[Clinical effect of "Tong Guan Li Qiao" needling method combined with swallowing training in the treatment of post-stroke dysphagia and its influence on surface electromyography and cerebral microcirculation].

OBJECTIVE: To observe the clinical efficacy of "Tong Guan Li Qiao"(unblocking gates and orifices) needling method combined with swallowing training in the treatment of post-stroke dysphagia (PSD) and its effect on surface electromyography (sEMG) and cerebral microcirculation. METHODS: A total of 116 patients with PSD were randomly divided into observation group (n=59) and control group (n=57). Patients in the control group received swallowing training on the basis of conventional treatment, whereas those in the observation group additionally received "Tong Guan Li Qiao" needling treatment, both groups were treated for 4 weeks. Swallowing function was assessed by video fluoroscopic swallowing study (VFSS) and standar-dized swallowing assessment (SSA) scale, the clinical efficacy was calculated. The sEMG was detected by a full-featured electromyography, the average EMG (AEMG), integrated EMG (IEMG) and peak value were calculated. Cerebral blood flow peak systolic velocity (PSV), end-diastolic velocity (EDV), mean velocity (MV) and pulse index (PI) were detected by cerebrovascular color Doppler ultrasound. RESULTS: The total effective rate of the observation group was 94.92% (56/59), higher than 82.46% (47/57) of the control group(P<0.05). After treatment, the initial scores, the scores of drinking 5 mL and 60 mL of water in the two groups were significantly lower than those before treatment (P<0.05), and the scores of drinking 5 mL and 60 mL of water in the observation group were lower than those in the control group (P<0.05). Compared with the same group before treatment， the AEMG, peak value， IEMG were higher (P<0.05)， PSV, EDV and MV were faster (P<0.05) while PI was lower(P<0.05) in the two groups after treatment. Compared with the control group, the AEMG, peak value， IEMG were higher (P<0.05)， PSV, EDV and MV were faster (P<0.05) while PI was lower (P<0.05) in the observation group. CONCLUSION: "Tong Guan Li Qiao" needling method combined with swallowing training can effectively improve cerebral microcirculation, enhance the motor function of swallowing muscles and promote the recovery of swallowing function in treating PSD patients.