Clinical Study Of Huiyan Zhuyu Decoction Combined With Swallowing Training In The Treatment Of Dysphagia After Stroke

Purpose:To observe the clinical effect of Epiglottis Stasis-Expelling Decoction combined with swallowing training on treating swallowing disorder(qi deficiency and blood stasis syndrome)after stroke,and to find a more effective and feasible therapeutic regimen for clinical treatment of swallowing disorder after stroke.Material and method:Eighty patients who were hospitalized in the Second Affiliated Hospital of Rehabilitation Center of Liaoning University of Traditional Chinese Medicine from November 2016 to August 2017 were selected as participants.They all accorded with the diagnostic criteria and inclusion criteria of swallowing disorder(Qi deficiency and blood stasis syndrome)after stroke.The patients were randomly divided into experimental group(the Epiglottis Stasis-Expelling Decoction combined with swallowing training)and control group(simple swallowing training),40 patients each.They all accepted conventional medication from the neurology department.The experimental group was treated by swallowing training plus the Epiglottis Stasis-Expelling Decoction,while the control group was treated only by swallowing training.The decoction was taken 1 dose daily,divided into 3 times in the morning,noon and evening,orally or by nasal feeding.And the swallowing training was continuously operated for 5 days,then resting for 2 days,every week.15 days served as a course of treatment,and one course of treatment were treated in this experiment.Patients' conditions were scored both before and after treatment by Water swallow test(WST),evaluation criteria of Dysphagia,Standardized Swallowing Assessment(SSA)and TCM syndrome classification and quantification table.T-test was used for the measurement data in the experiment,Rank-sum test for the ranked data,and Chi-square test for the counting data,in order to evaluate the clinical efficacy.Results: 1.Water Swallow Test evaluation of grade: the results of the two groups after treatment were statistically analyzed.Compared with that before the treatment,the results of both groups are statistically significant(P <0.01);and the result of the experimental group is better than that of the control group(P <0.05).Water Swallow Test evaluation of curative effect: total effective rates of experimental and control group are 95% and 87.5% separately.By rank-sum test,the total effective rates of the two groups are statistically different(P <0.05).2.Grade of the evaluation criteria of dysphagia: the results of the two groups after treatment were statistically analyzed.Compared with that before the treatment,the results of both groups were statistically significant(P <0.01);and the result of the experimental group was better than that of the control group(P <0.01).Evaluation criteria of dysphagia of curative effect: total effective rates of experimental and control group are 92% and 80% separately.By rank-sum test,the total effective rates of the two groups are statistically different(P <0.01).3.SSA assessment: the results of the two groups after treatment were statistically analyzed.Compared with that before the treatment,the results of both groups were statistically significant(P <0.01);and the result of the experimental group was better than that of the control group(P <0.01).4.Graded evaluation of TCM syndrome: the results of the two groups after treatment were statistically analyzed.Compared with that before the treatment,the results of both groups were statistically significant(P <0.01);and the result of the experimental group was significantly better than that of the control group(P <0.01).Comparison of curative effect on TCM syndrome: total effective rates of experimental and control group are 82.5% and 32.5% separately.By rank-sum test,the total effective rates of the two groups are statistically different(P <0.01).Conclusion: 1.Both the Epiglottis Stasis-Expelling Decoction combined with swallowing training therapy and simple swallowing training therapy can effectively improve the clinical symptoms of patients with swallowing disorder(qi deficiency and blood stasis syndrome)after stroke,and improve their swallowing function.2.The Epiglottis Stasis-Expelling Decoction combined with swallowing training to treat swallowing disorder after stroke(qi deficiency and blood stasis type)has significant effects on improving symptoms of cough when drinking water,improving nutritional status,and reducing aspiration.3.The Epiglottis Stasis-Expelling Decoction combined with swallowing training therapy can improve the curative effect in TCM symptom of the patients with swallowing disorder(qi deficiency and blood stasis syndrome)after stroke.