How to treat dysphagia with acupuncture after brainstem hemorrhage or brainstem infarction?

The brainstem is an anatomical structure of the brain, known as the "life center", which controls the human body's breathing, sleep, body temperature, hearing, vision, swallowing and other functions, because there are twelve pairs of very important cranial nerves from its ventral dorsal side.

"One smell, two vision, three eye movements, four slides, five forks and six abductions. Seven faces, nine tongues and pharynx, plus the sublingual whole." These are the twelve pairs of cranial nerves, namely the olfactory nerve, the optic nerve, and the eye movement. Nerves, trochlear, trigeminal, abducens, facial, auditory, glossopharyngeal, vagus, accessory, and hypoglossal.

The glossopharyngeal nerve controls swallowing. Once a cerebrovascular accident occurs, either cerebral infarction causes ischemic necrosis, or cerebral hemorrhage causes local necrosis of brain tissue, which will cause swallowing dysfunction.

What is swallowing dysfunction?

Dysphagia refers to a pathological condition in which patients cannot eat normally. Except for obstructive diseases of the swallowing passage, such as local tumor blocking of the mouth, throat or esophagus, which makes food unable to swallow, most of the other causes of difficulty in eating belong to the above-mentioned ones.

The most common manifestations are weak chewing, weak or uncoordinated tongue muscles, and weak throat sphincter muscles that cannot carry food down.

Due to weak or uncoordinated laryngeal muscles, the epiglottis is not fully closed, and water can enter the trachea when drinking, resulting in choking. When a large amount of water enters the lungs along the trachea, aspiration pneumonia occurs. In severe cases, suffocation may occur, or the lungs may be damaged or even ruptured due to severe coughing.

For patients with dysphagia, the most routine and simple test is the drinking water test. The specific method is: let the patient drink two or three sips of water, about one teaspoon. If there is no problem, let the patient sit up, swallow 30ml of warm water in one gulp, and record the drinking situation.

Class I: can be finished in one sip without choking;

Level II: drink more than two times without choking;

Class III: can drink it all at once, but choking;

Level IV: drink more than two times, and choke;

Class V: Often choking, it is difficult to drink it all.

In case I, if the drink is finished within 5 seconds, it is normal; if it exceeds 5 seconds, it is suspected that there is a dysphagia; the case II is also suspicious;

There are many treatments for swallowing disorders, the most common of which is acupuncture. Acupuncture treatment uses the theory of meridian circulation and acupuncture points to exert your curative effect.

Acupuncture therapy is based on the principles of "where the meridians pass, where the main treatment is reached" and acupoints "where the acupoint is located, where the main treatment is", and acupoints can be selected from far and near to form prescriptions. , Phlegm, blood stasis block the meridians, resulting in the lack of nourishment of the meridians and meridians. Acupuncture at the corresponding acupoints can promote blood circulation, remove blood stasis and dispel phlegm, regulate the reconstruction of pharyngeal nerve function, and improve swallowing ability.

Acupoint selection: Fengchi, Yifeng, Wangu; "Three Tongue Needles": Lianquan acupoint and the left and right sides open 1 cun each.

Acupuncture location:

Fengchi: It is located on the back of the neck, under the back of the skull, in the lacuna on the outer edge of the two large tendons, which is equivalent to the level of the earlobe.

Nebula: On the neck, behind the earlobe, in the depression in front of the lower end of the mastoid.

End Bone: On the head, in the depression behind the mastoid behind the ear.

Lianquan Point: On the neck, on the current midline, above the Adam's apple, in the depression on the upper edge of the hyoid bone.

Operation method: Select a filigree needle with a size of 0.3 × 45 mm. The needle points of Fengchi and Wangu points are directly pierced in the direction of the mandibular angle on the opposite side, and the needle is slowly inserted for about 30 mm. 30mm, with a small amount of lifting, inserting and twisting, it is better for the sensation of the needle to be transmitted to the throat; acupuncture is performed once every 10 minutes, and each acupuncture is performed for about 30s each time. When acupuncture at Lianquan point, let the patient tilt his head back slightly to fully expose the neck, and stab the needle straight to the base of the tongue. The needle can be inserted about 40mm.

According to the stage of dysphagia, three needles for the face (Dicang Toujiache, Xiaguan, and Zhengzheng) and three needles for the throat (Tianrong, Tianding, Renying) can be combined.

Operation method: choose a filigree needle with a size of 0.3×45mm, puncture the tip of the Dicang needle in the direction of the buccal car for about 30mm, puncture the Xiaguan and Qianzheng points straight for about 25-30mm, and puncture the Tianrong, Tianding and Renying acupoints for about 30mm. 2mm, with a small amount of twisting, stop when the needle feels, keep the needle for 30 minutes, and treat once a day.

For the treatment of dysphagia, acupuncture combined with modern rehabilitation is often effective. Deep puncturing of Lianquan acupoint is the key to the treatment of this disease. Below Lianquan acupoint is the root of the tongue muscle. It is also very safe to pierce all the 1.5-inch needles. This requires acupuncturists to experience carefully in clinical practice.

The above is Brother Long's experience, welcome to communicate with me in the comment area, welcome to like, forward and follow!