Effect Of Auricular Acupoint Pressing Combined With Neuromuscular Electrical Stimulation On Post-stroke Dysphagia Caused By Wind And Phlegm Blocking The Collateral

Objective: to explore the role of auricular point pressing bean combined with neuromuscular electrical stimulation in improving swallowing function,quality of life,TCM syndrome and nutritional status of patients with dysphagia after stroke with wind-phlegm blocking collaterals.to provide clinical basis for the combined application of external therapy of traditional Chinese medicine.Methods: using experimental study design,in this study,90 patients with dysphagia after stroke treated in the Department of Neurology,Neurosurgery and Acupuncture and Massage Rehabilitation Department of a third-class hospital in Hunan Province from March 2022 to December 2022 were randomly divided into nerve group(n = 30),auricular point group(n =30)and combined group(n = 30).Routine nursing care was carried out in each group,including daily life,condition observation,diet,emotion and health education.The nerve group was treated with neuromuscular electrical stimulation on the basis of routine nursing.The auricular point group was treated with auricular point pressing therapy on the basis of routine nursing,and the combined group was treated with auricular point pressing bean therapy and neuromuscular electrical stimulation on the basis of routine nursing.The course of treatment was 4 weeks.The intervention effect was evaluated by standard swallowing function rating scale(SSA),specific dysphagia quality of life scale(SWAL-QOL),TCM syndrome score,BMI,serum albumin(ALB)and hemoglobin(Hb)before and one month after intervention.One month after intervention,the incidences of aspiration and aspiration pneumonia in three groups were collected to evaluate safety.IBMSPSS25.0 statistical software was used to analyze the data.The normal distribution of the general data was analyzed by analysis of variance,and the counting data were analyzed by chi-square test or rank sum test,the standard swallowing function score,the specific quality of life of dysphagia and TCM syndrome scores of the three groups,BMI,ALB and Hb were determined by sing le factor analysis of variance,and the pairwise comparison was made by SNK-q test.The incidence of aspiration and aspiration pneumonia was tested by chi-square test,paired t-test or paired rank sum test was used to compare the differences of outcome indexes in each group before and after intervention,and single factor analysis of variance was used to compare the differences among the three groups before and after intervention.Results: 1.There was no significant difference in demographic data such as sex,age,previous medical history,stroke type,stroke frequency and focus location among the three groups.There was no significant difference in SSA score,SWAL-QOL score,TCM syndrome score,BMI,ALB,Hb score and other outcome indexes among the three groups before intervention.After intervention,the scores of SSA,SWAL-QOL,TCM syndrome,BMI,ALB and Hb in the three groups were significantly improved as compared with those at baseline(P < 0.05).The results of normality test and one-way ANOVA showed that there were significant differences in SSA score,SWAL-QOL score,TCM syndrome score,BMI,ALB and Hb scores among the three groups after intervention.3.After comparison,there were significant differences in SSA score,SWAL-QOL score,TCM syndrome score,BMI,ALB,Hb score between the combined group and the auricular point group,and between the combined group and the nerve group.There were significant differences in SSA score,SWAL-QOL score,TCM syndrome score,BMI,ALB and Hb scores among the three groups before and after intervention.4.There was no significant difference in the incidence of adverse events among the three groups(P > 0.05),and the occurrence of adverse events had nothing to do with intervention measures.Conclusion: 1.Auricular point pressing bean combined with neuromuscular electrical stimulation can effectively improve the swallowing function of patients with dysphagia wind-phlegm syndrome after stroke,improve the quality of life,reduce and improve the performance of TCM syndrome,and enhance the level of nutritional status.the effect of intervention is better than that of auricular point pressing bean or neuromuscular electrical stimulation alone.two。.During the intervention of auricular point pressing bean combined with neuromuscular electrical stimulation,the incidence of adverse events such as aspiration and aspiration pneumonia is low,and the occurrence of adverse events has nothing to do with the intervention measures,which is safe and worthy of clinical application.