The Study Of Clinical Observation On Pseudobulbar Paralysis And Dysphagia After Stroke By Three-acupoint Of Tongue Embedding

ObjectiveBy observing the effect of three-acupoint of tongue embedding on the treatment of pseudobulbar paralysis and dysphagia after stroke,and the improvement of the swallowing function,this paper focuses on the new ideas and solutions treating dysphagia,caused by stroke.MethodsSixty patients,fulfilling the criteria with the syndrome of dysphagia after-stroke,is picked to diagnosed in the First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine,Acupuncture and Rehabilitation Area 1,Acupuncture and Rehabilitation Area 2,and Acupuncture Clinic from Feb 2018 to Feb 2019.These sixty chosen patients were randomly divided into two groups:the embedding group(three-acupoint of tongue embedding group)and the acupuncture group(three-acupoint of tongue acupuncture group).Each of group was given the same basic Chinese and Western medicine for stabilization.According to the condition,and the problem of limb paralysis after-stroke,regular needle acupunctural treatment is applied.For the patients who are enrolled,uniform swallowing function training(oral sensory exercise training,manual exercise,transcutaneous electrical stimulation,and feeding training)is performed.The treatment group was cured with three-acupoint of tongue embedding thread.The proposal of acupoints was as following:three-acupoint of tongue,and a matching point in the Hot and enthusiasm type selected points:Zhongwan,double-side Zhigou,Tianshu.Liver yang type selected points:double-side Fengchi,Taixi,Taichong.Wind phlegm blocking certificate type selected points:double-side Fengchi,Fenglong,Taichong.The deficiency of Qi and blood-stasis type selected points:double side Xuehai,Zusanli,Sanyinjiao.Yin deficiency type selected points:double-side Fengchi,Taixi,Sanyinjiao.The control group was cured with three-acupoint of tongue acupuncture treatment.Besides,the acupoints were the same as previous.The treatment group was cured once every 7 days,4 weeks as 1 course period of treatment,and the control group was cured by acupuncture every day,within one day off every 6 days,and 4 weeks as 1 course period of treatment.Both groups received a total of 1 course period of treatment.Before the treatment,after 2-weeks treatment and after 4-weeks treatment,the patient's Water-Drinking Test grading and Standardized Swallowing Assessment(SSA)were recorded.Clinical studies were performed by using SPSS 22.0 for statistical analysis.Results1.Before the treatment,in terms of the gender,age,duration of disease,dialectical classification,stroke type,Water-Drinking Test' s grading,SSA score,there was no significant difference between these two groups(P>0.05),suggesting that the embedding treatment group and acupuncture group were comparable.2.Comparison on Water-Drinking Test:Comparison inside each group:Embedding treatment group:based on statistic analysis,comparing the performance of after 2-weeks treatment,after 4-weeks treatment with the performance before the treatment,all the curative impact has declined greatly(P<0.05).Acupuncture control group:based on statistic analysis,comparing the performance of after 2-weeks treatment,after 4-weeks treatment with performance before the treatment,the curative impact after 2-weeks presented slightly decline(P>0.05),and curative impact after 4-weeks presented huge decline.(P<0.05).Comparison between the groups:Overall,there is no statistic value to compare the performance between groups on Water-Drinking Test(P>0.05),which demonstrates the curative impact has no difference between these two groups.However,the difference on time and interaction both have statistic value(P<0.05).Before the treatment,the performance of Embedding group and Acupuncture control group are pretty similar,so there is no statistic value(P>0.05).After 2-weeks treatment,the performance of Embedding group and Acupuncture control group are pretty similar,so there is no statistic value(P>0.05).After 4-weeks treatment,compare Embedding Groups and Acupuncture control group,Embedding group has much better performance,the difference has statistic value(P<0.05).3.Comparison on SSA Score RatingComparison inside each group:Based on statistic analysis,comparing the performance of after 2-weeks treatment,after 4-weeks treatment with the performance before the treatment,both Embedding group and Acupuncture control group both have huge declined curative impact.(P<0.05)Comparison between the groups:Overall,there is no statistic value to compare the performance between groups on SSA Score Rating(P>0.05),which states the curative impact has no difference between these two groups.However,the difference on time and interaction both have statistic value(P<0.05).Before the treatment,the SSA score of Embedding group and Acupuncture control group are pretty close,so there is no statistic value(P>0.05).After 2-weeks treatment,the SSA score of Embedding group and Acupuncture control group has difference,so there is some statistic value(P<0.05).After 4-weeks treatment,compare Embedding Groups and Acupuncture control group,Embedding group has much better SSA score,the difference has statistic value(P<0.05).4.The overall evaluation of clinical efficacy:the total effective rate of the three-acupoint of tongue embedding treatment group was 96.67%,in which 2 cases were cured,17 cases were extraordinary effective,10.cases were effective,and 1 case was ineffective.The total effective rate of the acupuncture control group was 93.33%,in which 0 case was cured,3 cases were evidently effective,25 case were effective,and 2 cases were ineffective.According to the numbers,the curative effect of the Embedding group was much better than that of the Acupuncture control group.With Rank Sum Test,the comparison of curative impact between these two groups has statistic value(P<0.05).Moreover,Embedding Group presented a much better curative impact than Acupuncture control group.Therefore,it turned out that the effect of the three-needle embedding is better.ConclusionThe three-acupoint of tongue embedding and three-needle acupuncture treatment both have curative effect on the treatment of symptoms of dysphagia after-stroke.To sum up,the curative effect of both two methods will be obvious within one-month treatment.Nonetheless,at the forth week treatment,the treatment effect of three-needle embedding is greatly better than three-acupoint treatment,which clarifies the advantage of embedding treatment presents in later period of the treatment.On top of that,according to the clinical performance,the efficiency of the Embedding group is greatly higher than Acupuncture Control group.Thus,the three-acupoint of tongue embedding treatment of dysphagia is not only effective,but also has three advantages:effective treatment with only couple of times,low cost,and long duration of treatment.In other words,it is worthwhile working on clinical promotion in further research.