| Objective: To explore a more effective acupuncture treatment for spittoon-gas obstruction dysphagia after ischemic stroke through the idea of "eliminating phlegm to benefit the orifice" and based on the new understanding of spittoon-gas obstruction dysphagia.Methods: 62 cases of ischemic cerebral apoplexy type nitrogen/resistance after swallowing disorders are in line with the diagnostic criteria and inclusion criteria,to 2020 July to December 2021,the first affiliated hospital of tianjin medical university acupuncture Lin Chuang Bu hospitalized patients.The above patients were randomly divided into treatment group(group 1)and control group(group 2),with 31 cases in each group.At the same time of conventional drug treatment of cerebrovascular disease,the treatment group used "Juan phlegm,qiao" acupuncture method(crowd,tian tu,make,hong leong,yongquan,sun),the control group with common acupuncture method,two groups of patients were treatment 1times a day,30 min,retaining needle six times a week,from Monday to Saturday,acupuncture,treatment 2 weeks,after the end to observe and compare the clinical curative effect of two groups.In this study,WST score scale and MMASA scale were used to assess the swallowing status of the subjects,and NIHSS was used to assess the neurological deficit of the patients.Using quantitative TCM symptom integral table for patients with swallowing disorder(choke diaphragmatic)symptoms,tongue veins assessed,at the end of the test before and after two weeks to evaluate subjects respectively,using SPSS 25.0 software with the result of the test data statistical analysis,the results with P<0.05 for statistically significant,P<0.01 is significant difference,P>0.05 was not statistically significant.Results:1.In terms of improving symptoms of dysphagia:(1)Comparison of scores of modified Mann Swallowing Ability Assessment Scale(MMASA): Intra-group comparison: From the sub-item scores,the results of patients in the two groups before and after treatment were statistically significant(P<0.05);After treatment,the scores of the two groups were higher than before,and the difference was statistically significant(P<0.01).Comparison between groups: the total score of MMASA scale was compared between the two groups: the difference was significant and statistically significant(P<0.01);The score comparison of the subitems of MMASA scale showed statistically significant differences in the four subitems of "articulation disorder","tongue muscle strength","cough reflex" and "soft palate lifting"(P<0.05).(2)the kubota’s drinking water test(WST)score comparison: group comparison:comparison before and after treatment in both groups,the difference had statistical significance(P<0.01);Comparison between groups: There was no statistical significance in WST scores between the two groups before and after treatment(P >0.05).2.In terms of improving patients’ neurological deficits:NIHSS scale score comparison: intra-group comparison: the score of the two groups after treatment was lower than that before,with statistical significance(P<0.01);Comparison between groups: there was no statistically significant difference between the two groups after treatment(P>0.05).3.In terms of improving TCM symptoms of patients:TCM symptoms scale comparison: group comparison: comparison before and after treatment in both groups,each item differences have statistical significance(P<0.01);There was no significant difference in "chest and diaphragm depression" in the control group(P>0.05).The other subitems were statistically significant(P<0.05).In the treatment group,there were statistically significant differences in "eating and swallowing difficulty","salivation","chest and diaphragm ruffiness","vomiting and salivation","greasy tongue and smooth pulse"(P<0.05).Comparison between groups: there was statistically significant difference between the two groups in total score(P<0.01);There were statistically significant differences in "swallowing and choking","chest and diaphragm ruffiness" and "vomiting and salivation" in the treatment group(ALL P<0.05).4.Evaluation and analysis of clinical efficacyIn the treatment group,the recovery rate was 20% and the total effective rate was90.00%.The recovery rate of ordinary acupuncture group was 13.33% and the total effective rate was 86.67%.By rank sum test,P clinical efficacy = 0.395(P<0.05),indicating no statistical significance.Conclusion:1.Both the treatment with rheum and common acupuncture can effectively improve the swallowing function of patients,and the treatment with rheum and rheum acupuncture has certain advantages in improving "articulation disorder","tongue muscle strength","cough reflex","soft palate lifting" and other aspects.2.The therapeutic effect of acupuncture with remitting phlegm and remitting orificum was similar to that of ordinary acupuncture in the improvement of nerve function defect.3.The acupuncture therapy is designed for the TCM syndrome of dysphagia after ischemic stroke,which is spittoon and gas obstruction.It is targeted in the treatment and can better improve the TCM symptoms such as "eating and swallowing obstruction","chest and diaphragm depression","vomiting and phlegm salivation". |
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