Objective To observe the efficacy of Tongdu Tiaoshen(dredging Governor Vessel and regulating mind needling combined with swallowing training in the treatment of ischemic stroke(IS)with dysphagia

and to investigate its effect on cerebral blood flow and serum levels of brain-derived neurotrophic factor(BDNF)and nerve growth factor(NGF).Methods A total of 100 IS inpatients with dysphagia were enrolled in the present study

and randomly and equally divided into control group and treatment group by using a random number table.The patients of the control group received routine swallowing training including tongue extending and retracting

cheek-muscle training

breathing exercise

and laryngopharyngeal exercise

beginning from the 2 nd day after hospitalization.The patients of the treatment group received manual acupuncture stimulation of Dazhui(GV14)

Fengfu(GV16)

Shenting(GV24)

Shendao(GV11)

Baihui(GV20)

Shuigou(GV26)

etc.

on the basic treatment as those mentioned in the control group.The treatment was conducted once daily

5 times per week and for 4 successive weeks.The swallowing ability was tested by using video fluoroscopic swallowing study(VFSS)

Kubota water swallowing test

and the standard swallowing function assessment(SSA)scale

separately

and patients' daily life quality was assessed by using swallowing related quality of life questionnaire(SWAL-QOL).The cerebral hemodynamics including mean blood flow velocity(Vm)

maximum peak flow speed(Vs)

and vascular resistance index(RI)of the bilateral cerebral arteries was detected by transcranial color Doppler ultrasound tests

and serum BDNF and NGF contents were assayed by enzyme linked immunosorbent assay.The therapeutic effect of swallowing ability was evaluated after the treatment.Results After 4 weeks' treatment

the scores of Kubata water swallowing test

SSA

and SWAL-QOL and RI were considerably decreased(P<0.01)

and the VFSS scores

Vs and Vm levels as well as serum BDNF and NGF contents were significantly increased(P<0.01)in both groups compared with their own pre-treatment.Of the 48 and 49 cases in the control and treatment groups

4(8.33%)and 8(16.33%)were cured

26(54.17%)and 33(67.35%)effective

18(37.50%)and 8(16.33%)failed

with the effective rate being62.50% and 83.67%

respectively.The therapeutic effect of the treatment group was significantly superior to that of the control group in the effective rate(P<0.05)

and in lowering the scores of Kubota water swallowing test

SWAL-QOL

SSA

RI

and in up-regulating the scores of VFSS

Vs and Vm

and serum BDNF and NGF levels(P<0.01).Conclusion Tongdu Tiaoshen needling combined with swallowing training is effective in improving swallowing ability

promoting cerebral blood flow and in up-regulating serum neurotrophic factor levels in patients with dysphagia after ischemic stroke.