dysphagia after stroke, shorten the recovery time of swallowing function and improve the clinical efficacy.
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As a result of introducing swallowing rehabilitation at a special nursing home for the elderly, a resident became able to take food orally for the first time in about 4 years since having a PEG tube inserted. Further, the resident's FIM, FG, and DSS values improved to some extent. While nutritional care using the PEG tube is recognized as a long-term enteral nutritional therapy, the tube is mostly used as a “PEG tube for survival” and scarcely used as a “PEG tube for eating”, which indicates a PEG tube for supporting oral ingestion. The result indicates that it is preferable to use the PEG tube “for eating” in addition to its use as an option for long-term enteral nutritional therapy. The result also indicates the need to conduct, with the cooperation of nurses and nursing care workers, the nutritional care and regular follow-ups of all nursing home residents, as well as to maintain and improve the residents' swallowing function and their activities of daily living (ADL) by continuing swallowing rehabilitation, oral care, and measures against gastroesophageal reflux disease.
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BACKGROUND AND OBJECTIVES: Supracricoid partial laryngectomy is popular due to its satisfactory oncological and functional outcomes in selected laryngeal cancers. Their postoperative management is now well codified, but functional failures still persist. The aims of this study were to analyze the deglutition modification induced by these intervention and to plan a better rehabilitation program of swallowing. MATERIALS AND METHOD: For the evaluation of swallowing function, the swallowing analysis was performed by following the videofluoroscopic evaluation using the modified barium swallow (Logemann, 1983) in 14 laryngeal cancer patients. RESULTS: Asymptomatic aspiration was observed in 4 patients (28.6%), especially in patients with the extended procedures (p=0.032) and delayed decannulation (p=0.035). Aspiration was associated with faulty backward tilting of epiglottis and inadequate movement of the base of tongue (p<0.05). CONCLUSIONS: In planning the swallowing rehabilitation program after supracricoid partial laryngectomy, recuperation of proper epiglottic movement, which is promoted by exercise of backward tongue movement, is the most important concern.