Aphasia, a language disorder caused by brain damage due to a variety of diseases, is most common in stroke (stroke). After stroke, infarct foci, embolic foci, or hemorrhagic lesions damage the language centers in the dominant hemisphere of the brain, triggering a corresponding loss or impairment of expressive language and comprehension. Aphasia can be classified into 8 categories: motor, sensory, conductive, named, complete (mixed), transcortical sensory, transcortical motor and transcortical mixed.
The eight types of aphasia can be divided into motor, sensory and mixed aphasia.
1.Tongue acupuncture
Tongue acupuncture is a more traditional therapy. The main manifestation of stroke aphasia is strong tongue without speech, and the tongue is closely related to the meridians of the whole body, especially the heart, liver, kidney and spleen, and the tongue is an important organ of sound composition. There are more clinical reports of acupuncture points on the tongue, focusing on acupuncture points on or around the tongue body to treat stroke aphasia.
(1) Yin Chunping et al. used Lianquan and sublingual points (under the outer edge of the sublingual vein on both sides of the tongue ligament) as the main acupuncture points and added or subtracted with Fenglong, Hehai, Taichong, Taixi, and Feosanli points with 10 days as a course of treatment, and the efficacy was evaluated after 2 courses of treatment. 86 cases of aphasia were treated. The total effective rate was 98.8%.
(2) Li Ziping took the heart point (located at the tip of the tongue), the spleen point (1 inch backward along the front and back median line of the tongue, with a 0.4 inch side opening), the kidney point (1.6 inch backward along the front and back median line of the tongue, with a 0.4 inch side opening), and the Fengchi point (Fengchi), together with the method of injecting Danshen injection into the Fengchi points on both sides, once a day, 12 times for a course of treatment, with 3-5 days of rest between courses of treatment. The efficacy was evaluated after 2 courses of treatment: 40 cases of aphasic patients were treated, with an overall efficiency of 90%.
(3) Wang Ping et al. used milli-needle to pierce from Jinjin and Yuyi points to the root of the tongue at a depth of about 1 inch, with mild twisting, so that the patient’s tongue would feel sore, numb and swollen, without leaving the needle. The treatment is given once a day, and 10 times is one course of treatment. Treatment of stroke aphasia 30 cases, total effective rate 96.7%.
(4) Lin Yaogeng et al. treated 36 cases of stroke aphasia with Jinjin and Yuyi together with Fengchi, Lianquan, Cataract and Fenglong, once a day for 10 times as a course of treatment. After 1-3 courses of treatment, 10 cases (27.8%) were significantly effective and 25 cases (69 .4%) were effective.
(5) Feng Weimin et al. needled the Kaiyin point to treat motor aphasia after cerebral infarction, “Kaiyin point” positioning: 1M directly below the bilateral mandibular angle is the point. The tip of the needle was pricked to the root of the contralateral tongue, and the patient was instructed to make “ah, ee” sounds 7 times every 5 minutes after the patient’s tongue felt sore, swollen, numb and hot. The treatment course: 1 time per day, 12 times for 1 course, rest 2 days to continue the next course, 3 courses of treatment after the statistical efficacy. The efficacy was significantly better than that of the control group.
(6) Li Jingliang used three points under the jaw, namely Lianquan and Punlianquan (Lianquan point is open about 0.8 minutes, one point on each side). The supporting points were taken from Tongli, Hegu, and Taixi; Blood Sea was added for very stagnant blood; Taichong was added for hyperactive liver yang; and Fenglong was added for phlegmatic yong. After each treatment, the patient’s pronunciation was trained for 20 min. 14 times a day, and the efficacy was evaluated after 2 courses of treatment. A total of 68 cases of post-stroke speech disorders were treated, with a total effective rate of 91.18%.
2. Head acupuncture points
Aphasia is caused by damage to the cerebral hemispheres, therefore, it is generally believed that it may be related to improving local blood circulation, increasing cerebral blood flow, restoring blood supply to brain tissue and improving cerebral electrical activity to activate cerebral language function.
(1) Head acupuncture for stroke aphasia, which used to be mainly based on the corresponding projection areas of the cortical function localization (Jiao’s head acupuncture), has been further developed in recent years based on the traditional acupuncture of language areas.
Jiang Ganghui et al. used the CT localization method, using the perimeter of the vertical projection area (nearest distance in the projection area) of the scalp on the same side of the lesion shown in the CT as the acupuncture site, surrounded by 4-8 needles (the number of needles depends on the size of the lesion) with 30-gauge 1.5-inch stainless steel milli-needles (the number of needles depends on the size of the lesion), all in the direction of the center of the projection area, and after obtaining the qi, twisting at 180- After obtaining the qi, twist the needle at a frequency of 180-200 times/min for 2 min, retain the needle for 30 min, and perform the needle once in between. The acupuncture points are Mute Gate, Lianquan and Tongli. The treatment was carried out once a day, 15 times for a course of treatment, and a total of 2 courses of treatment. The effective rate was 86.67%.
(2) Han Baojie treated 52 cases of stroke aphasia with scalp acupuncture plus electroacupuncture, taking bilateral scalp acupuncture in language 1 area. Then the needle handle was connected to the output electro-acupuncture electrode of the electro-acupuncture therapy instrument and stimulated with pulse current at a frequency of 100-120 rpm for 20 min. 20 min, once a day, 15 times for a course of treatment, generally 2-3 courses of treatment. The total effective rate was 96.15%.
(3) Liu Fang et al. treated 33 cases of cerebrovascular disease aphasia with head acupuncture in language zone 1, language zone 2, Baihui point and body acupuncture in conjunction with Lianquan point, with the result that 21 cases were effective, 10 cases were effective and 2 cases were ineffective.
(4) Wang Suxia and other head acupuncture-based treatment of post-stroke aphasia, the treatment group of 50 cases, taking the head acupuncture language zone 3, using 26-28 No. 2 inch milli-needle, from the ear tip straight up 1.5cm along the skin backward horizontal penetration 4cm, rapid twisting 2min, so that the patient local numbness and swelling is appropriate, retention of needles 30min; with Tongli, Baihui, Taixi points with conventional acupuncture. The efficacy was counted after 2 courses of treatment. The total effective rate was 90%.
(5) Jiao Wei et al. treated post-stroke aphasia mainly with buried head acupuncture points: Baihui, language zone 1, zone 2, zone 3, 1 time a month, 6 times as a total course of treatment, and various methods of conventional treatment of post-stroke aphasia were applied as usual during the course of treatment. The total effective rate was 91.8%.
3.Comprehensive treatment
The use of multiple therapies, mainly embodying head acupuncture combined with body acupuncture, is conducive to improving clinical efficacy and is one of the current trends in the treatment of aphasia.
(1) Zhao Baixiao et al. treated 35 cases of stroke aphasia with acupuncture based on clearing the heart and awakening the mind to open the orifices. The main acupuncture points were selected from Si Shen Cong, Shen Ting, Ben Shen, Tong Li, Xin Yu, and Tong Tongue three needles. For wind-yang upward disturbance, diarrhea of Fengchi and Dazhi; for phlegm-stasis blocking the ligaments, diarrhea of Fenglong and Sanyinjiao, and release of blood by Jinjin and Yuyi; for phlegm-heat and internal organs solidity, diarrhea of Quchi, Tianshu, and Shangjiu; for qi deficiency and blood stasis, tonification of Foot Sanli, Tai Bai, and Zhonggui, diarrhea of Sanyinjiao, and release of blood by Jinjin and Yuyi; for yin deficiency and wind movement, Tai Chong through Yongquan, tonification of Taixi and Lijiu.
The four basic language functions of spontaneous talk, oral comprehension, repetition, naming and related symptoms were observed, and the results showed that acupuncture could significantly improve the language functions of aphasic patients, and at the same time could correct the language-related symptoms.
(2) Li Zhi used Lianquan, Mute Gate and Fengchi as the main acupuncture points, together with Neiguan and Zhaohai, with swallowing and speech training.
The above three acupuncture points require the sensation of needles to be transmitted to the throat, and the patient is instructed to practice swallowing and pronunciation. The treatment was carried out once a day, 10 times as a course of treatment, with 2 days of rest between courses, and the efficacy was observed after 3 courses of treatment. Treatment of 30 patients, the results of the cure 10 cases, 12 cases of significant effect, progress 6 cases, invalid 2 cases.
(3) Huang Shifu treated cerebral hemorrhage hemiplegia aphasia with head acupuncture, body acupuncture and sublingual acupuncture, head acupuncture: motor area on the side of the lesion, language area 1. Body acupuncture: Baihui, Sishencong, Fengchi on the affected side, shoulder skeleton, Jiquan, Quchi, Hegu, Liangqiu, Hai of Blood, Feet Sanli, Yanglingquan, Huanjiao, Weizhong, Sanyinjiao, Taixi, Taichong (alternating Yin and Yang meridians). Acupuncture points for symptomatology: add Renzhong, Neiguan, Yongquan, and Twelve Wells points to release blood;
For aphasia, add Lianquan, Tongli, and sublingual acupuncture (below Jinjin and Yuyi points, take 3 points each in a fan shape to the left and right of the tongue tether, with a spacing of 0.5 cm diagonally toward the pharynx); for orofacial distortion, add Dicang, Chee Che, Cataract, and Xiaoguan. The above acupuncture points were selected according to the classification of evidence or electro-acupuncture as appropriate. In conjunction with rehabilitation exercises, the needles were left for 30-40 min each time (sublingual needles were not left), once a day, stopping for 6 consecutive days, 30 times for a course of treatment, the total effective rate was 87.5%.
(4) Wang Laiqun et al. treated 48 cases of stroke aphasia by using the method of awakening the brain and opening the orifices with acupuncture points: Neiguan (double), Renzhong, Sanyinjiao (single), Fengchi (double), Cataract (double), Shanglianquan, Jinjin and Yuyi. The manipulation was performed according to the method of awakening the brain and enlightening the mind. The treatment was carried out once a day, and the needles were left for 20 min, and Jinjin and YuYi were punctured to release blood without leaving the needles. 10 times was considered as a course of treatment, and the next course of treatment was carried out at an interval of 3 days after the end of the course of treatment, and the efficacy was counted after 2 courses of treatment. The total effective rate was 85.42%.
(5) Wu Qi et al. treated 51 cases of Chinese aphasia repetition disorder in stroke patients with comprehensive acupuncture. scalp acupuncture: motor zone, language zone 1 and language zone 2 were selected. Twisting transfer needle speed 180 rpm, continuous twisting for 3 min, then retain the needle for 10 min, and then operate as before to start the needle once. Body acupuncture therapy: select points Baihui, Lianquan, Fengchi, Tongli, Taixi. After acupuncture, twist and turn to get qi. Then retain the needles for 10 min, and again for 2 min, repeat the above 3 times to start the needles.
The needle under the tongue is selected at about 5mm on both sides of the tongue ligament, i.e., at the 4th equiv. of the line connecting Jinjin and Yuyi. Stabbing about 2 inches in the direction of the tongue root, into the needle after not lifting the plug, to get the degree of gas, do not retain the needle. The above method is used once a day, 10 times as a course of treatment, with a rest period of 2 days between courses, and the efficacy is evaluated after 3 courses of treatment. 51 patients were treated, with 23 cases of significant effect, 24 cases of effective effect and 3 cases of ineffective effect.
(6) Li Xiaojin applied acupuncture plus hyperbaric oxygen for the treatment of post-stroke aphasia, and selected acupoints: Lianquan, Mute Gate, Tongli and Fenglong, and strictly mastered the direction of acupuncture when acupuncture Lianquan and Mute Gate, and used the technique of flat patching and flat diarrhea, and did not keep the needles; Tongli and Fenglong were treated bilaterally, and used the technique of flat patching and flat diarrhea, and kept the needles for 20 min. Mu Rong [28] applied head acupuncture, tongue three acupuncture and body acupuncture to treat 49 cases of aphasia caused by cerebral infarction, and the efficiency was 91.84% in 15 days as a course of treatment.