| ObjectiveResearch Purpose Based on the theory of "vocal cord belongs to liver ",the clinical efficacy of acupuncture combined with voice training in the treatment of primary muscle tension disphonia(Qi stagnation and blood stasis pattern)was evaluated by multi-dimensional and specific laryngeal muscle oxygen parameters.In order to provide new ideas and methods for clinical treatment,the mechanism of acupuncture treatment was preliminarily discussed.Methods2.1 Systematic Evaluation of Acupuncture in the Treatment of Primary Muscle Tension Vocal DisorderThe following 7 Chinese and foreign language databases are searched systematically: CNKI,VIP,Wang Fang Data,CMB,English database includes Pub Med、The Cochrane Library.Use the combination of theme words and free words to search.Chinese key words include "needle "," acupuncture "," electroacupuncture "," voice disease "," muscle tension and vocal disturbance "," vocal disturbance ",The English key words include acupuncture "" electroacupuncture "" silver needle "" needle pricking "and muscle tension dysphonia".The two were independently screened and extracted,Meet differences and discuss solutions with third parties.Outcome index is VHI-10 scale integral(voice disorder index scale).2.2 Clinical study and mechanism of vocal cord liver acupuncture combined with voice training in the treatment of primary muscle tension vocalization disorderIn this trial,108 patients with primary myotonia were treated with randomized controlled clinical design Obstruction and recruited 40 healthy subjects as normal groups.Acupuncture was used in the test group,Hegu,Taichong,Once every other day,3 joint voice training sessions(1/7 days)per week,40 min/)Treatment;In control group1,acupuncture was used,Hegu,Taichong,Once every other day,3 times/week)for treatment;Voice training(1/7 days,40 min/),The course of treatment was 30 days;The normal group did not intervene.Blood oxygen saturation parameters were collected in four groups before treatment,To detect the difference between the level of laryngeal muscle oxygen saturation and the healthy population.A voice disorder index scale(Voice Handicap Index,)was used in the test and control groups 1 and 2 VHI-10,TCM syndrome subscale The acoustic parameters(frequency perturbation(jitter),amplitude perturbation(shimmer),and the maximum vocal time(maximum phonation time)were used as the subjective evaluation indexes MPT),severe index of dyspronunciation(dysphonia severity index,DSI)and parameters of laryngomyuscular oxygen saturation(suprhyoid muscle group and hyoid muscle group oxygen saturation)as objective evaluation indicators,adverse reactions will also be recorded during treatment.Results3.1 Systematic Evaluation of Acupuncture in the Treatment of Primary Muscle Tension Vocal DisorderTen documents were retrieved,Eight duplicate documents were obtained.By reading the title,abstract and full text,Finally,a Chinese document was included,That is,Chengdu University of traditional Chinese Medicine Wang Lianfeng 2020 master’s thesis "Acupuncture combined with voice training in the treatment of Qi stagnation and blood stasis type muscle tension vocal disorder patients clinical efficacy observation ".The experimental group used acupuncture combined with voice training and behavioral intervention,The control group was treated with simple voice training and behavioral intervention.The selected acupoints are bilateral Yanan 1 point,Kaiyin 1 point,Kaiyin 2 point,Hegu point,Zusanli point,Sanyinjiao point,Taichong point.3.2 Clinical study and mechanism of vocal cord liver acupuncture combined with voice training in the treatment of primary muscle tension vocalization disorder(1)The correlation between laryngeal muscle oxygen saturation and primary muscle tension vocalization disorder: the normal group had significantly higher laryngeal muscle oxygen saturation than acupuncture group,voice training group,acupuncture combined with voice training group MTD patients.There was a significant correlation between laryngeal muscle oxygen saturation and VHI score and DSI.(2)The total scores of acupuncture group,voice training group and acupuncture combined voice training group VHI-10 decreased in turn,and the difference was statistically significant(p<0.05).(3)The results of functional integration of VHI-10 scale:The functional scores of acupuncture group,voice training group,acupuncture combined voice training group VHI-10 the scale decreased in turn,and the difference was statistically significant(p<0.05).(4)The results of physiological score of VHI-10 scale :The physiological scores of acupuncture group,voice training group,acupuncture combined voice training group VHI-10 scale decreased in turn,and the difference was statistically significant(p<0.05).(5)The results of VHI-10 expression scores :There was difference between the two groups after treatment in the VHI-10 expression score of voice training group,acupuncture group and voice training group(p<0.05).(6)GRBAS scale scores:The GRBAS scores of acupuncture group,voice training group and acupuncture combined voice training group decreased in turn,and the difference was statistically significant(p<0.05).(7)Laryngeal muscle tension: After treatment,the incidence of laryngeal muscle tension in acupuncture combined with voice training group was lower than that in voice training group and acupuncture group(p<0.05).There was no significant difference in the incid ence of laryngeal muscle tension between acupuncture group and voice training group.(8)TCM symptom scale score: After treatment,the TCM symptom score of voice training group,acupuncture group and acupuncture combined voice training group decreased in turn,and the difference was statistically significant(p<0.05).(9)Acoustic parameters of voice: The difference between the three groups was statistically significant(p<0.05).The Jitter 、Shimmer of acupuncture group,voice training group and acupuncture combined voice tra ining group decreased,the MPT increased and the DSI increased in turn,and the difference was statistically significant(p<0.05).(10)Blood oxygen saturation of hyoid muscle group: The difference between acupuncture group and voice training group was statistically significant(p<0.05).There was no significant difference before and after treatment in voice training group.The blood oxygen saturation of hyoid muscle group in acupuncture group and voice training group was better than that in voice training group.training group,acupuncture group and acupuncture combined voice training group decreased in turn,and the difference was statistically significant(p<0.05).Conclusion4.1 Systematic Evaluation of Acupuncture in the Treatment of Primary Muscle Tension Vocal DisorderThe number of literature included in this study is small,which is not enough to make a systematic conclusion on the safety and effectiveness of acupuncture in the treatment of primary muscle tension vocal dysfunction.In addition,there are some limitations in the literature included in this study,including small sample size,low frequency of acupuncture intervention,no single acupuncture control group and so on.4.2 Clinical Study and Mechanism of Treatment of Primary Muscle Tension Vocal Disorder(Qi-stagnation and Blood Stasis pattern)by Acupuncture Combined with Voice Training(1)Laryngeal muscle oxygen content is related to MTD and can be used as a specific index to evaluate mtd efficacy.(2)Acupuncture combined with voice training and simple acupuncture can effectively treat patients with primary muscle tension vocal disorder(Qi stagnation and blood stasis pattern),especially in improving emotional anxiety(VHI-10 emotional integral)and systemic symptoms(TCM syndrome scale integral)of patients.(3)Simple and combined acupuncture treatment can effectively improve the parameters of laryngeal muscle oxygen,suggesting that the mechanism of acupuncture treatment in patients with primary muscle tension vocal dysfunction(Qi stagnation and blood stasis pattern)may be related to the improvement of laryngeal muscle oxygen metabolism.(4)Acupuncture combined with voice training is a more optimized treatment plan,which is worthy of clinical application. |
