Correlation Analysis Of Clinical Effect And Influencing Factors On Treatment Of Dysphagia After Stroke By “Tong Guan-Liqiao” Acupuncture

Objective: Explore the relevant factors of acupuncture treatment of swallowing disorder(Post-stroke Dysphagia,PSD)under different efficacy evaluation criteria,provide reference basis for clinical optimization treatment plan and reasonable selection of efficacy evaluation index,provide a basis for rigorous randomized control trial,provide opinions and suggestions on patient lifestyle and public health management,and maximize the effect of customs clearance acupuncture treatment of PSD.Methods: This study included 125 patients in the acupuncture and rehabilitation departments of our hospital from June 2020 to February 2021.All patients were diagnosed with cerebral infarction,and the general demographic data,disease-related data,specific diagnosis and treatment plan,and dysphagia-related efficacy evaluation indicators were collected from the medical records.All patients included customs clearance acupuncture prescription(not limited),efficacy evaluation indicators selected functional oral food score(Functional Oral Intake Scale,FOIS),and Wada Drinking Water Test(Water Swallow Test,WST)score.Referring to the relevant recommendations of the rehabilitation efficacy evaluation standard for patients with swallowing disorders,the WST score and the improvement of FOIS score.Single-factor analysis was used to select candidates that influence acupuncture effective and ineffective groups;then colinearly,then incorporate candidates into the binary logistic regression model,and explore the potential efficacy factors by analyzing the indicators and induction and summary of other information.Results: To FOIS improve one level above OR WST and FOIS improve at the same time more than 1 level for curative effect standard,found the tube(OR = 0.102,P = 0.022)/(OR =0.077,P = 0.022),the true bulbar paralysis(OR = 0.178,P = 0.003)/(OR = 0.167,P = 0.003)is a direct impact on whether acupuncture curative effect of risk factors,treatment cycle(OR= 1.180,P = 0.000)/(OR = 1.083,P = 0.001)is a strong protective factors influencing curative effect of acupuncture,More than 4 weeks is more likely to be effective.When the improvement of WST by more than one grade was taken as the efficacy standard,it was found that the previous history of cerebral infarction(OR=0.296,P=0.006)was a single risk factor affecting the efficacy of acupuncture.When FOIS was improved by more than 2 grades,high BI index(OR=1.042,P=0.029)and long treatment period(OR=1.095,P=0.002)were protective factors affecting the efficacy of acupuncture,while previous history of cerebral infarction(OR=0.123,P=0.013)and history of diabetes(OR=6.816,P=0.008)were risk factors affecting the efficacy of acupuncture.Conclusion: According to the relevant influencing factors,firstly,the current acupuncture treatment plan should be actively promoted to optimize and improve.Patients with true medulla oblongata paralysis after stroke have severe dysphagia,so we can combine the Tongtongli Qiaojiao acupuncture method with Gao’s ninja needle to accurately act on the medulla oblongata swallowing center to promote the acupuncture effect.For hospitalized patients with indwelling gastric tube,intermittent indwelling gastric tube or timely withdrawal of gastric tube combined with volumetric viscosity test can be used to reduce the time of indwelling gastric tube and promote the recovery of patients’ swallowing function.For patients with PSD complicated with cerebral infarction and diabetes history,doctors should actively deal with the primary and combined diseases,improve the neurological function,customize the acupuncture treatment plan individually,improve the patient’s ability of daily activities,and facilitate the generation of acupuncture effect.Acupuncture treatment cycle is a direct impact on whether there important factors affecting the efficacy of acupuncture treatment period may be extended appropriately can increase the accumulation of acupuncture efficacy,especially in the recovery period in acupuncture treatment and want to dramatically improve feeding function of patients should be appropriately extended acupuncture treatment cycle,with the permission of the relevant policy,It is suggested that the period of acupuncture treatment for PSD should be extended to 3～4 weeks as far as possible.Later studies can focus on in-depth exploration of the clinical effects of acupuncture treatment in different groups of PSD.Secondly,if the conditions for using gold standard to evaluate PSD are not met in clinical or scientific research design,it is suggested that the bedside drinking water test and FOIS scale should be used together in the efficacy standard,and researchers should speed up the development of a multi-dimensional comprehensive efficacy evaluation system that can reflect the characteristics of acupuncture effect.In addition,comprehensive health education should be vigorously popularized,the relevant medical policy system should be improved,and the clinical treatment effect should be maximized in an all-round way.