Research Of Acupuncture Treatment Technique Of Post-stroke Dysphagia

Objective1To compare the therapeutic effects between acupuncture combined with rehabilitation therapy and simple rehabilitation training on post-stroke dysphagia.2To form a standardized diagnosis and treatment scheme of acupuncture treatment post-stroke dysphagia, and to enhance the utility ratio, standard rate and qualified rate.3To establish an effective and feasible mode of popularization and application about acupuncture treatment technology ofpost-stroke dysphagia.4To offer testimony of evidence-based medicine to evaluation, popularization and application.MethodsThree hundred and thirty nine patients with post-stroke dysphagia In the10Study Center were randomly divided into an experimental group (n=168), and a control group (n=171).Each group shed seven cases. Control group received conventional (conventional therapy of neurologic internal medicine and rehabilitation training), the experimental group received conventional therapy with acupuncture (Including prick blood, body acupuncture, electric acupuncture treatment). Acupoint selection:Fengfu(DU16) Jingbailao(EX-HN15) Lianquan(RN23) Jinjin(EX-HN12) Yuye (EX-HN13) Jialianquan(EX-HN) Yanhoubi (EX-HN). In first days, fourteenth days, twenty-eighth days, forty-second days and sixty days after entering the group, assess the patients respectively, and3months after the end of treatment follow up. The level of Kubota water-swallowing test, Fujishima Ichiro dysphagia evaluation criteria were used to evaluate swallowing function of patients. According to patient blood and chest X-ray evaluate lung infection. According to the incidence of adverse events assess the safety. According to medical costs assess health-economic indicators after the end of treatment.Results1therapeutic evaluationIn the end of the treatment, the cure rate of experimental group is52.4%in FAS and54.7%in PPS, effective rate is92.3%in FAS and94.4%in PPS. The cure rate of control group is42.1%in FAS and43.9%in PPS, effective rate is87.1%in FAS and89.6%in PPS. Two groups using CMH chi-square test:Cure rates between the two groups has a significant difference (FAS P=0.008, PPS P=0.017),and effective rate between the two groups has no difference (FAS P=0.1014, PPS P=0.0710).2The comparison of treatment of aspiration and lung infection control between two groups in the process of research, aspiration or lung infection between the two groups has no statistical difference In FAS and PPS data set (P>0.05), and At the end of treatment, cure rates aspiration or pulmonary infection has no statistical difference in the FAS and PPS data set (P>0.05)3The comparison of healing timeIn the experimental group cure time for28days, the control for29days, by the Log-rank test between the two groups there is a statistically difference in the both FAS and PPS data set (P<0.05).4Health-economic indicatorsTreatment costs between the two groups in the10centres (according to the charged per person per day) has no statistical difference (P>0.05).5security analysisThe incidence of adverse events between the two groups has no statistically significance (P>0.05). Among them,2cases of recurrence,1case of death in experimental group, and1case of recurrence,1case of death in the control group.Conclusion1Compared with pure rehabilitation therapy, acupuncture treatment of post-stroke dysphagia has higher cure rate.2compared with pure rehabilitation treatment, in acupuncture treatment of post-stroke dysphagia group, the time to achieve healing is short.3After the acupuncture treatment of swallowing disorders after stroke, Long-term follow-up therapeutic evaluation has no change.4Acupuncture treatment of post-stroke dysphagia does not increase the risk of aspiration or lung infection.5Acupuncture treatment of post-stroke dysphagia is safe, and does not increase the economic burden of patients.