RÉSUMÉ
Objective By observing the effect of deeply needling Lianquan (CV23) plus acupuncture at the ten nape points on the deglutition function in post-stroke pseudobulbar palsy, to objectively evaluate the efficacy of deeply needling Lianquanplus acupuncture at the ten nape points in treating post-stroke pseudobulbar palsy.Method A total of 141 patients diagnosed with post-stroke pseudobulbar palsy were divided into a treatment group (71 cases) and a control group (70 cases) by following asimple-randomized design (random number table). The treatment group was intervened by deeply needling Lianquan plus acupuncture at the ten nape points, while the control group was intervened by conventional acupuncture. A month later, the general therapeutic efficacy, Kubota's water drinking test, Toshima Ichiro's swallowing assessment, and Standardized Swallowing Assessment (SSA) were evaluated, and the therapeutic efficacies of the two groups were compared.Result The general therapeutic efficacy, waterdrinking test result, Toshima Ichiro's swallowing assessment, and SSA score were significantly improved in both groups after the treatment (P<0.05). After the treatment, the general therapeutic efficacy, water drinking test result, Toshima Ichiro's swallowing assessment, and SSA score in the treatment group were significantly different from those in the control group (P<0.05), and the treatmentwas superior to the control group. The total effective rate was 91.5% in the treatment group, versus 70.0% in the control group, and the between-group difference was statistically significant (P<0.05).Conclusion Deeply needling Lianquan plus acupunctureat the ten nape points is effective in treating post-stroke pseudobulbar palsy, superior to the conventional needling method.
RÉSUMÉ
Objective To observe the therapeutic efficacy and action mechanism of muscle-region alignment electroacupuncture in treating post-stroke shoulder pain. Method Eighty patients were randomized into a muscle-region alignment needling group and a conventional acupuncture group. The Short-form McGill Pain Questionnaire (SF-MPQ), and serum levels of IL-6, TNF-?, and NO were majorly observed before and after the treatment. Result The muscle-region alignment electroacupuncture and conventional acupuncture both obviously reduced the SF-MPQ score and down-regulated the serum levels of IL-6, TNF-?, and NO, and the decreases by the muscle-region alignment electroacupuncture were more significant than that by the conventional acupuncture. Conclusion The action of muscle-region alignment electroacupuncture in treating post-stroke shoulder pain is plausibly by down-regulating serum levels of IL-6, TNF-?, and NO, reducing or inhibiting the production of inflammatory factors and restraining inflammation.
RÉSUMÉ
Objective To observe the clinical effect of digital acupoint pressure on sensory dysfunction in hemiplegic patients after stroke. Methods From March to December, 2015, 60 hemiplegic patients with sensory dysfunction after stroke were randomly divided into control group and observation group with 30 cases in each group. The control group received routine rehabilitation exercise, while the obser-vation group received digital acupoint pressure in addition. Fugl-Meyer Assessment for Sense (FMA-S), Fugl-Meyer Assessment for Motor (FMA-M) and modified Barthel index (MBI) were used to evaluate the sensory dysfunction, motor function and activities of daily living be-fore and eight weeks after treatment. Results After treatment, the scores of FMA-S, FMA-M and MBI increased in both groups (t>6.430, P2.100, P<0.05). Conclusion Digital acupoint pressure can facilitate the recovery of sensory dysfunction, improve the motor function and the activties of daily living in hemiplegic patients after stroke.
RÉSUMÉ
Objective To investigate the correlation between clinical presentations and the findings of video fluoroscopic swallowing study (VFSS)in patients with post-stroke dysphagia. Methods A total of 56 consecutive patients with post-stroke dysphagia admitted to Wenzhou Hospital of Traditional Chinese Medicine Affiliated to Zhejiang Chinese Medical University from June 2012 to May 2014 were enrolled. Four different kinds of food were selectively used to complete clinical assessment of swallowing function and VFSS respectively. The SPSS 20. 0 statistical software was used to perform univariate and multivariate Logistic regression analyses for all observed indexes of the 2 methods. Results there were significant correlations in the point correspondence relation among the clinical manifestations and VFSS in food residue in the mouth and abnormal closure of lips in the oral phase (95%CI 1. 430-101. 468;P=0. 022);poor soft palate elevation and food residue in the mouth (95%CI 1. 476-102. 033;P=0. 020);graded swallowing and piecemeal deglutition with delayed oral transit (95% CI 2. 616 -182. 897;P = 0. 004);tongue movement disorders,poor soft palate elevation and tongue dyskinesia with poor bolus formation (95%CI 1. 468-50. 795,1. 220-13. 825;P=0. 017,0. 023);food leak from the corner of mouth,dysphagia,bolus falling to the epiglottis from the base of tongue or trachea (95%CI 1. 146-125. 459,1. 657-174. 400;P=0.038,0. 017). The weakened pharyngeal reflex with weak laryngeal elevation in the pharyngeal phase (95%CI 1. 150-92. 815;P =0. 037);dysphagia and delayed swallowing with prolonged triggering of swallowing reflex (95%CI 2. 123-37. 770,1. 233-114. 176;P=0. 003,0. 032);graded swallowing,hard swallowing, choking sensation,and poor laryngeal elevation with prolonged pharyngeal transit (95%CI 1. 619-223. 316,1. 061-31. 445,2. 834 -132. 707;P =0. 019,0. 042,and 0. 003);dysphagia and the opening of cricopharyngeal muscle insufficiency (95%CI 1. 037 -24. 115;P =0. 045);weak laryngeal elevation,foreign body sensation in the throat,and choking after swallowing with food retention or residual in vallecula or pyriform sinus (95%CI 1. 046 -13. 685,1. 116 -87. 741;P =0. 043, 0.040);and coughing during swallowing and eating choking or aspiration (95%CI 0. 010-0. 921,0. 037-0. 826;P=0. 042,0. 028). Conclusion Some clinical manifestations are closely correlated with the swallowing dysfunction revealed by VFSS. With the help of this law,it may more simply and safely determine the degree and type of dysphagia in patients,and provide guidance for patients with dysphagia after stroke who can not accept VFSS in the rehabilitation treatment.