The Clinical Study Of Neck-acupuncture On Dysphagia After Stroke

Cerebrovascular accident is one of the most common causes of dysphagia. Clinical reports has found that there are about57%-73%of Stroke patients will have varying degrees of dysphagia [1], resulting in complications like the dehydration, malnutrition, lung infection because of aspiration. The dysphagia seriously affects the patient’s quality of life and the rehabilitation process of disease [2], and causes a heavy mental and psychological burden to the patients, resulting in the difficulty of the movement, speech therapy and other rehabilitation carrying out, failure of achieving the goals of returning to the society, as well. Modern medical study has proved that dysphagia after stroke is due to a series of dysfunction, including injury of the bilateral corticobulbar tract or cortical in the upper motor neuron (causing the paralysis of the upper motor neuron in the glossopharyngeal nerve, the vagus nerve and hypoglossal nerve, which jointly control the swallowing movement) tongue movement disorders, soft palate paralysis and the oral cavity and pharynx caused by elevated pressure can not be sufficiently. The traditional medicine suggests dysphagia is a syndrome because of Qi block and blood stasis, meridian blockage causing throat disordersm. It is called "Yinfei","Houbi" or "Shejian" in Chinese, Medicine. The symptom is in the throat and the disease location is in the brain.In the evaluation of swallowing function, Videofluoroscopic Swallowing Examination (VFSE), can understand the status of each phase of swallowing function, can clearly show the pathway of barium-containing foods in the normal or abnormal processed of barium-containing foods via oral cavity, pharynx, esophagus. Even a slight movement abnormalities or aspiration, it can easily be seen via VFSE. Thus, you can observe whether there is a motion abnormalities, aspiration or not and the position of the Cricopharyngeal by VFSE, in order to assess the swallowing function and rehabilitation progress. Though VFSE is a gold standard of evaluating the function of swallowing [3], due to poor compliance of this examination, complex operation and there is a risk of aspiration during the inspection, it is difficult to carry out widespreadly. However, the current "Depression cropland water drinking test" exists disadvantages of bad correlation of gold standard. What’s more, that scale merely evaluates the patients’aspiration to liquid, rather than completely test and reflect the risk of various food aspiration. So, the scale cannot be comprehensively and objectively reflect the swallowing function. Taking the reliability, validity, etc into consideration, my study selects three e evaluation scales. These three scales which evaluate swallowing function in patients before and after treatment are more objective, more comprehensive and accurate.In the treatment of swallowing disorders, modern medical show no direct and special cure in the treatment of patients with dysphagia after stroke, mainly taking rehabilitation in swallowing movement as a direct treatment. However, patients need to take the initiative to meet the exercise. In this case, it significantly increases the limitation of the treatment. On the other side, the professors among Chinese Medicine, especially acupuncture have done a lot of useful discussion, also achieved a certain effect in the treatment of dysphagia after stroke. According to the reports [4-11],many researchers take the acupoints mostly in the head, neck, and tongue as main points, showing the principle of the concept of "partial selection of points, nearby the selection of points". Acupuncture treatment is targeted, fully embodying the core ideology "diagnosis and treatment" ideology of traditional Chinese medicine. Basing on the basis of individualized therapy, a great amount of acupuncture therapies has achieved good outcomes. Neck-acupuncture definitely improves the function of dysphagia, but it lacks the accuracy, objectiveness and comprehensive assessment. In this study,3selected scales are used to evaluate the efficacy of Neck-acupuncture in the treatment of dysphagia after strokeObjectTo investigate the efficacy of Neck-acupuncture on dysphagia after strokeMethod60patients with swallowing disorder after stroke were chosen, and then randomly divided into control group and treatment group, each with30cases. Both groups were treated in modern medicine and rehabilitation training and other basic treatment. Besides, the control groups with treatment of conventional acupuncture, such as EX-HN12、EX-HN13、GB20、SJ17、DU26、HT5, etc. While treatment group with Neck-acupuncture, which includes GB20、GB19、 GB12、SJ17、DU17、DU16、DU15, etc. Both treatments lasted for14days. In the first and the last day, the swallowing function of patients was evaluated by3assessment scales. We marked the data and statistical analysis was performed on database.Result1. The baseline of two groups including(sex, age, disease duration, swallowing function evaluated by assessment scales before any treatment was given) was statistically analyzed and showed a P>0.05, indicating no significant difference between2groups.2. The swallowing function of the patients was respectively scaled by3assessment scales before and after treatment. Statistical analysis by rank sum test, suggested that the outcome of treatment group was significantly higher (P<0.05).3. Among the treatment groups, patients were scaled by2assessment scales, evaluating their swallowing function before and after treatment, the statistical analysis by rank sum test, suggested that acupuncture term efficacy in patients with cerebral infarction were higher than cerebral hemorrhage.ConclusionNeck-acupuncture can improve the swallowing function of the patients after stroke, even better results for patients with cerebral infarction.