Clinical Study Of "Huatan Tongfu" Acupuncture Prescription In Treatment Of Dysphagia After Severe Stroke Undergoing Tracheotomy With Phlegm-Heat And Fu-viscere Excess Type

ObjectiveBy observing the difference of therapeutic effect of Huatan Tongfu acupuncture prescription and neuromuscular electrical stimulation in treatment of dysphagia after severe stroke undergoing tracheotomy with Phlegm-heat and Fu-viscere excess type,and to provides a new idea and method for the treatment of dysphagia after severe stroke undergoing tracheotomy with Phlegm-heat and Fu-viscere excess type by acupuncture.Methods72 patients with dysphagia after severe stroke undergoing tracheotomy with Phlegm-heat and Fu-viscere excess type who met the inclusion criteria were divided into a control group and a treatment group,36 patients in each group,all of them were given basic treatment.The control group was treated with neuromuscular electrical stimulation;the treatment group was treated with Huatan Tongfu acupuncture prescription;both groups were treated from Monday to Saturday,30 min/time for 4 weeks.The changes of standardized swallowing assessment(SSA),penetration-aspiration scale(PAS),tracheostomy cough reflex grading score(TCRGS),the sputum of the paitens and TCM syndrome score were observed before and after treatment,and evaluate incidence of aspiration pneumonia and the extubation success rate of the two groups.The data were statistically analyzed by SPSS 22.0.ResultsA total of 68 cases completed the clinical trial observation and 3 cases fell off,1 case eliminated,which includes 1 case fell off and 1 case eliminated in the treatment group,and 2cases fell off in the control group.1.Between the two groups,there was no significant difference in the basic data and observing indexes before treatment(P>0.05).2.Objective indicators:(1)SSA:After the treatment,the standardized swallowing assessment of the two groups were improved(P<0.01),and the improvement degree of the treatment group was more significant than that of the control group(P<0.01).(2)PAS:After the treatment,the PAS scores of the two groups were improved(P<0.01),and the improvement degree of the treatment group was more significant than that of the control group(P<0.01).(3)TCRGS:After the treatment,the TCRGS of the two groups were improved(P<0.01),and the improvement degree of the treatment group was more significant than that of the control group(P<0.01).(4)Sputum:After the treatment,the amout of the sputum of the two groups was lesser than before(P<0.01).The amout of the sputum of the treatment group were lesser than that of the control group(P<0.01).(5)TCM syndrome score:After the treatment,the TCM syndrome score of the two groups were improved(P<0.01),and the improvement degree of the treatment group was more significant than that of the control group(P<0.01).3.Incidence of aspiration pneumonia:the treatment group 14.7%(5/34),the control group38.2%(13/34),the difference was statistically significant(P<0.05).4.Clinical therapeutic effect:After 4 weeks of treatment,the success rate of extubation of the treatment group was 85.3%amd that of the control group was 52.9%(P<0.01).Conclusions1.Huatan Tongfu acupuncture prescription and neuromuscular electrical stimulation can both effectively improve the swallowing function,cough reflex,sputum and TCM syndrome of patients of dysphagia after severe stroke undergoing tracheotomy with Phlegm-heat and Fu-viscere excess type.The efficacy of Huatan Tongfu acupuncture prescription was better than neuromuscular electrical stimulation.2.Huatan Tongfu acupuncture prescription can ruduce the incidence of aspiration pneumonia better than neuromuscular electrical stimulation of patients of dysphagia after severe stroke undergoing tracheotomy with Phlegm-heat and Fu-viscere excess type.3.Huatan Tongfu acupuncture prescription can improve the success rate of extubation of dysphagia after severe stroke undergoing tracheotomy with Phlegm-heat and Fu-viscere excess type better than NMES by improving the swallowing function.It is worthy of clinical application and promotion.