Acupuncture for Dysphagia Among Patients with Acute Ischemic Stroke: A Randomized Clinical Trial

Background: Acupuncture may be effective for post-stroke dysphagia (PSD) after acute ischemic stroke, but the evidence is limited. The aim of this trail was to assess the effect of acupuncture for PSD after acute ischemic stroke.

Methods: A multicentre, randomised, sham-controlled trial was conducted at 23 hospitals in China between 4 August 2020 and 25 April 2023 (Chinese Clinical Trial Registry, ChiCTR1900028061). We enrolled 300 participants diagnosed with PSD after acute ischemic stroke, whose Functional Oral Intake Scale levels were between 2 and 4. Participants were randomised 1:1 to receive 10 sessions of either true acupuncture (TA) or sham acupuncture (SA) delivered over 14 days. The primary outcome was the response rate at day 14, defined as the percentage of participants achieving the Functional Oral Intake Scale level ≥6. Secondary outcomes assessed included measures of swallowing function, quality of life, patient-reported outcomes, nutritional status, and incidence of pneumonia.

Results: Of 300 eligible participants, 149 were randomly assigned to SA and 151 were randomly assigned to TA (1 did not diagnose ischemic stroke). At day 14, the TA group exhibited a higher response rate compared to the SA group (117 [78.0%] vs. 85 [57.0%]; relative risk, 1.37 [95% CI, 1.16 to 1.61]; P< 0.001). Four cases of treatment-related adverse events were reported in the TA group, and 3 were reported in the SA group. All events were mild and transient.

Interpretation: Two weeks of TA demonstrated superior recovery of swallowing function compared to SA in patients with dysphagia after acute ischemic stroke.