Clinical observation of Tongdu Tiaoshen acupuncture combined with swallowing therapy device in the treatment of post-stroke dysphagia

doi:10.3877/cma.j.issn.2095-123X.2024.06.005

Abstract

Abstract:

Objective

To observe the effect of Tongdu Tiaoshen acupuncture combined with swallowing therapy device on swallowing function in patients with post-stroke dysphagia （PSD）.

Methods

One hundred PSD patients admitted to Hefei Second People's Hospital for rehabilitation from June 2021 to June 2023 were selected as the research subjects. According to the random number table method，the patients were divided into an observation group （n=50） and a control group （n=50）. The control group received routine swallowing function training combined with a swallowing therapy device，while the observation group used the Tongdu Tiaoshen acupuncture method in combination with the control group.The patient's oral transit time （OTT），pharyngeal transit time （PTT），hyoid bone superior movement（HSM），and upper esophageal opening （UO） of the cricopharyngeal muscle，nutritional support time，autonomous feeding time，hospitalization time，and incidence of adverse reactions were recorded. The patient's nutritional status and prognosis were evaluated，and the clinical efficacy was determined based on the grading changes of the water swallowing test （WST） before and after treatment.

Results

After treatment，the SSA scores of both groups decreased compared to before treatment，while the FOIS scores increased compared to before treatment，the SSA scores of the observation group were lower than that of the control group，and the FOIS scores were higher than that of the control group，with statistically significant differences （P＜0.05）. After treatment，the OTT and PTT of both groups decreased compared to before treatment，while HSM and UO increased compared to before treatment，the observation group had lower OTT and PTT than the control group，while HSM and UO were higher than the control group，with statistically significant differences （P＜0.05）. The nutritional support time，independent eating time，and hospitalization time of the observation group patients were shorter than those of the control group，and the differences were statistically significant （P＜0.05）. The total effective rate of the observation group was 96.0%，which was higher than that of the control group （86.0%），and the difference was statistically significant （P＜0.05）.

Conclusion

The use of Tongdu Tiaoshen acupuncture combined with swallowing therapy device can improve patients' oral and pharyngeal swallowing conditions，promote autonomous eating，reduce nutritional support and hospitalization time，shorten oral feeding time，and help improve PSD.

Key words: Stroke, Post-stroke dysphagia, Tongdu Tiaoshen acupuncture, Swallowing therapy device, Video fluoroscopic swallowing study

Xingchun Zan, Jixiang Xu, Peng He, Yinliang Qi, Xiaomei Zhou. Clinical observation of Tongdu Tiaoshen acupuncture combined with swallowing therapy device in the treatment of post-stroke dysphagia[J]. Chinese Journal of Brain Diseases and Rehabilitation(Electronic Edition), 2024, 14(06): 346-352.

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References 27

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组别	例数	性别（男/女）	年龄（岁，Mean±SD）	卒中类型
组别	例数	性别（男/女）	年龄（岁，Mean±SD）	脑出血	脑梗死
观察组	50	30/20	60.24±5.94	22	28
对照组	50	31/19	59.26±6.12	23	27
χ²/t值		0.042	0.812	0.040
P值		0.838	0.419	0.841

组别	例数	性别（男/女）	年龄（岁，Mean±SD）	卒中类型
组别	例数	性别（男/女）	年龄（岁，Mean±SD）	脑出血	脑梗死
观察组	50	30/20	60.24±5.94	22	28
对照组	50	31/19	59.26±6.12	23	27
χ²/t值		0.042	0.812	0.040
P值		0.838	0.419	0.841

组别	例数	SSA评分（Mean±SD）				FOIS评分[M（P₂₅，P₇₅）]
组别	例数	治疗前	治疗3周	t值	P值	治疗前	治疗3周	Z值	P值
观察组	50	37.12±2.45	21.16±4.05	24.521	＜0.001	2.5（2，3）	5（4，6）	-6.073	＜0.001
对照组	50	36.90±3.78	28.30±5.11	9.425	＜0.001	2（2，3）	4（3，5）	-5.189	＜0.001
t/Z值		0.345	-7.739			-0.603	-4.431
P值		0.731	＜0.001			0.546	＜0.001

组别	例数	SSA评分（Mean±SD）				FOIS评分[M（P₂₅，P₇₅）]
组别	例数	治疗前	治疗3周	t值	P值	治疗前	治疗3周	Z值	P值
观察组	50	37.12±2.45	21.16±4.05	24.521	＜0.001	2.5（2，3）	5（4，6）	-6.073	＜0.001
对照组	50	36.90±3.78	28.30±5.11	9.425	＜0.001	2（2，3）	4（3，5）	-5.189	＜0.001
t/Z值		0.345	-7.739			-0.603	-4.431
P值		0.731	＜0.001			0.546	＜0.001

项目		观察组（n=50）	对照组（n=50）	t/Z值	P值
OTT[s，M（P₂₅，P₇₅）]	治疗前	2.76（1.3，4.11）	2.76（1.11，4.12）	-0.052	0.959
	治疗后	1.53（0.96，2.03）	2.1（1.09，2.93）	-2.365	0.018
	Z值	-5.237	-4.122
	P值	＜0.001	＜0.001
PTT（s，Mean±SD）	治疗前	3.68±0.46	3.72±0.45	-0.341	0.734
	治疗后	0.88±0.28	1.56±0.35	-10.861	＜0.001
	t值	39.29	25.286
	P值	＜0.001	＜0.001
HSM（mm，Mean±SD）	治疗前	15.28±2.80	15.45±2.49	-0.321	0.749
	治疗后	21.51±2.29	18.38±3.12	5.725	＜0.001
	t值	-13.292	-6.656
	P值	＜0.001	＜0.001
UO（mm，Mean±SD）	治疗前	0.27±0.16	0.30±0.11	-0.954	0.343
	治疗后	0.72±0.05	0.58±0.02	18.617	＜0.001
	t值	-19.536	-17.052
	P值	＜0.001	＜0.001

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