Zhang Chun-Hong, Bian Jin-Ling, Meng Zhi-Hong, Meng Li-Na, Ren Xue-Song, Wang Zhi-Lin, Guo Xiao-Yan, Shi Xue-Min
Department of Acupuncture and Moxibustion, the First Teaching Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Department of Acupuncture and Moxibustion, Tianjin University of Traditional Chinese Medicine, Tianjin, China.
Neural Regen Res. 2016 Feb;11(2):285-91. doi: 10.4103/1673-5374.177737.
Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group (n = 22), a midbrain and pons infarction group (n = 16), and a multiple cerebral infarction group (n = 26) according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan (PC6), Renzhong (DU26), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), and Yifeng (SJ17). Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction (95.9%). These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient's swallowing ability and quality of life.
通关利窍针刺疗法已被证明能有效治疗中风后假性球麻痹所致的吞咽困难。我们推测该疗法对脑干梗死患者的延髓麻痹后吞咽困难也有效。招募了64例脑干梗死伴吞咽困难的患者,根据磁共振成像结果将其分为延髓梗死组(n = 22)、中脑和脑桥梗死组(n = 16)和多发性脑梗死组(n = 26)。所有患者均接受通关利窍针刺治疗28天。主要穴位为内关(PC6)、人中(DU26)、三阴交(SP6)、风池(GB20)、完骨(GB12)和翳风(SJ17)。此外,对咽后壁进行点刺。治疗前后,采用久保田饮水试验、藤岛一郎评分量表和标准吞咽评估对患者的吞咽功能进行评估。还采用Barthel指数评估他们的生活质量。结果显示,治疗28天后,各组久保田饮水试验和标准吞咽评估的评分降低,但藤岛一郎评分量表和Barthel指数的评分升高。治疗后总有效率为92.2%,在延髓梗死患者中最为明显(95.9%)。这些结果表明,通关利窍针刺疗法可修复上运动神经元与延髓运动核的连接,促进脑干梗死的恢复,提高患者的吞咽能力和生活质量。