Deep acupuncture of Lianquan (CV23) and Yifeng (TE17) in combination with conventional acupuncture of other acupoints is superior to swallowing rehabilitation training in improving post-stroke dysphagia in apoplexy patients / 针刺研究

ABSTRACT

OBJECTIVE: To observe the therapeutic effect of acupuncture therapy in the treatment of dysphagia in apoplexy patients. METHODS: A total of 104 patients with post-stroke dysphagia were randomized into a control (conventional swallowing rehabilitation training) group and an acupuncture group (n＝ 52 cases in each one). In the control group, the conventional swallowing rehabilitation training was conducted, twice daily, 6 times a week for 4 weeks. In the acupuncture group, deep needling of main acupoints Lianquan (CV23) and Yifeng (TE17), and conventional acupuncture of adjuvant acupoints as Fengchi (GB20) and Fengfu (GV16), Wangu (GB12), Lieque (LU7), Jinjin (EX-HN12), Yuye (EX-HN13), etc. as well as electroacupuncture stimulation (15－20 Hz, 5 mA, and duration of 30 min) of ipsilateral CV23-GV16, TE17-GB20, and bilateral Neidaying acupoints were conducted. The acupuncture treatment was given once daily, 6 times a week for consecutive 4 weeks. In addition, patients of the two groups also received routine symptomatic treatment with drugs for anti-platelet aggregation, nourishing cranial nerve, lowering blood pressure, controlling blood glucose, improving cerebral circulation, etc. Before and after the treatment, the standard swallowing assessment (SSA, 18－46 points) and Kubota water swallowing test (WST, 1－5 grades) were conducted to evaluate the patient's swallowing function. The comprehensive therapeutic effect was assessed in accordance with the SSA and Kubota WST, and adverse reactions were recorded. RESULTS: After the treatment, the SSA score was considerably reduced in the two groups relevant to their own pre-treatment (both P<0.05), and was significantly lower in the acupuncture group than in the control group (P<0.05). The Kubota WST grade was evidently increased in the number of patients with grade Ⅰ (P<0.05) and reduced in the numbers of patients with grade Ⅲ－Ⅴ in both groups relevant to their own pre-treatment, and was more patients with grade Ⅰ in the acupuncture group than in the control group (P<0.05). Outcomes of the comprehensive therapeutic effect indicated that of the two 52 cases in the control and acupuncture groups, 8 (15.38%) and 19 (36.53%) were cured, 7 (13.46%) and 15 (28.45%) had marked improvement, 17 (32.69%) and 12 (23.08%) were effective, and 20 (38.46%) and 6 (11.54%) failed in the treatment, with the effective rate being 61.54% and 88.46%, respectively. The total effective rate of the acupuncture group was significantly higher than that of the control group (P<0.05). The adverse reactions such as regional hematoma (in 3 cases) and pain (in 2 cases) in the acupuncture group, and choking-coughing in the control group were seen, being 9.62% and 11.54% in the incidence rate, respectively. CONCLUSION: Deep needling of main acupoints Lianquan (CV23) and Yifeng (TE 17) in combination with conventional acupuncture of other acupoints is effective in improving local glossopharyngeal function in apoplexy patients with dysphagia, which is obviously superior to conventional swallowing rehabilitation training in the therapeutic effect and is applicable in clinical practice.