To Explore The Effect Of Tongyan Liqiao Acupuncture On The Excitability Of Swallowing Motor Pathway In Patients With Post-stroke Pharyngeal Dysphagia Based On MEP

Objective:To observe the changes of latency and amplitude of motor evoked potential(MEP)of supramehyoid muscle group in patients with pharyngeal dysphagia after stroke by transcranial magnetic stimulation(TMS),and to evaluate the effects of MEP on swallowing function and excitability of swallowing motor pathway by swallowing scale.Methods:62 patients were randomly divided into tongyanliqiao acupuncture group and ordinary acupuncture group by randomized control method,with 31 cases in each group,and 28 cases in each group after 3 cases in each group were lost due to illness,economy and other reasons.The two groups received basic medical treatment and rehabilitation training,and the general acupuncture group chose Lianquan,Fengchi,Wangu,Tongli and Zhaohai.Jiaji point in the neck(C3-C6),Lianquan and Sanyinjiao were selected for tongyanliqiao group.Before treatment and4 weeks after treatment,the motor evoked potentials of suprhyoid muscle group,wauda drinking water test grading and Fujima Ichiro swallowing efficacy score were compared and analyzed between the two groups.Results:1.On the hyoid muscle motion evoked potential(MEP)research results:compared with before treatment,the two groups after treatment increased volatility than before treatment(P<0.05),the incubation period were reduced(P<0.05).After treatment,the effect of tongyanliqiao acupuncture group on wave amplitude and latency was better than that of ordinary acupuncture group(P<0.05).2.Classification of water swallow test:compared with before treatment,classification of water swallow test after treatment was lower in both groups(P<0.05),and tongyan-liqiao acupuncture group was superior to ordinary acupuncture group(P<0.05).3.Evaluation of swallowing efficacy of Ichiro Fujishima:Compared with before treatment,Ichiro Fujishima swallowing efficacy score after treatment was improved in both groups(P<0.05),and tongyanliqiao acupuncture group was superior to ordinary acupuncture group(P<0.05).Conclusions:1.Based on the experience of chief physician Su Jiafu,"Tongyanliqiao acupuncture method" can affect the changes of MEP amplitude and latency of suprahyoid muscles,improve the grade of water swallow test and the score of swallowing efficacy of Ichiro Fujishima,and improve the swallowing function of patients with dysphagia after stroke.2.Through the changes of MEP amplitude and latency of suprahyoid muscles induced by TMS,the effect of "Tongyanliqiao acupuncture method" on swallowing nerve pathway can be observed,which provides objective basis for "Tongyanliqiao acupuncture method" from the point of view of electrophysiology and neuroregulation.