The Clinical Study Of The Combined Treatment Of Electro-acupuncture And Rehabilitation Training For Dysphagia After Stroke

BackgroundDysphagia caused by stroke is a type of functional Dysphagia. Research shows that the occurrence of Dysphagia after stroke can reach 30% to 65% with serious complications such as aspiration pneumonia, dehydration, malnutrition, bronchiospasm, airway obstruction. The negative social psychology would also onset in the disease, like social isolation and depression. They would seriously affect the physical and mental health of the patients. Nowadays, the hot and focal points of study home and abroad have been the different treatment plan for Dysphagia in apoplexy, improvement of the prognosis and prevention of condition rebounding. With the help of the deep clinical research for the recent years, the combined treatment of acupuncture and rehabilitation training for Dysphagia in cerebral apoplexy has obtained satisfactory effect. But the research results lack scientificity and credibility because of the nonstandard diagnosis and assessment method, failure to adopt the randomized double-blind controlled experiment, small sample size and lacking follow-up studies.Object ivesCompare the three weeks'combined treatment of electro-acupuncture and rehabilitation training (experimental group) with simple rehabilitation training (control group)。Assess the efficacy and safety of the combined treatment of electro-acupuncture and rehabilitation on the Dysphagia patients after stroke. Try to initially investigate the possible mechanism of electro-acupuncture therapy on them, provid evidence-based medicine foundationand In clinical, and do some basis investigation for further studies.MethodsCompare the three weeks'combined treatment of electro-acupuncture and rehabilitation training (experimental group) with simple rehabilitation training (control group). Compare the correlation between the two assessment methods, SSA and VFSS, which are used for assessing efficacy, and record the adverse events.ResultsAfter the comparison of a patient before the treatment with himself after it, his total SSA score decreases, while his total VFSS score increase, whose differences are statistically significant (P<0.01). Comparing the experimental group with the control one, the decreases of the SSA and the increases of the VFSS in the test group are higher that those in the control one, whose differences are statistically significant. (P<0.01)In the VFSS score, patients'each stage values in both groups all increase after the treatment, whose differences are statistically significant. (P<0.05) Comparing the differences of the VFSS each stage scores before and after the treatment, those of the test group are higher than those of the control one, which is statistically significant. (P<0.05)The selected patients are divided into two groups:the group with brain stem injury and the group without brain stems injury, according to their cranial MR results. The research shows that the patients in the group with brain stems have more severe overall Dysphagia situations than those in the group without brain stems before the treatment according to their SSA and VFSS scores in both lesions, whose differences are statistically significant. (P<0.01) In terms of the concrete situation of each Dysphagia stage, the Dysphagia in The group with brain stems injury are less severe than that in The group without brain stems injury, while the Dysphagia period and the aspiration situation are more severe, whose differences are statistically significant. (P<0.05)From the perspective of the curative effect, the patients with two lesions in the experimental group have better effect than those in the control group, according to their VFSS and SSA scores, whose differences are statistically significant. (P<0.01) From that of each stage of the VFSS score, there is no statistical significance in the curative effect of oral improvement in the patients with two lesions in both groups. The curative effect of the pharyngeal improvement in the patients of the experimental group are better than that of the control group, whose differences are statistically significant. (P<0.01)The curative effect of the aspiration improvement in the patients with brain stems damaged in the experiemental group is better than that in the control group, whose differences are statistically significant. (P<0.05) But to the patients without the lesion of brain stem, there is no statistical significance in the aspiration improvement in both groups.The assessment method for Dysphagia, SSA, is highly related to the TV-fluoroscopy VFSS score by increasing with negative growth rate.During the researching process, no adverse events occur except that two patients are found subcutaneous ecchymosis after being acupunctured.ConclusionsIn terms of Dysphagia in celebral apoplexy, the effect of the combined treatment of electro-acupuncture and rehabilitation training group is better than that of the control group.The SSA for assessing Dysphagia is highly related to the TV-fluoroscopy VFSS score by increasing with negative growth rate.