Abstract
Objective
This study aimed to compare the effects of Shi's “Tongguan Liqiao” therapy and Gao's cervical acupuncture, combined respectively with swallowing function rehabilitation training, on poststroke dysphagia.
Methods
From June 2019 to December 2020, 120 patients with poststroke dysphagia who were admitted to our hospital were selected and randomly divided into three groups of 40 patients each according to their admission sequence. The control group received standard pharmaceutical treatment + conventional swallowing rehabilitation training. Study group A received additional Shi's “Tongguan Liqiao” therapy. Study group B received additional Gao's cervical acupuncture therapy. After 4 weeks of treatment, the efficacy of the three groups was evaluated, and the results of the water swallow test, Fujishima Ichiro's swallowing disability scale, and Barthel index were compared before treatment, after 2 weeks, and after 4 weeks. After 4 weeks of treatment, the incidence of aspiration pneumonia and the duration of nasogastric tube retention were compared among the three groups.
Results
(1) After 4 weeks of treatment, the total effective rates of study groups A and B were both higher than those of the control group (χ2 = 6.050, df = 1, P = 0.014; χ2 = 4.588, df = 1, P = 0.032). (2) After 2 weeks of treatment, the water swallow test results of the three groups were all better than before treatment (P < 0.05), and the results of study groups A and B were better than those of the control group (Z = −2.629, −2.741, P = 0.009, 0.006). After 4 weeks of treatment, the control group's water swallow test results were better than before treatment (P < 0.05), but there was no significant difference compared with 2 weeks (P > 0.05). The water swallow test results of study groups A and B were both better than before treatment (P < 0.05) and better than after 2 weeks (P < 0.05), and both were superior to the control group (Z = −2.708, −3.534, P = 0.007, 0.000). (3) After 2 weeks of treatment, Fujishima Ichiro's swallowing disability scale and BI scores of the three groups were all higher than before treatment (P < 0.05), and the scores of study group A were higher than those of the control group (t = 2.697, df = 78, P = 0.009; t = 2.125, df = 78, P = 0.037). The scores of study group B were also higher than those of the control group (t = 2.064, 2.606, P = 0.042, 0.011). After 4 weeks of treatment, Fujishima Ichiro's swallowing disability scale and BI scores of all three groups were higher than before treatment (P < 0.05) and higher than after 2 weeks (P < 0.05). The scores of study group A were higher than those of the control group (t = 3.185, 2.400, P = 0.002, 0.019), and the scores of study group B were higher than those of the control group (t = 3.079, 3.073, P = 0.003, 0.003). (4) The incidence of aspiration pneumonia in study group B was 2.5% (1/40), lower than 20.00% (8/40) in the control group (Fisher's exact test, P = 0.029), but there was no significant difference compared with 7.50% (3/40) in study group A. (5) The nasogastric tube retention time in study group A (21.14 ± 4.93 days) was shorter than that in the control group (30.35 ± 5.26 days) (t = 6.571, P < 0.001). The retention time in study group B (16.43 ± 4.08 days) was shorter than that in the control group (30.35 ± 5.26 days) (t = 11.109, P < 0.001) and shorter than that in study group A (t = 3.875, P < 0.001).
Conclusion
Shi's “Tongguan Liqiao” therapy and Gao's cervical acupuncture, combined respectively with swallowing function rehabilitation training, have similar curative effects on poststroke dysphagia, both improving patients’ swallowing function and performance in activities of daily living. Moreover, Gao's cervical acupuncture showed a significant advantage in shortening nasogastric tube retention time, with a trend toward a lower incidence of aspiration pneumonia compared with Shi's therapy, although this difference was not statistically significant.
Keywords
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