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Title: [Clinical trials of Xingnao Kaiqiao needling combined with respiratory training for post-stroke dysphagia].
Author: Li ZH, Li HM, Ai NN.
Journal: Zhen Ci Yan Jiu; 2021 Oct 25; 46(10):875-9. PubMed ID: 34698463.
Abstract:
OBJECTIVE: To observe the clinical effect of Xingnao Kaiqiao needling combined with respiratory training on swallowing function, quality of life and throat surface muscle function in patients with post-stroke dysphagia. METHODS: A total of 124 patients with post-stroke dysphagia were randomized into an observation group and a control group, 62 cases in each group. On the basis of conventional western medication treatment, respiratory training was applied in the control group, once daily, 5 times a week for 4 weeks. On the base of the treatment as the control group, Xingnao Kaiqiao needling was applied at Neiguan (PC6), Sanyinjiao (SP6), Fengchi (GB20), Wangu (GB12), Yifeng (SJ17), posterior pharyngeal wall, Shuigou (GV26) and Lianquan (CV23) in the observation group, once daily, 6 times a week for 4 weeks. Before and after treatment, the Kubota water swallowing test (KWST) scale, swallowing function, swallowing-quality of life (SWAL-QOL) scale, maximum amplitude of pharyngeal surface electromyography (sEMG), and complications of dysphagia were observed and recorded. RESULTS: After the treatment, self-comparison showed that the KWST and swallowing function scores were significantly decreased (P<0.05), the SWAL-QOL score and sEMG were notably increased in both groups (P<0.05) in comparison with their own pre-treatment. The KWST and swallowing function scores were obviously lower in the observation group than in the control group (P<0.05), whereas the SWAL-QOL score and sEMG were evidently higher in the observation group than in the control group (P<0.05). The total effective rate of the observation group was 95.16% (59/62), which was higher than 80.65% (50/62) of the control group (P<0.05). The incidence of dysphagia complications in the observation group was 24.19% (15/62), which was lower than 50.00% (31/62) of the control group (P<0.01). CONCLUSION: Xingnao Kaiqiao needling combined with respiratory training in the treatment of post-stroke dysphagia can increase the activity of throat muscles, promote the swallowing function, improve the quality of life, and reduce the incidence of dysphagia related complications. 目的：探讨醒脑开窍针刺法联合呼吸训练对脑卒中后吞咽障碍(DAS)患者吞咽功能、生活质量、咽喉部表面肌肉功能的影响。方法：选取2017年6月至2018年10月收治的124例DAS患者，使用简单随机数字表法将其分成观察组(62例)与对照组(62例)。两组均给予相同的常规药物治疗，对照组在此基础上联合呼吸训练治疗，观察组在对照组基础上加用醒脑开窍针刺法治疗，取双侧内关、三阴交、风池、完骨、翳风、咽后壁及水沟、廉泉，除咽后壁、廉泉外均留针30 min，1次/d，每周连续治疗6 d，休息1 d，共治疗4周。对比两组治疗前后洼田氏饮水试验评分、吞咽功能(脑卒中患者神经功能缺损程度评分标准中的吞咽困难亚量表评分)、生活质量［吞咽障碍(DD)特异性生活质量量表(SWAL-QOL)评分］、咽喉部表面肌电图(sEMG)最大波幅、临床疗效、DD相关并发症总发生率和不良反应发生情况。结果：两组治疗后洼田氏饮水试验评分、吞咽功能评分均较治疗前显著降低(P<0.05)，而SWAL-QOL评分、咽喉部sEMG最大波幅均显著升高(P<0.05)；且治疗后观察组洼田氏饮水试验评分、吞咽功能评分低于对照组(P<0.05)，SWAL-QOL评分、咽喉部sEMG最大波幅高于对照组(P<0.05)。观察组总有效率为95.16%(59/62)，对照组总有效率为80.65%(50/62)，观察组总有效率高于对照组(P<0.05)。观察组DD相关并发症的总发生率为24.19%(15/62)，对照组为50.00%(31/62)，观察组DD相关并发症的总发生率显著低于对照组(P<0.01)，且两组不良反应均少而轻微。结论：醒脑开窍针刺法联合呼吸训练治疗DAS能明显增加患者咽喉部肌肉的活动度，有效促进吞咽功能的改善，提高生活质量，降低DD相关并发症的发生风险，疗效确切。.

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