| Objective: Through clinical randomized controlled trial,to evaluate the clinical efficacy of fire needle therapy on dysphagia caused by pseudobulbar palsy after stroke and observe the improvement of fire needle therapy on aspiration and quality of life of patients with dysphagia.Method: 76 patients with dysphagia caused by pseudobulbar palsy after stroke were randomly divided into treatment group and control group.38 cases in each group,75 cases were finally completed,and 1 case in control group lost.Both groups were given the same basic conventional western medicine treatments.In addition to that,the treatment group was treated with fire needle,and the control group was treated with the swallowing function rehabilitation training.The treatment group had been treated with the acupoints: Lianquan(CV 23),Fengchi(GB 20,bilateral),Wangu(GB 12,bilateral),Shuigou(GV 26),Neiguan(PC 6,bilateral)and Zusanli(ST 36,bilateral),taking out immediately after acupuncture,no needle left.The fire needle group was treated every two days and two weeks as a course,the control group was treated every day and two weeks as a course.the two groups were both treated for two courses and then rested for 2 days.After treatment,the swallowing function scores,evaluation criteria of Toshima Ichiro’s swallowing efficacy,the swallowing dysfunction evaluation scale of TCM and Kubota water swallowing test before and after the pulse oximetry values were measured for statistical analysis to understand the swallowing function and aspiration of patients.Swallow Quality-of-Life Questionnaire(SWAL-QOL)for evaluating the improvement in basic life and psychology.The safety assessment was carried out in the observation table of adverse reactions of acupuncture.Furthermore,we used the swallowing function scores as the main evaluation indicator to assess the clinical efficacy of the treatment of dysphagia.In 4th week after the end of the treatment,following up the swallowing function scores and evaluation criteria of Toshima Ichiro’s swallowing efficacy to assess the effect of fire needle therapy to improve long-term swallowing function.Results:(1)76 cases were included in total in this clinical trial.During the treatment,1 case lost in the control group and 75 cases were completed,38 cases in the treatment group and 37 cases in the control group.(2)The total effective rate was 89.5% in the treatment group and 75.7% in the control group,with a significant difference between the two groups(P<0.05).(3)Results after treatment: the swallowing function scores after treatment compared to before had significant difference.After treatment,there was significant difference in the swallowing function scores between the two groups,the improvement of the swallowing function in the treatment group was better than that in the control group(P<0.05).Evaluation criteria of Toshima Ichiro’s swallowing efficacy after treatment compared to before had significant difference.After treatment,there was significant difference in evaluation criteria of Toshima Ichiro’s swallowing efficacy between the two groups,the improvement of the swallowing function in the treatment group was better than that in the control group(P<0.05).Kubota water swallowing test before and after the pulse oximetry values after treatment compared to before had significant difference.After treatment,there was significant difference in Kubota water swallowing test before and after the pulse oximetry values between the two groups,the improvement of aspiration in the treatment group was better than that in the control group(P<0.05).SWAL-QOL after treatment compared to before had significant difference.After treatment,there was significant difference in SWAL-QOL between the two groups,the improvement of the quality of life in the treatment group was better than that in the control group(P<0.05).The swallowing dysfunction evaluation scale of TCM after treatment compared to before had significant difference.After treatment,there was significant difference in the swallowing dysfunction evaluation scale of TCM between the two groups,the improvement of the swallowing function in the treatment group was better than that of the control group(P<0.05).(4)Follow-up results: compared with before treatment,there were significant differences in both the swallowing function scores and evaluation criteria of Toshima Ichiro’s swallowing efficacy(P<0.05),and there was significant difference between the two groups,the improvement of the treatment group was better than that of the control group(P<0.05).(5)The results of adverse reactions: there were 6 cases of mild pain in the treatment group and 4 cases of mild pain in the control group,while the patients could bear the pain and be treated normally.No other discomfort was found.Conclusions:1.Fire needle therapy can be effective in the treatment of dysphagia caused by pseudobulbar palsy after stroke.2.The improvement of fire needle therapy on swallowing function is better than that of the control group.3.Fire needle therapy can reduce the rate of aspiration effectively,and improve the quality of life in patients with dysphagia.4.Using fire needle therapy to treat dysphagia caused by pseudobulbar palsy after stroke is a safe and easy option and worth to be popularized and applicated. |
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