Jin Hai-Peng, Li Xiang-Liang, Ye Qing-Jing, Wang Yong
Department of Acupuncture and Rehabilitation, Xiamen Hospital of Beijing University of Chinese Medicine, Xiamen 361009, Fujian Province, China.
Zhen Ci Yan Jiu. 2020 Jun 25;45(6):473-9. doi: 10.13702/j.1000-0607.190697.
To investigate the effect of electrical stimulation with bilateral scalp acupuncture on time parameters in video fluoroscopic swallowing study and cortical excitability in patients with dysphagia after cortical stroke, as well as its possible mechanism of action.
A total of 84 patients with dysphagia after cortical stroke were randomly divided into control group with 41 patients and observation group with 43 patients. The patients in the control group were given acupuncture based on acupoint selection for pseudobulbar palsy, and in addition to the treatment in the control group, the patients in the observation group were given electrical stimulation of bilateral scalp acupuncture, with acupuncture and pulse acupuncture at the lower 2/5 of the bilateral anterior oblique parietotemporal lines[on the line connecting Qianshencong (EX-HN1) to Xuanli (GB6)] and the lower 2/5 of the bilateral posterior oblique parietotemporal lines [on the line connecting Baihui (GV20)and Qubin (GB7)], with a needle retaining time of 30 minutes, once a day and 6 times a week for 3 weeks. Before treatment and after 3 weeks of treatment, oral delay time (ODT), oral transit time (OTT), pharyngeal delay time (PDT), and pharyngeal transit time (PTT) were compared between the two group; the Rosenbek Penetration-Aspiration Scale was used to evaluate penetration-aspiration and appro-ximate entropy (ApEn) of EEG nonlinear index.
After treatment, both groups had significant reductions in ODT, OTT, PDT, PTT, and Rosenbek Penetration-Aspiration score and a significant increase in ApEn (<0.05). Compared with the control group after treatment, the observation group had significant reductions in ODT and OTT (<0.05) and significant increases in the ApEn values of bilateral central, parietal, and posterior temporal regions (<0.05), while there were no significant differences in PDT, PTT, and Rosenbek Penetration-Aspiration score between the two groups (>0.05).
In addition to body acupuncture, electrical stimulation with bilateral scalp acupuncture can improve ODT and OTT in the treatment of patients with dysphagia after cortical stroke, which may be associated with the increased excitability of the swallowing cortex.
探讨双侧头皮针电刺激对皮质下卒中后吞咽困难患者视频透视吞咽研究中的时间参数及皮质兴奋性的影响及其可能的作用机制。
将84例皮质下卒中后吞咽困难患者随机分为对照组41例和观察组43例。对照组采用假性球麻痹选穴针刺治疗，观察组在对照组治疗基础上，给予双侧头皮针电刺激，针刺双侧前斜顶颞线中下段（神聪穴至悬厘穴连线）及双侧后斜顶颞线中下段（百会穴至曲鬓穴连线），留针30分钟，每日1次，每周6次，共3周。比较两组治疗前及治疗3周后口腔延迟时间（ODT）、口腔通过时间（OTT）、咽部延迟时间（PDT）、咽部通过时间（PTT）；采用Rosenbek渗透-误吸量表评估渗透-误吸情况及脑电图非线性指标近似熵（ApEn）。
治疗后，两组ODT、OTT、PDT、PTT及Rosenbek渗透-误吸评分均显著降低，ApEn显著升高（P<0.05）。治疗后与对照组比较，观察组ODT、OTT显著降低（P<0.05），双侧中央、顶叶及颞后区ApEn值显著升高（P<0.05），两组PDT、PTT及Rosenbek渗透-误吸评分比较差异无统计学意义（P>0.05）。
双侧头皮针电刺激在体针基础上可改善皮质下卒中后吞咽困难患者的ODT和OTT，其机制可能与吞咽皮质兴奋性增加有关。
