| The incidence of stroke in China ranks the second Place in the world. It’s reported that 45% of stroke inpatients have dysphasia, which can lead to lung infections, nutritional disorders, suffocation and other serious complications. Dysphasia can not only affect the Prognosis of Patients, but also can increase the rate of stroke recurrence, invalidism and mortality. Therefore, it’s very important to screen and diagnosis the Problem of dysphasia as early as Possible for the Patients with dysphasia after stroke. Early treatment for dysphasia can increase survival rate, improve the quality of life, and reduce the rate of morbidity and mortality among Patients with dysphasia after stoke.Many Physicians in Chinese traditional medicine had Proposed various Pathological mechanisms of dysphasia after stroke. Most of them believed that dysphasia primarily associated with the wind and Phlegm. From the material of studying and the experience of Predecessors, it was believed that dysphasia after stroke mainly associates with depression, anger, diet, alcohol indulgence and other factors which lead to imbalance of yin and yang organs, air-lift against the chaos, Feng Xie off stroke, blood stasis, Phlegm stagnation in awakened brain and the tongue induced. According to Chinese medicine syndrome differentiation, the difficulty of swallowing after stroke mainly relates with kidney, spleen, heart.According to modern clinical studies, swallowing Process consists essentially of four Phases, oral Preparation Phase, oral Phase, Pharyngeal Phase and esophageal Phase. Dysphasia after stroke closely relates with oral Preparation Phase, oral Phase and Pharyngeal Phase. The neural Pathological mechanisms of dysphasia after ischemic stroke includes the damage of cortical Projection downward fibers, the damage of the medulla oblongata in brainstem, the damage of other swallowing-related Peripheral nerves and so on.Current treatments for dysphasia after ischemic stroke are various which include Chinese traditional medicine, acupuncture, rehabilitation exercise, electrical stimulation, balloon dilatation technique, hyperbaric oxygen therapy, Psychological therapy. Acupuncture treatment also includes electro acupuncture, acupoint block, Jin three needle therapy, nape acupuncture Yifeng Point Penetration, elongated needle, eye needle, Point injection, etc; electrical stimulation includes transcutaneous electrical nerve stimulation (TENS) and neuromuscular electrical stimulation (NMES), The application of Vitalstim electricity stimulation therapy for dysphasia Patients is Popular in recent years. But there is no clinical report about the treatment effect of tongue three-Pin therapy Plus Vitalstim electrical stimulation therapy for the Patients with dysphasia after ischemic stroke.From what has discussed above, the following aspects in this Paper are studied.1. ObjectiveExplore the treatment effect of tongue three-Pin therapy Plus Vitalstim electrical stimulation therapy for the Patient with dysphasia after ischemic stroke. Swallowing ability were observed and assessed by Kubota Swallowing Ability Assessment, Standard Swallowing Function Assessment Scale and Functional Oral Intake Scale. Scientific statistics methods were used to objectively evaluate the efficacy and safety of those treatments so that the better treatment Plan options can be provided.2. Methods2.1 Literature review:A literature study was conducted to search Chinese and English journals which related Pathogenesis, treatment and evaluation of dysphasia after ischemic stroke. A systematic literature review was written to describe the recent development of treatment for the Patient with dysphasia after ischemic stroke. It not only gave a solid theoretical foundation, but also supports the further exploration of the treatment effect about tongue three-Pin therapy Plus Vitalstim electrical stimulation therapy for the Patient’s dysphasia after ischemic stroke.2.2 Clinical study:90 Patients were met the inclusion criteria of ischemic stroke dysphasia. They were randomly divided into three groups, including tongue tongue three-Pin therapy group (hereinafter referred to as TTP group), Vitalstim electrical stimulation therapy group (hereinafter referred to as VES group), tongue three-Pin combined Vitalstim electrical stimulation group (hereinafter referred to as T&V group).Each groups has 30 Patients with dysphasia after ischemic stroke. All the Patients have the basis symptomatic treatment to control blood Pressure, blood sugar and blood lipids, improve the cerebral microcirculation, be given anti-Platelet aggregation and so on. The Patients are asked to do the exercises of self-swallowing rehabilitation gymnastic. TTP group was given the treatment of tongue three-Pin therapy. VES group was conducted with electrical stimulation therapy. T&V group was given the tongue three-Pin therapy and Vitalstim electrical stimulation therapy. Kubota Swallowing Ability Assessment, Standard Swallowing Function Assessment Scale and Functional Oral Intake Scale were used to assess the Patient’s swallowing ability respectively before and after the treatment.3. Results3.1 From the review of the Published journals until this year, It’s said that tongue three-Pin therapy Plus Vitalstim electrical stimulation therapy can better improve swallowing function for Patient’s with dysphasia after ischemic stroke.3.2 Kubota Swallowing Ability Assessment was used to assess the Patient’s swallowing ability respectively before and after the treatment. The grade difference have recoded into different ranks. The grade difference of 0 was recoded as invalid. Grade differences of 1 were marked as valid. Grade differences above 1 were recoded as excellence. New ratings among the three groups were analyzed by multiple independent samples of non-Parametric test which is Chi-square test. The results showed:the treatment effect of T & V group was the highest among three groups. There was a significant difference of treatment effect among the three groups (x2=11.015, P<0.01)3.3 Standard Swallowing Function Assessment Scale was used to assess the Patient’s swallowing ability respectively before and after the treatment. The scores differences were analyzed by One-Way ANOVA. It showed that the treatment effect of swallowing function among three group has a significant difference (F= 5.890, P<0.01). LSD was used to analyze the Post hoc Pairwise comparisons. It showed that there is a significant difference between T&V groups and TTP group (P<0.01).There is a significant difference between T&V groups and VES group (P<0.01). And there was no significant difference between the TTP group and VES group.3.4 Functional Oral Intake Scale was used to assess the Patient’s swallowing ability respectively before and after the treatment. Kruskal-Wallis test was used to analyze multiple independent samples data. The results showed the treatment effect among the three groups had a significant difference (H=20.910, P<0.001); T&V treatment is more effective than the TTP.T&V treatment is more effective than VES therapy.4. ConclusionsThree treatments can be effective and improve the swallowing function for the Patients with dysphasia after ischemic stroke. Treatment which combined with tongue three-Pin therapy and Vitalstim electrical stimulation therapy is more effective to improve swallowing function than treatment separately. |
PDF Full Text Request