ObjectiveTo observe the impact of"Tongyuan"(regulating the Governor Vessel to tranquilize mental activities

conducting qi back to its origin)acupuncture treatment on cough reflex

pulmonary infection and swallowing function in stroke patients undergoing tracheotomy.MethodsSeventy-four cerebral stroke patients with tracheotomy were randomly allocated to scalp acupuncture and"Tongyuan"acupuncture groups(n=37 in each group). All the patients of the two groups received basic treatment

including treatment of primary diseases

routine nursing

respiratory muscle training

physical therapy

acupuncture of Chize(LU5)

Quchi(LI11)

Hegu(LI4)

Weizhong(BL40)

Zusanli(ST36). In addition

for patients of the scalp acupuncture group

the middle 2/5 of Dingnieqianxiexian(MS6)

the middle 2/5 of Dingniehouxiexian(MS7)and Dingpangerxian(MS9)on the contralateral side of lesions were punctured with filiform needles. For patients of the"Tongyuan"acupuncture group

Baihui(GV20)

Zhongwan(GV12)

Guanyuan(CV4)

Qihai(CV6)

Tianshu(ST25)

Feishu(BL13)

Pishu(BL20)were needled. The treatment in both groups lasted30 minutes each time

once daily

6 times a week for 4 weeks. The cough reflex grading score(CRGS

assessed according to cough

independent expectoration

sputum suction)

clinical pulmonary infection score(CPIS

assessed according to the body temperature

white blood cell count

airway secretion in 24 h

PaO2/FiO2

infiltration status

cultured pathogenic bacteria)

and swallowing function were evaluated by a researcher who was blinded to the grouping and treatment procedures. The success rate of extubation was calculated in a week at the end of treatments.ResultsAfter the treatment

the CRGS and CPIS of both groups were apparently decreased in comparison with their own pre-treatment(P<0. 05)

suggesting an improvement of the cough reflex and pulmonary infection. Regarding the swallowing function

of the two 37 cases in the scalp acupuncture and"Tongyuan"acupuncture groups

9(24. 3%)and 19(51. 4%)experienced marked improvement

12(32. 5%)and 14(37. 8%)were effective

and 16(43. 2%)and 4(10. 8%)failed in the treatment

with the effective rate being 56. 8% and 89. 2%

respectively. In regard to the successful extubation

of the two 37 cases in the scalp acupuncture and"Tongyuan"acupuncture groups

5(13. 5%)and 11(29. 8%)had a marked improvement

10(27. 0%)and 18(48. 6%)were effective

and 22(59. 5%)and 8(21. 6%)failed

with the effective rate being 40. 5%and 78. 4%

respectively. The therapeutic effect of"Tongyuan"acupuncture was significantly superior to that of scalp acupuncture in decreasing CRGS and CPIS

and in improving the swallowing function and raising the rate of successful extubation(P<0. 05).Conclusion"Tongyuan"acupuncture treatment can improve cough reflex to remove sputum

reduce pulmonary infection

enhance swallowing function

and raise the success rate of extubation in stroke patients

which is better than scalp acupuncture.