To observe the clinical effect of Kaiqiao Liyan (opening orifices and benefiting the throat) acupuncture therapy combined with six-character exercise in treatment of post-stroke dysarthria.

Seventy-five patients with post-stroke dysarthria were randomly divided into a comprehensive therapy group (25 cases, 1 case dropped out), an acupuncture group (25 cases), and a six-character exercise group (25 cases, 1 case was eliminated). The patients of the three groups received basic treatment and conventional rehabilitation training. In the acupuncture group, Kaiqiao Liyan acupuncture therapy was used at Baihui (GV20), Sishencong (EX-HN1), Lianquan (CV23), three-tongue points (Extra), Fengfu (GV16), Yamen (GV15), and bilateral Fengchi (GB20) and Yifeng (TE17). Acupuncture intervention was given once daily, 20 min each time. In the six-character exercise group, the patients practiced the six-character exercise for 20 min each intervention, once daily. In the comprehensive therapy group, both acupuncture therapy and the six-character exercise were delivered. Once after consecutive 6 days of treatment, the intervention was discontinued for 1 day, and 2 weeks of intervention were required in each group. The patients' vocal function (loudness, maximum phonation time [MPT], and maximum counting ability [MCA]), speech intelligibility, and the score of the modified Frenchay dysarthria evaluation table (FDET) were evaluated before and after treatment. The clinical effect was assessed in each group.

After treatment, all three groups showed the improvements in vocal function (loudness, MPT and MCA), speech intelligibility, and the scores of each item and the total scores of the modified FDET compared with those before treatment (P＜0.05). The comprehensive group demonstrated the improvements in loudness, speech intelligibility, the scores for respiration, soft palate and speech and the total score of the modified FDET when compared with the acupuncture group and the six-character exercise group, respectively (P＜0.05). In the comprehensive therapy group and the six-character exercise group, the MPT, MCA and scores for laryngeal function of the modified FDET were better than those of the acupuncture group (P＜0.05). The speech intelligibility in the acupuncture group was superior to the six-character exercise group (P＜0.05). The scores for the tongue function in the modified FDET in the comprehensive therapy group and the acupuncture group were higher when compared with the six-character exercise group (P＜0.05). The total effective rate in the comprehensive therapy group was 88% (22/25), higher than that of the six-character exercise group (60%, 15/25) and the acupuncture group (64%, 16/25, P＜0.05), respectively.

The combination of Kaiqiao Liyan acupuncture therapy and six-character exercise improves speech and vocal function in patients with post-stroke dysarthria.

To observe the effect of electroacupuncture (EA) on high mobility group box 1 (HMGB1)/toll-like receptor 4 (TLR4) signaling pathway and inflammatory injury in rats with focal cerebral ischemia (FCI), so as to explore its mechanisms underlying amelioration of ischemic stroke.

Male SD rats were randomly divided into sham operation (n=18), model (n=18) and EA (n=18) groups. The FCI model was established according to Longa's method. In the EA group, 24 h after modeling, EA stimulation was applied to "Baihui" (GV20), "Fengfu" (GV16), and "Neiguan" (PC6) and "Xinshu" (BL15) on the left side for 20 min, once a day for 1 week. The neurological deficit severity was evaluated by the modified neurological severity score (mNSS), and the morphological changes of neurons were observed after H.E. staining. The expression of HMGB1 and TLR4 proteins were detected by immunofluorescence staining. The contents of tumor necrosis factor (TNF)-α and interleukin (IL)-6 in the ischemic area tissue of the brain were detected using ELISA. The mRNA expressions of HMGB1 and TLR4 as well as the expression of miR-218 in the ischemic cortex were detected by PCR.

Compared with the sham operation group, the mNSS at 2 h, 48 h and 7 day (d), IL-6 and TNF-α contents, HMGB1 and TLR4 immunoactivity and mRNA expression at 48 h and 7 d were significantly increased (P < 0.01), while miR-218 expression at 48 h and 7 d was obviously downregulated (P < 0.01) in the model group. In comparison with the model group, the mNSS at 7 d, IL-6 and TNF-αcontents, HMGB1 and TLR4 immunoactivity and mRNA expression at 7 d not at 48 h were significantly decreased (P < 0.01, P < 0.05), while the expression of miR-218 at 7 d was apparently up-regulated (P < 0.05) in the EA group. H.E. staining showed that there were signs of neuronal necrosis including blurred outline of the cells, disordered internal structure, dense cytoplasm, shrunk nuclei, etc. in the ischemic area of the brain at 48 h and 7 d in the model group, which was evidently milder on day 7 in the EA group.

EA can reduce the inflammatory injury of brain tissue and improve the neurological impairment in rats with FCI, which may be associated with its effects in inhibiting HMGB1/TLR4 signaling and down-regulating the level of pro-inflammatory cytokines.