Clinical Study On The Treatment Of Post Stroke Dysphagia By Yu’s Cluster Scalp Acupuncture

Objective:1.To observe the changes of vertebrobasilar hemodynamics,surface electromyography of submental muscle group,subhyoid muscle group and geniohyoid muscle movement in patients with post stroke dysphagia treated with Yu’s cluster scalp acupuncture and conventional acupuncture,the immediate effects of the two therapies were compared.2.To provide a theoretical basis for clinical treatment by comparing the effects of Yu’s cluster scalp acupuncture and conventional acupuncture on the swallowing function of patients with post stroke dysphagia.Methods:206 patients with post stroke dysphagia were 1:1 randomly divided into treatment group(Yu’s cluster scalp acupuncture group,n=103)and the control group(conventional acupuncture group,n=103)by SAS 9.3 software,two groups were given basic post stroke treatment,swallowing rehabilitation equipment and swallowing rehabilitation training,treatment group were given Yu’s cluster scalp acupuncture treatment,control group were only given conventional acupuncture treatment,six days per week,one day off,4 weeks as a course treatment.After the first time treatment,transcranial doppler ultrasonography(TCD)was used to detect vertebrobasilar artery systolic blood flow velocity(Vs),mean blood flow velocity(Vm),diastolic blood flow velocity(Vd)and pulsatility index(PI),and the surface electromyography(sEMG)instrument was used to detect the swallowing latency and amplitude of the submental muscles and subhyoid muscles of dry and wet swallowing,The movement,time and speed of the geniohyoid muscle were measured by ultrasound to evaluate the immediate effect of treatment.After treatment,the patients in the treatment group(n=97)and the control group(n=92)were evaluated by the water swallowing test(WST),standard swallowing assessment(SSA),quality of life scale for swallowing disorders(SWAL-QOL),modified Mann assessment of swallowing ability(MMASA),at the same time,combined with videofluoroscopic swallowing study(VFSS),TCD,sEMG and ultrasound detection,the effects of Yu’s cluster scalp acupuncture on vertebrobasilar artery hemodynamics and the movement ability of swallowing related muscle groups in patients with dysphagia were evaluated,and the clinical efficacy of the two groups was compared.Results:1.After the first treatment,TCD test showed that Vs,Vm and Vd of left and right vertebral artery and basilar artery in the treatment group were all increased compared with before treatment,and PI was lower than before treatment,with statistical significance(P<0.05),There were no significant changes in VS,VM,VD and PI of vertebrobasilar artery in control group(P>0.05).In addition,the immediate effect of increasing Vs,Vm,Vd and decreasing PI in the treatment group was better than that in the control group,with statistical significance(P<0.05).2.After the first treatment,sEMG test showed that the dry and wet swallowing time of the submental muscle group and the subhyoid muscle group in the treatment group were shorter than before treatment,and the amplitude of the submental muscle group was higher than before treatment.Ultrasound test showed that the movement time of the geniohyoid muscle was significantly shortened,and the movement speed was significantly increased,with statistical significance(P<0.05).In addition,the immediate effect of shorting the dry and wet swallowed time of submental muscle and subhyoid muscle,increasing the sEMG amplitude of submental muscle,reducing the movement time and improving the movement speed of geniohyoid muscle in the treatment group was significantly better than that in the control group,with statistical significance(P<0.05).3.Before treatment,there were no significant differences in gender,age and other baseline data between the two groups(P>0.05),and there were no significant differences in WST,SSA,SWAL-QOL and MM AS A scores(P>0.05).After treatment and at follow-up,compared with before treatment,WST rating was significantly improved,SSA score was significantly decreased,SWAL-QOL and MM AS A scores were significantly increased in 2 groups,with statistical significance(P<0.05).The improvement of WST,SSA,SWAL-QOL and MMASA in the treatment group was significantly better than that in the control group,with statistically significant(P<0.05).4.Before treatment,there were no significant differences in mouth period,pharynx period,hyoid upward distance and hyoid forward distance between the two groups tested by VFSS detection,there were no significant differences in vertebral basilar artery Vs,Vm,Vd,PI,dry and wet swallowing time,amplitude,ultrasonic testing of hyoid muscle movement distance,movement time and movement speed between two groups(P>0.05).After treatment compared with before treatment,the oral phase time,pharynx period time were significantly shortened,the hyoid upward distance and hyoid forward distance were significantly increased,vertebrobasilar artery Vs,Vm,Vd are improved obviously,PI were significantly lower,submental muscles and subhyoid muscles dry and wet swallowing time were significantly shortened,amplitude increased significantly,geniohyoid muscle movement and speed increased significantly in the treatment group,and the difference was statistically significant(P<0.05).The improvement of each index in the treatment group was significantly better than that in the control group,and the difference was statistically significant(P<0.05).5.After treatment,the total effective rate of the treatment group was 92.78%,which was higher than that of the control group(7 1.74%),and the difference was statistically significant(P<0.05).Conclusion:1.The immediate effect of Yu’s cluster scalp acupuncture in the treatment of post stroke dysphagia is related to improving blood circulation of vertebrobasilar artery,shorting the movement time and increasing the electromyographic amplitude of submental muscle group and the motion speed of geniohyoid muscle.2.Yu’s cluster scalp acupuncture can shorten the oral phase time and pharynx phase time,improve vertebrobasilar artery hemodynamics in patients with post stroke dysphagia,and improve the motion ability of hyoid and swallowing related muscles,and the effect is better than conventional acupuncture.3.Yu’s cluster scalp acupuncture can effectively improve the swallowing function of patients with post stroke dysphagia,improve patients’ quality of life,and the clinical effect is definite.