The Effects Of Acupuncture Ren And Du Meridians On Brainstem Projections In The Swallowing System By Non-invasive Magnetic Stimulation Of Trigeminal Nerve In Physiological State

BackgroudAs the growth in the living standard and tempo unceasingly, dysphagia is one of main symptoms of post-stroke, which is a major problem today. Swallowing disorder, because of its high incidence and severe consequences, has become a social health problems. Epidemiological data shows that the incidence of 50 years old or older is 16 to 22 Percent. Acute stroke is the leading cause of swallowing disorder which more than half of the acute stroke patients with. Swallowing disorders can lead to dehydration, malnutrition, aspiration pneumonia, airway obstruction and other complications, can seriously affect the patients quality of life, can increase morbidity and mortality of the stroke patients. Past 20 years, although a number of studies around the neurons in the brain stem of the swallowing reflex networks make us have a relatively clear understanding of swallowing on the physiological mechanism, there are no effective treatments for post-stroke dysphagic patients, and there is few research on its internal mechanism research.ObjectiveThis study will explore the effects of acupuncture Ren and Du meridians on brainstem projections in the swallowing system by non-invasive magnetic stimulation of trigeminal nerve in physiological state, which would be an important guideline to the clinical acupuncture using.MethodsAccording to the research purposes and the subjects’standards including inclusion criteria and exclusion criteria, the study will be consisted of several subjects who fit the standards above. There are 15 healthy subjects successfully recruited in this experiment, ageing from 19 to 28 year old, including 9 males and 6 females falling off 1 man and 1 woman in the midway. The study uses the self-contrast method to deal with the 13 subjects respectively from two parts. The first part: transcutaneous magnetic stimulation bilateral trigeminal nerves are performed respectively to obtain the pharyngeal muscle’s and the mylohyoid muscle’s threshold stimulus intensities that the corresponding amplitute is more than 20 μV in 5 of 10 trials, respectively to obtain the latencies and the amplitutes of the early pharynx muscle, the late pharynx muscle, the ipsilateral mylohyoid muscle and the contralateral mylohyoid muscle. The second part:acupuncture FengFu and LianQuan using the parameter of 2 hz and 15 min. Then immediately after the needle transcutaneous magnetic stimulation bilateral trigeminal nerves are performed respectively to obtain the latencies and the amplitutes of the early pharynx muscle, the late pharynx muscle, the ipsilateral mylohyoid muscle and the contralateral mylohyoid muscle under the threshold stimulus intensities above.ResultsThe early pharynx muscles, the late pharynx muscles, the ipsilateral mylohyoid muscles and the contralateral mylohyoid muscles of 13 subjects can not be all evoked. Transcutaneous magnetic stimulation on the left side trigeminal nerve can evoke six subjects appear early pharyngeal muscle responses, six subjects appear late pharynx muscle responses, four subjects appear early and late pharynx muscle responses at the same time, eight subjects appear ipsilateral mylohyoid muscle responses, nine subjects appear the contralateral mylohyoid muscle responses, eight subjects simultaneously appear bilateral mylohyoid muscle responses. Transcutaneous magnetic stimulation on the right side trigeminal nerve can induce nine subjects appear early pharyngeal muscle responses, ten subjects appear late pharynx muscle responses, six subjects appear early and late pharyngeal muscle reactions at the same time, ten subjects appear ipsilateral mylohyoid muscle responses, ten subjects appear the contralateral mylohyoid muscle responses, ten subjects appear simultaneously bilateral mylohyoid muscle responses. Respectively to compare the amplitutes and latencies of the early pharynx muscles, the late pharynx muscles, the ipsilateral mylohyoid muscles and the contralateral mylohyoid muscles induced by the left and right trigeminals, then it gets the following results:1. The latencyThe latency of the six subjects’early pharyngeal muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see significant difference (P＞0.05); the latency of the six subjects’ late pharyngeal muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see significant difference (P＞0.05); the latency of the nine subjects’ipsi lateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see significant difference (P＞0.05); the latency of the eight subjects’contralateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see the statistical significance (P＞0.05). The latency of the nine subjects’ early pharyngeal muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see significant difference(P＞0.05); the latency of the ten subjects’late pharyngeal muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see significant difference (P＞0.05); the latency of the ten subjects’ipsilateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see significant difference (P＞0.05);the latency of the ten subjects’ contralateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do not see the statistical significance (P＞0.05).2.The AmplituteThe amplitute of the six subjects’early pharyngeal muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see significant difference (P＜0.05); the amplitute of the six subjects’late pharyngeal muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see significant difference (P=0.05); the amplitute of the nine subjects’ipsilateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see significant difference (P＜0.05); the amplitute of the eight subjects’ contralateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the left side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see the statistical significance (P＜0.05). The amplitute of the nine subjects’early pharyngeal muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see significant difference (P＜0.05); the amplitute of the ten subjects’late pharyngeal muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see significant difference (P＜0.05); the amplitute of the ten subjects’ipsilateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see significant difference (P＜0.05); the amplitute of the ten subjects’contralateral mylohyoid muscle responses which transcutaneous magnetic stimulation on the right side trigeminal nerve evoked before and after acupuncturing Ren and Du meridians do see the statistical significance (P＜0.05).ConcluusionAcupuncture Du meridians can facilitate brainstem excitory in swallowing system in some way by non-invasive magnetic stimulation of trigeminal nerve in physiological state a Physiological state, mainly the increace of excitement.