Clinical Study Of Tongue Acupuncture Combined Motor Imagery Therapy In Rehabilitation Nursing Of Patients With Dysphagia After Stroke

Objective: To observe and compare in swallowing ability and quality of life between patients with dysphagia after stroke after treatment of of tongue acupuncture and tongue acupuncture combined motor imagery therapy through randomized controlled methods,and to explore the clinical efficacy of tongue acupuncture combined motor imagery therapy in rehabilitation nursing of patients with dysphagia after stroke.Methods: In strict accordance with the inclusion criteria,60 patients with post-stroke dysphagia admitted to the Department of Acupuncture and Moxibustion of Hubei Provincial Hospital of Traditional Chinese Medicine from July 2017 to May 2018 were selected in this study.According to the random number table method,they were randomly divided into the tongue acupuncture group and the tongue acupuncture combined motor imagery therapy group,30 cases in each group.Basic treatment?tongue acupuncture therapy and dialectical nursing were used in both groups.Basic treatment:All patients included were treated with the routine treatment of clinical Chinese medicine clinical path of stroke,a key Acupuncture Specialist of State Administration of Traditional Chinese Medicine,namely conventional acupuncture treatment such as head and limbacupuncture,intravenous infusion of nutrient nerves and improvement of blood circulation drugs.Routine rehabilitation therapy included hemiplegic limb function training? swallowing dysfunction training and speech training,etc.Tongue acupuncture therapy: the acupuncture points of the tongue were Lianquan,Juquan,Haiquan,Jinjin and Yuye.Jinjin,Yuye,and Haiquan are all shallow punctured.After the needle was inserted into the Juquan piont,the needle was punctured along the tongue to the base of the tongue.The depth of the needle could reach 0.8-1.2 inches.There was a small amount of bleeding after the Jinjin,Yuye,Haiquan and Juquan points.After the needle was inserted into Lanquan,needle was punctured to the center of the tongue and to the left and right sides of the tongue.and the depth of the needle was 1.2-1.5 inches;All acupoints were treated with neutral supplementation and draining method.Dialectical nursing:According to the actual situation of the patients,the nursing was carried out from four aspects of the living,emotional care,dialectical diet,and rehabilitation training.In the tongue acupuncture combined motor imagery therapy group,the motor imagination therapy was added on the basis of the tongue acupuncture therapy,and the rehabilitation guidance was given to patients through the motor imagination instruction prompt.The treatment of the tongue acupuncture was treated once a day,6 times a week,with a one-day interval;the rest of the treatment were once a day.7 days was a course of treatment,a total of 4 courses of treatment.SPSS20.0software was used to process all data collected.T test was used for count data,and rank sum test was used for rank data analysis.At the initial diagnosis,2 weeks ± 2 days,4 weeks ± 2 days,the main outcome indicator,the kubota drinking water test and the secondary outcome indicators,the kubota swallowing ability evaluationmethod,the kubota swallowing dysfunction assessment method,and quality of life instruments for stroke patients(QOLISP)were observed to compare the intervention effects of the two treatment methods.Results: 1.No patients were lost during the study,and 60 patients who met the criteria were finally included.30 patients were in the tongue acupuncture group and 30 patients were in the tongue acupuncture combined motor imagery therapy group.The basic information such as age,sex,duration of disease and type of stroke in the experimental group and the control group were compared,showing no significant difference between the data groups(P>0.05);The kubota drinking water test,the kubota swallowing ability evaluation method,the kubota swallowing dysfunction assessment method,and QOLISP of the two groups before treatment were compared.The results showed that there was no significant difference between the two scales(P>0.05).Comprehensive analysis,the two groups were balanced at baseline and the conditions were comparable.2.Clinical efficacy:(1)The comparison between the two groups showed that the evaluation criteria of Kubota water swallowing test and the kubota swallowing ability evaluation method,the kubota swallowing dysfunction assessment method,and QOLISP improved after 2 weeks ± 2 days compared with that before the treatment(P<0.05).After 4 weeks ± 2 days,the improvement was further improved after 2 weeks ± 2 days.Before and after comparison,the difference was statistically significant(P<0.05).It indicated that the two groups had improved effects on swallowing function and quality of life,and the effect was further improved within 4 weeks.The swallowing function and the life quality of patients were gradually improved.(2)Comparison between groups: after 2 weeks ±2 days of treatment,Kubota water swallowing test and the kubotaswallowing ability evaluation method,the kubota swallowing dysfunction assessment method,and QOLISP improved(P<0.05);After4 weeks±2 days of treatment,the scores of each index were compared again,and the difference between groups was statistically significant(P<0.05),indicating that both groups had improved swallowing ability and living ability.However,the improvement of the tongue acupuncture combined motor imagery therapy group was significantly better than that of tongue acupuncture group.Conclusion: 1.Tongue acupuncture combined motor imagery therapy for the treatment of post-stroke dysphagia can promote the recovery of muscle strength of the glossopharyngea,improve the swallowing function of patients,and improve the quality of life of patients.2.The curative effect of this treatment is better than that of simple tongue acupuncture and the long-term curative effect is affirmative,in order to obtain clinical promotion and application.