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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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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.