[Clinical effect of Liyan Tongqiao acupuncture in treatment of post-stroke dysphagia: an analysis based on diffusion tensor imaging]

Zhen Ci Yan Jiu. 2020 Dec 25;45(12):985-9. doi: 10.13702/j.1000-0607.200085.
[Article in Chinese]

Abstract

Objective: To investigate the clinical change of post-stroke dysphagia after the intervention of Liyan Tongqiao (relieving sore-throat and dredging orifices)acupuncture using cranial diffusion tensor imaging (DTI).

Methods: A total of 60 patients with post-stroke dysphagia were enrolled and randomly divided into Liyan Tongqiao acupuncture group and neurology treatment group, with 30 patients in each group. The patients in the neurology treatment group were given routine neurology treatment and swallowing rehabilitation training, and those in the Liyan Tongqiao acupuncture group received acupuncture at Sishencong (EX-HN1), Baihui (GV20), bilateral Tai-yang (EX-HN5), and bilateral Fengchi (GB20) and tongue triple acupuncture, with an electroacupuncture apparatus for EX-HN1, bilateral GB20, and tongue triple acupuncture, for a needle retaining time of 30 minutes each time, once a day and 5 times a week, in addition to the treatment in the neurology treatment group. Each course of treatment was 3 weeks, and both groups were treated for 2 courses. Swallowing function assessment and cranial DTI were performed after treatment.

Results: After 6 weeks of treatment, both groups had a marked improvement in swallowing function, a significantly greater change in video fluoroscopic swallowing study (VFSS) score and a higher mean FA value (P<0.05). Compared with the neurology treatment group, the Liyan Tongqiao acupuncture group had a marked improvement in swallowing function, a significantly greater change in VFSS score in the pharyngeal phase and a higher mean FA value (P<0.05).

Conclusion: Liyan Tongqiao acupuncture can improve dysphagia and swallowing function in the pharyngeal phase in VFSS, possibly by promoting the remodeling of cerebral cortex and increasing the FA value of infarct zone through the stimulation of related acupoint signals.

目的:利用头颅弥散张量成像(DTI)技术观察利咽通窍针法治疗脑卒中后吞咽障碍的临床疗效。方法:60例脑卒中后吞咽障碍患者根据随机数字表法随机分为利咽通窍针法组及神经内科组,每组30例。神经内科组予神经内科常规治疗及吞咽康复训练,利咽通窍针法组在神经内科组治疗的基础上针刺四神聪、百会、双侧太阳、双侧风池、舌三针,其中四神聪、双侧风池及舌三针接电针治疗仪,每次留针30 min,均每天治疗1次,每周5次,3周为1个疗程,治疗2个疗程。治疗后进行吞咽功能评估及头颅DTI检测。结果:治疗后,两组患者吞咽功能均有一定程度的改善,利咽通窍针法组优于神经内科组(P<0.05);两组患者口腔期、咽喉期、食管期的透视吞咽功能检查(VFSS)评分较治疗前均有明显提高(P<0.05),其中,利咽通窍针法组咽喉期VFSS评分升高较神经内科组更为明显(P<0.05);两组各向异性分数(FA)值较治疗前均增大(P<0.05),其中利咽通窍针法组大于神经内科组(P<0.05)。结论:利咽通窍针法能改善吞咽困难,可能与针刺刺激相关腧穴的信号使大脑皮质重塑,提高梗死区域的FA值有关。.

Keywords: Diffusion tensor imaging; Dysphagiaa; Liyan Tongqiao acupuncture treatmenta.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Acupuncture Points
  • Acupuncture Therapy*
  • Deglutition Disorders* / etiology
  • Deglutition Disorders* / therapy
  • Diffusion Tensor Imaging
  • Drugs, Chinese Herbal
  • Humans
  • Stroke* / complications
  • Stroke* / therapy
  • Treatment Outcome

Substances

  • Drugs, Chinese Herbal
  • liyan