A Randomized Controlled Study On Therapeutic Effect Of Acupuncture For Stroke Pseudobulbar Palsy Dysphagia

Objectives:To observe the therapeutic effects and long-term efficacy of acupuncture for dysphagia after pseudobulbar palsy and its effect to reduce the complications by a randomized controlled clinical trial which maybe an easy,economical and safe treatment method to promo for patients.Method:Consecutive pseudobulbar palsy dysphagic subjects with routine swallow management were randomized to receive 20 sessions of acupuncture(treatment group)or no acupuncture group(control group).Each group recruited 40 subjects.For the first course of treatment,sessions 1 to 10,subjects of treatment group received acupuncture on consecutive days.And for the second course,sessions 11 to 20,subjects received acupuncture on alternative days.There was one week rest for the subjects without acupuncture between first and second courses.Each treatment session was 30 minutes in duration.Acupoints used were GB12,GB20,SJ17,CV23 and the post pharyngeal wall.The outcome measures used were the Royal Brisbane Hospital Outcome Measure for Swallowing(RBHOMS)and the food and fluid consistencies.The body mass index(BMI),aspiration pneumonia and mortality rate were observed during the study period.Assessments were undertaken at baseline,after 10th session of treatment,after the 20th session of treatment,and at three months after the last session of treatment.They were carried out by blinded physician and speech therapists.Results:1.Within group analyze of the results of RBHOMS,food and fluid consistencies after treatments to baseline,there were remarkable statistical significate difference for the treatment group(p<0.01)but no significance for the control group(p>0.05).2.Comparing results of both groups of follow-up to baseline,there were significate difference shown for RBHOMS(p<0.01),food consistency(0<0.01)and fluid consistency(p<0.05).3.There were 4 and 8 subjects got aspiration pneumonia for the treatment group and control group respectively throughout the research period.There was no statistical significance between two groups(p>0.05).There were 4 and 8 subjects dead for the treatment group and control group respectively throughout the study period.There was no statistical significance between two groups(p>0.05).Conclusions:1.This study demonstrate that acupuncture plus routine swallow management had significate therapeutic effect on dysphagia after pseudobulbar palsy with compare to routine swallow management alone.2.Acupuncture plus routine swallow management showed long-term efficacy on dysphagia after pseudobulbar palsy with compare to routine swallow management alone.3.Acupuncture plus routine swallow management may reduce the chance of having aspiration pneumonia with enough stimulation after 2 courses of treatment.This study cannot show the effect of acupuncture on reducing the death rate of dysphagic patients.