Observation On The Clinical Curative Effect Of Tongdutiaoshen Acupuncture Combined With Swallowing Therapeutic Instrument On Dysphagia After Stroke

Objective: This project evaluated the clinical efficacy of Tongdutiaoshen acupuncture,which combined with swallowing therapy instrument in the treatment of dysphagia after stroke(DAS)by observing the score changes of Video Fluoroscopic Swallowing Study(VFSS)? Kubota Water Swallow Test and Standardized Swallowing Assessment(SSA).And also to observe its safety and explore its possible mechanism for patients with DAS.Methods: All the 60 cases in this study were derived from the rehabilitation department in The Second Affiliated Hospital of Anhui University of Traditional Chinese Medicine.According to the random number table and proportion of 1:1,these patients which in order of visit with DAS were divided into the treatment group and the control group with 30 cases in each group.On the basis of routine medical treatment in the two groups,the control group was treated with swallowing therapeutic instrument,and the treatment group was treated with Tongdutiaoshen acupuncture on the basis of the control group.Two groups were treated 6 times a week with 1 day resting.Treatment continued for 28 days.The curative effect evaluation points of the two groups were evaluated before treatment,after 14 and 28 days.VFSS?Kubota Water Swallow Test and SSA scale were used to assess the changes of swallowing function of patients throughout the initial,middle and final stages of rehabilitation.Results:(1)After 28 days of treatment,the efficacy was assessed as 93.33% in the treatment group and 76.67% in the control group,and the total effective rate in the two groups was significantly different(P<0.01).(2)As to the VFSS score in the treatment group,the score in the prior treatment group was 2.03±1.17 and 6.24±3.49 after treatment;The VFSS score in the control group was 2.25±1.18 and 5.47±2.33 in the before and after treatment.The difference between the two groups was significant.(3)As to the water test grade score in the treatment group,the score in the prior treatment group was 1.83±0.59 and 3.73±1.01 after treatment;the water test grade score in the control group was 1.83±0.69 and 2.87±1.27 before and after treatment.The difference between two groups was tested and showed significant difference(P<0.01).The results suggested that effect of the treatment group on improving the swallowing function of patients with DAS is better than that of the control group.(4)As to the SSA score in the treatment group,the score in the prior treatment group was 36.00±3.67 and 23.47±4.34 in post treatment;The SSA score in the control group was 35.63±3.46 and 29.07±5.56 before and after treatment.The difference between the two groups was tested and showed a significant difference(P<0.01).(5)During the treatment,there was no adverse reaction in the treatment group,and all 60 patients with DAS completed the treatment without shedding cases.Before treatment,fourteenth days and twenty-eighth days,there were no abnormal changes in urine routine,stool routine,blood electrolyte,liver and kidney function,electrocardiogram and other safety indexes in two groups.Conclusion:(1)Both Tongdutiaoshen acupuncture combined with swallowing therapeutic instrument have curative effect in the treatment of DAS.(2)The therapeutic effect of Tongdutiaoshen acupuncture combined with swallowing therapeutic instrument is better than that of simple swallowing therapeutic instrument in increasing VFSS,Kubota Water Swallow Test scores and reducing SSA scores,which can significantly improve the swallowing condition of DAS patients.