Study on the effect pattern and mechanism of acupuncture in treating post-stroke dysphagia

注册号:

Registration number:

ITMCTR2024000680

最近更新日期:

Date of Last Refreshed on:

2024-11-08

注册时间:

Date of Registration:

2024-11-08

注册号状态:

Registration Status:

预注册

Prospective registration

注册题目:

针刺治疗脑卒中后吞咽障碍的效应规律与机制研究

Public title:

Study on the effect pattern and mechanism of acupuncture in treating post-stroke dysphagia

注册题目简写:

English Acronym:

研究课题的正式科学名称:

针刺治疗脑卒中后吞咽障碍的效应规律与机制研究

Scientific title:

Study on the effect pattern and mechanism of acupuncture in treating post-stroke dysphagia

研究课题的正式科学名称简写:

Scientific title acronym:

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

支晓东

研究负责人:

毛忠南

Applicant:

Xiaodong Zhi

Study leader:

Zhongnan Mao

申请注册联系人电话:

Applicant telephone:

+86 182 9319 1002

研究负责人电话:

Study leader's telephone:

+86 135 1964 1937

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

zhixiaodong2013@163.com

研究负责人电子邮件:

Study leader's E-mail:

470874946@qq.com

申请单位网址(自愿提供):

Study leader's website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website
(voluntary supply):

申请注册联系人通讯地址:

甘肃省兰州市嘉峪关西路732号

研究负责人通讯地址:

甘肃省兰州市嘉峪关西路732号

Applicant address:

No.732 Jiayuguan West Road Lanzhou City Gansu Province China

Study leader's address:

No.732 Jiayuguan West Road Lanzhou City Gansu Province China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

甘肃中医药大学附属医院

Applicant's institution:

Affiliated Hospital of Gansu University of Traditional Chinese Medicine

是否获伦理委员会批准:

Approved by ethic committee:

伦理委员会批件文号:

Approved No. of ethic committee:

伦理[2024]095号

伦理委员会批件附件:

Approved file of Ethical Committee:

View

批准本研究的伦理委员会名称:

甘肃中医药大学附属医院医学伦理委员会

Name of the ethic committee:

Medical Ethics Committee of Affiliated Hospital of Gansu University of Traditional Chinese Medicine

伦理委员会批准日期:

Date of approved by ethic committee:

2024/6/5 0:00:00

伦理委员会联系人:

张璐娟

Contact Name of the ethic committee:

Lujuan Zhang

伦理委员会联系地址:

甘肃省兰州市嘉峪关西路732号

Contact Address of the ethic committee:

No.732 Jiayuguan West Road Lanzhou City Gansu Province China

伦理委员会联系人电话:

Contact phone of the ethic committee:

+86 136 5944 1668

伦理委员会联系人邮箱:

Contact email of the ethic committee:

470874946@qq.com

研究实施负责(组长)单位:

甘肃中医药大学附属医院

Primary sponsor:

Affiliated Hospital of Gansu University of Traditional Chinese Medicine

研究实施负责(组长)单位地址:

甘肃省兰州市嘉峪关西路732号

Primary sponsor's address:

No.732 Jiayuguan West Road Lanzhou City Gansu Province China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

甘肃省

市(区县):

兰州市

Country:

China

Province:

China

City:

Lanzhou City

单位(医院):

甘肃中医药大学附属医院

具体地址:

甘肃省兰州市嘉峪关西路732号

Institution
hospital:

Affiliated Hospital of Gansu University of Traditional Chinese Medicine

Address:

No.732 Jiayuguan West Road Lanzhou City Gansu Province China

经费或物资来源:

甘肃省科技计划(联合科研基金)

Source(s) of funding:

Gansu Provincial Science and Technology Program (Joint Research Fund)

研究疾病:

脑卒中后吞咽障碍

研究疾病代码:

Target disease:

post-stroke dysphagia

Target disease code:

研究类型:

Study type:

干预性研究

Interventional study

研究设计:

Study design:

随机平行对照

randomized controlled trial(parallel group design)

研究所处阶段:

Study phase:

探索性研究/预试验

Pilot clinical trial

研究目的:

(1)通过分析观察电针治疗对卒中后咽期吞咽障碍患者腭咽闭锁能力不足和咽缩肌运动能力不足的各项指标变化,进一步验证疗效总结规律。 (2)通过fMRI和DTI技术,探索咽期吞咽障碍患者腭咽闭锁能力不足和咽缩肌运动能力不足的神经机制,验证电针治疗的作用原理。

Objectives of Study:

(1) By analyzing and observing the changes of various indexes of electroacupuncture treatment on the insufficiency of palatopharyngeal atresia and the insufficiency of pharyngeal retractor motor ability in patients with pharyngeal stage dysphagia after stroke to further validate the efficacy of the summarized law. (2) Through fMRI and DTI techniques we will explore the neural mechanism of insufficient palatopharyngeal atresia and insufficient pharyngeal retractor motor ability in patients with pharyngeal dysphagia and validate the principle of electroacupuncture treatment.

药物成份或治疗方案详述:

治疗方案详细描述: (1)标准吞咽训练方案:①主被动口唇闭锁训练,②下颌主被动运动训练,③舌主、被动训练,④咽部冷刺激,⑤空吞咽训练,⑥促吞咽反射训练,⑦呼吸道训练,⑧直接摄食训练。上述吞咽训 练 1 次/日,每次训练 30min,连续训练 10 天为 1 个疗程,中间休息2 天,共训练 2 个疗程。 (2)“吞咽康复组穴”针刺治疗:“吞咽康复组穴”参考中国康复医学会团体标准《针刺治疗卒中后吞咽障碍技术规范》,针对咽缩肌力弱、鼻咽关闭不全,选取翳风、风池、哑门针刺,同时加用咽后壁点刺;根据经络辨证远端选列缺、后溪、申脉、照海。 (3)电针组方案:电针组在针刺组基础上加用电针治疗,双侧翳风穴连接 KWD-808Ⅰ型脉冲针灸治疗仪,予 5 Hz 断续波,电流强度为 3mA,每次留针20 min。1 次/日,10 次为一个疗程,中间休息 2 天,持续干预 2 个疗程。

Description for medicine or protocol of treatment in detail:

Detailed description of the treatment program: (1) Standard swallowing training program: ① active and passive orofacial atresia training ② active and passive mandibular movement training ③ active and passive tongue training ④ cold pharyngeal stimulation ⑤ empty swallowing training ⑥ facilitated swallowing reflex training ⑦ respiratory training ⑧ direct food intake training. The above swallowing training 1 time / day each training 30min continuous training for 10 days as a course of treatment with a break of 2 days in the middle a total of 2 courses of training. (2) Swallowing rehabilitation group points acupuncture treatment: Swallowing rehabilitation group points refer to the group standard of Chinese Society of Rehabilitation Medicine Technical specification for acupuncture treatment of post-stroke swallowing disorders targeting the weak pharyngeal contraction muscle and nasopharyngeal closure insufficiency selecting cataract wind wind pool mute door acupuncture and adding the posterior wall of the pharynx for acupuncture. At the same time puncture on the posterior pharyngeal wall was added; according to the meridian identification of the distal part of the body Leixiao Houxi Shenwei and Zhaohai were selected. (3) Electroacupuncture group program: the electroacupuncture group added electroacupuncture treatment on the basis of acupuncture group bilateral cataract points connected to the KWD-808 Ⅰ pulse acupuncture therapeutic instrument given 5 Hz intermittent wave the current strength of 3mA and each time to stay in the needle for 20 min. 1 time / day 10 times for a course of treatment with a break of 2 days in the middle of the course of continuous intervention for 2 courses of treatment.

纳入标准:

同时满足以下4个标准: (1)同时符合《中国脑卒中防治指导规范(2021年版)》中关于缺血性卒中和出血性卒中的相关标准,《中医内科常见病诊疗指南》中关于中风病的相关标准,《中国吞咽障碍评估与治疗专家共识(2017年版)》中关于吞咽障碍的诊断标准。 (2)年龄18~80岁; (3)神志清楚,生命体征平稳; (4)受试者及其家属充分理解研究内容,同意参与研究,并签署知情同意书。

Inclusion criteria

Meet the following 4 criteria at the same time: (1) Simultaneously meet the relevant criteria for ischemic stroke and hemorrhagic stroke in the Chinese Guidelines for the Prevention and Treatment of Stroke (2021 edition) the relevant criteria for stroke disease in the Guidelines for Diagnosis and Treatment of Common Diseases of Traditional Chinese Medicine Internal Medicine and the diagnostic criteria for dysphagia in the Chinese Expert Consensus on the Evaluation and Treatment of Dysphagia (2017 edition). (2) Age 18 to 80 years old; (3) Clear consciousness and stable vital signs; (4) Subjects and their families fully understood the study agreed to participate in the study and signed an informed consent form.

排除标准:

符合 以下至少1 项均予以排除: (1)无法完成VFSS和FEES检查者。 (2)短暂性脑缺血发作、活动性脑出血等持续或进展性脑血管疾病; (3)合并严重的肝肾功能障碍、凝血功能障碍,严重的糖尿病、支气管哮喘、心功能不全、甲状腺功能亢进等; (4)非脑卒中原因引发的吞咽障碍者; (5)对针刺材料或协议物品过敏,不适宜针刺操作者,施针部位有破损; (6)具有核磁公正检查禁忌症,如金属植入物、心脏起搏器、幽闭恐惧症等患者; (7)一个月内参加过其他临床试验。 (8)认知障碍、不能够配合者。

Exclusion criteria:

Compliance At least 1 of the following was excluded: (1) Those unable to complete the VFSS and FEES. (2) Transient ischemic attack active cerebral hemorrhage and other persistent or progressive cerebrovascular diseases; (3) Combination of severe hepatic and renal dysfunction coagulation dysfunction severe diabetes mellitus bronchial asthma cardiac insufficiency and hyperthyroidism; (4) People with swallowing disorders caused by non-stroke reasons; (5) People who are allergic to needling materials or protocol items unsuitable for needling operation and have broken needle application sites; (6) Patients with contraindications to nuclear magnetic fairness examination such as metal implants cardiac pacemakers claustrophobia and so on; (7) Participated in other clinical trials within one month. (8) Those who have cognitive impairment and are not able to cooperate.

研究实施时间:

Study execute time:

From 2024-12-01

To      2027-06-30

征募观察对象时间:

Recruiting time:

From 2025-01-01

To      2027-06-30

干预措施:

Interventions:

组别:

电针组

样本量:

40

Group:

Electro-acupuncture group

Sample size:

干预措施:

在针刺组基础上加用双侧翳风穴电针治疗

干预措施代码:

Intervention:

Electroacupuncture treatment with bilateral cataract points added to the acupuncture group

Intervention code:

组别:

针刺组

样本量:

40

Group:

acupuncture group

Sample size:

干预措施:

“吞咽康复组穴”针刺治疗

干预措施代码:

Intervention:

“Swallowing Rehabilitation Group Points” Acupuncture Therapy

Intervention code:

组别:

对照组

样本量:

40

Group:

control groups

Sample size:

干预措施:

标准吞咽训练方案

干预措施代码:

Intervention:

Standard swallowing training program

Intervention code:

样本总量 Total sample size : 120

研究实施地点:

Countries of recruitment
and research settings:

国家:

中国

省(直辖市):

甘肃省

市(区县):

兰州市

Country:

China

Province:

Gansu Province

City:

Lanzhou City

单位(医院):

甘肃中医药大学附属医院

单位级别:

三级甲等

Institution/hospital:

Affiliated Hospital of Gansu University of Traditional Chinese Medicine

Level of the institution:

grade 3A

测量指标:

Outcomes:

指标中文名:

腭咽闭锁能力评分

指标类型:

主要指标

Outcome:

Palatopharyngeal Atresia Competency Score

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

不良事件记录

指标类型:

副作用指标

Outcome:

Adverse event recordsAdverse event records

Type:

Adverse events

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

微型营养评价量表

指标类型:

附加指标

Outcome:

mini-nutritional assessment

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

吞咽障碍特异性生存质量量表

指标类型:

次要指标

Outcome:

ChSWAL-QOL

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

食物摄入量表等级评分

指标类型:

次要指标

Outcome:

Food Intake LEVEL Scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

咽缩肌向前下方突出的最大距离

指标类型:

主要指标

Outcome:

Maximum distance the pharyngeal constrictor muscle protrudes anteriorly and inferiorly

Type:

Primary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

日常生活能力评分

指标类型:

附加指标

Outcome:

Activities of Daily Living

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

fMRI静息态扫描,任务态fMRI检查

指标类型:

附加指标

Outcome:

fMRI resting state scanfMRI task state scan

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

Osenbek渗透-误吸量表评分

指标类型:

次要指标

Outcome:

Penetration Aspiration Scale

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

组织:

Sample Name:

none

Tissue:

人体标本去向

其它

说明

Fate of sample 

Others

Note:

征募研究对象情况:

尚未开始

Not yet recruiting

年龄范围:

最小 18
Min age years
最大 80
Max age years

Recruiting status:

Participant age:

性别:

Gender:

男女均可

Both

随机方法(请说明由何人用什么方法产生随机序列):

120例患者被随机分配到对照组、针刺组和电针组,每组40例患者。根据随机数字表,按照入组顺序从1开始编号,从随机数字表中任一个数字开始,依次选取120个随机数字,然后将全部随机数从小到大编号,一名不参与该研究的研究人员将连续的数字放入一个密封的信封中,并以1:1:1的比例将其随机分为3组。

Randomization Procedure (please state who generates the random number sequence and by what method):

120 patients were randomly assigned to control group acupuncture group and electroacupuncture group with 40 patients in each group. According to the table of random numbers numbered from 1 according to the order of enrollment 120 random numbers were selected sequentially starting from any number in the table of random numbers and then all the random numbers were numbered from smallest to largest and a researcher who was not involved in the study put the consecutive numbers into a sealed envelope and randomly divided them into 3 groups in the ratio of 1:1:1.

盲法:

由不知分组情况的第三者进行疗效评价;实行研究者、疗效评价者、统计者三分离。由于干预性质,患者和针灸医师并未采用盲法。负责结果评估、数据输入和分析的人员将对小组分配采用盲法。实施干预的针灸师将不负责评估量表。

Blinding:

Efficacy evaluation was performed by a third party who was unaware of the subgroups; the separation of investigator efficacy evaluator and statistician was practiced. Due to the nature of the intervention patients and acupuncturists were not blinded. Those responsible for outcome assessment data entry and analysis will be blinded to group assignment. The acupuncturist administering the intervention will not be responsible for evaluating the scales.

是否共享原始数据:

IPD sharing:

No

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

暂不共享原始数据

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

No sharing of raw data for now

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

原始数据采集均以纸质版形式进行,后续汇总输入EXCEL及SPSS软件进行汇总和统计学分析。

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Raw data collection was done in paper format and subsequent summaries were entered into EXCEL and SPSS software for summary and statistical analysis.

数据管理委员会:

Data Managemen Committee:

暂未确定

Not yet

研究计划书或研究结果报告发表信息
(杂志名称、期、卷、页,时间;或网址):

Publication information of the protocol/research results report
(name of the journal, volume, issue, pages, time; or website):

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