Clinical study on Bushen-Liyan Decoction combined with low frequency pulse acupoint electrical stimulation in the treatment of swallowing dysfunction in patients with stroke at convalescent stage / 国际中医中药杂志

ABSTRACT

Objective:To investigate the clinical application of Bushen-Liyan Decoction combined with low frequency pulse acupoint electrical stimulation in the treatment of swallowing dysfunction of stroke patients in convalescent stage. Methods:From January 2018 to March 2020, 108 stroke patients with swallowing dysfunction in the Shandong Provincial Third Hospital were selected. They were randomly divided into two groups with 54 in each according to the random number table method. The control group was given low frequency pulse acupoint electrical stimulation on the basis of conventional treatment, and the study group was given Bushen-Liyan Decoction combined with low frequency pulse acupoint electrical stimulation on the basis of conventional treatment. Both groups were treated for 4 weeks. The National Institutes of Health Neurological Deficit Score (NIHSS) was used to assess the degree of neurological impairment, the Wada Drinking Water Test was used to assess the degree of swallowing dysfunction, and Barthel Index was used to assess the ability of daily living. The serum levels of brain-derived neurotrophic factor (BDNF), insulin-like growth factor-1 (IGF-1), VEGF, IL-18, IL-23, SOD and MDA were detected by ELISA. The adverse reactions during the treatment were observed and the clinical efficacy was evaluated.Results:The total effective rate was 92.6% (50/54) in the study group and 72.2% (39/54) in the control group, with significant difference between the two groups( χ2=7.728, P=0.005). After treatment, NIHSS score and Wata’s drinking water test score of the study group were lower than those in the control group ( t=8.383, 9.740, P<0.001), Barthel index of the study group was significantly higher than that of the control group ( t=4.064, P<0.01). The serum BDNF [(8.42 ± 0.72) μg/L vs. (6.69 ± 0.63) μg/L, t=13.288], IGF-1[(142.20 ± 12.29) μg/L vs. (118.35 ± 10.73) μg/L, t=10.742] and VEGF[(151.29 ± 12.26) ng/L vs. (102.21 ± 9.77) ng/L, t=23.006] were significantly higher than those in control group( P<0.01); The serum levels of IL-18, IL-23 and MDA were significantly lower than those in the control group( t=7.892, 9.897, 6.206, P<0.001), and the level of SOD was significantly higher than that of the control group ( t=18.510, P<0.001). During the treatment, no serious adverse events occurred in both groups. Conclusion:Bushen-Liyan Decoction combined with low-frequency pulse acupoint electrical stimulation can reduce the clinical symptoms, inflammatory reaction and brain tissue damage of stroke patients with dysphagia, improve the swallowing function and improve the clinical efficacy.