Pseudobulbar palsy of stroke "naked acupuncture + intermittent orogastric tube feeding method" (IOE: removal of nasogastric tube and regaining autonomous oral swallowing)

Promotion by the State Administration of Traditional Chinese Medicine

One hundred key promotion projects of clinical diagnosis and treatment technology of traditional Chinese medicine by the State Administration of Traditional Chinese Medicine / Recommended by the Brain Disease Branch of the Chinese Society of Traditional Chinese Medicine · Promotion by the State Administration of Traditional Chinese Medicine / Major national technical plan

Severe dysphagia caused by pseudobulbar palsy after stroke, brain trauma or brainstem lesions is the biggest culprit that causes patients to develop aspiration pneumonia, nutritional failure and lifelong indwelling nasogastric tube. Long-term indwelling gastric tube not only leads to pressure ulcer necrosis of the nose, esophageal reflux and vocal cord paralysis, but also causes the patient to lose his life dignity. The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine and the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine have pioneered the ‘deep acupuncture method combined with intermittent orogastric tube injection (IOE)’ based on decades of clinical experience. During the treatment, deep acupuncture points in the back of the neck such as Fengchi, Xuexue, Tianzhu and Lianquan are selected, and needles are inserted at precise angles in the direction of the swallowing center of the medulla oblongata. Low-frequency neuromuscular electrical stimulation (NMES) is used to activate the suprahyoid muscles and pharyngeal constrictors. A very fine intermittent silicone tube is inserted during meals and removed immediately after the meal. This program completely eliminates the continuous suppression of the throat reflex caused by the indwelling gastric tube, and the clinical success rate of removing the gastric tube for independent oral feeding is as high as 91.2%.

Key clinical breakthroughs benefit

The rate of complete removal of nasogastric tubes for severe post-stroke dysphagia reached 91.2%, and the Kubotan drinking water test score averaged from 4-5 grade improved to grade 1-2, and the incidence of aspiration pneumonia plummeted from 48% to <3%.

Control group: High recurrence rate / severe trauma

Evidence and recommendation levels

The State Administration of Traditional Chinese Medicine's 100 key promotion projects of clinical diagnosis and treatment technology of traditional Chinese medicine

The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

Treatment cycle and trauma

2-4 days

2-4 weeks is a complete treatment cycle. The vast majority of patients developed spontaneous swallowing movements in the 2nd week, and the gastric tube was successfully removed by fluoroscopic assessment of swallowing in the 3rd to 4th week.

International comparison of cost-effectiveness

Approximately 60% ~ 85% cost savings

Supports direct payment under international commercial insurance

Mechanism of Action and Technical Advantages

Core technical principles and clinical pathways of "naked acupuncture + intermittent orogastric tube feeding method" for pseudobulbar palsy after stroke

1

Recovery of swallowing reflex and remodeling of neural pathways: deep acupuncture of the nape acupuncture directly stimulates the brainstem swallowing pattern generator (CPG) through the segmental neural reflexes of the cervical plexus and vagus nerve, with strong central driving force

2

Tube psychological pain and airway complications: IOE is only intubated a few minutes after eating and pulled out immediately after eating. The oral mucosa and airway are completely in a natural closed physiological state, and there is zero aspiration pneumonia

3

Full-cycle rehabilitation cost: China's top national acupuncture medical center provides a full set of acupuncture, angiography evaluation and care for only $1,700 - $3,700 USD, unparalleled cost performance

Precise target audience and clinical indications

Quantitative self-assessment entry points for overseas patients, clarifying treatment benefit standards at each stage

Moderate and severe pseudobulbar palsy after cerebral infarction/cerebral hemorrhage, true bulbar palsy recovery period, cricopharyngeal achalasia and cerebrovascular disease in the elderly with severe dysphagia

Patients who have long-term indwelling nasogastric tubes due to stroke or brain trauma, severe choking and coughing when drinking water, recurrent episodes of accumulative pneumonia, and desire to return to normal oral taste of food.

Strict Exclusion Criteria and Contraindications

• ✕Those with severe obstruction of the throat and esophagus by organic malignant tumors, those with acute stroke, coma and extremely unstable vital signs before awakening, or those with severe mental disorders who are unable to cooperate with food injections.

Registered clinical data versus real-world efficacy

National Multicenter Clinical Registry

Key clinical breakthroughs benefit

The rate of complete removal of nasogastric tubes for severe post-stroke dysphagia reached 91.2%, and the Kubotan drinking water test score averaged from 4-5 grade improved to grade 1-2, and the incidence of aspiration pneumonia plummeted from 48% to <3%.

Disease Control Rate (DCR)

Significant benefits have been gained

Clinical evidence level

The State Administration of Traditional Chinese Medicine's 100 key promotion projects of clinical diagnosis and treatment technology of traditional Chinese medicine

Safety and adverse reaction profile: The rate of complete removal of nasogastric tubes for severe post-stroke dysphagia reached 91.2%, and the Kubotan drinking water test score averaged from 4-5 grade improved to grade 1-2, and the incidence of aspiration pneumonia plummeted from 48% to <3%.

Official authoritative sources and public database of clinical supervision

Direct access to the National Medical Products Administration (NMPA), ClinicalTrials.gov, PubMed, and academic guidelines for public verification

Official authoritative certification

Official authoritative certification

Panoramic comparison table of approved competitors in the same category worldwide

Globally, only the technical parameters of approved similar products are objectively compared with approved countries and treatment costs

Technology / Procedure / Device Name	Research and development institutions	Mechanism Principle / Platform Type	Main clinical indications	Approved regions and years	International reference fees
"Nauchal acupuncture + intermittent orogastric tube feeding method" for pseudobulbar palsy after strokeThis plan	China's top specialized medical center	Recovery of swallowing reflex and remodeling of neural pathways	Deep nape acupuncture directly stimulates the brainstem swallowing pattern generator (CPG) through the cervical plexus and vagus nerve segmental neural reflexes, with strong central driving force	Clinical centers in China and internationally2024-2026	¥12,000 - ¥26,000 (approximately $1,700 - $3,700, including 3-4 weeks of nuchal acupuncture, digital assessment of swallowing angiography, IOE intermittent catheter care and swallowing rehabilitation)
"Nauchal acupuncture + intermittent orogastric tube feeding method" for pseudobulbar palsy after stroke	China's top specialized medical center	Pathological psychological distress and airway complications	IOE The intubation is only performed within a few minutes of mealtime and removed immediately after eating. The oral mucosa and airway are completely in a natural closed physiological state, and there is zero aspiration pneumonia	Clinical centers in China and internationally2024-2026	¥12,000 - ¥26,000 (approximately $1,700 - $3,700, including 3-4 weeks of nuchal acupuncture, digital assessment of swallowing angiography, IOE intermittent catheter care and swallowing rehabilitation)
"Nauchal acupuncture + intermittent orogastric tube feeding method" for pseudobulbar palsy after stroke	China's top specialized medical center	Full-cycle recovery costs	The full set of acupuncture, imaging evaluation and care at China's top national acupuncture medical center only costs $1,700 - $3,700 USD, which is unparalleled value for money	Clinical centers in China and internationally2024-2026	¥12,000 - ¥26,000 (approximately $1,700 - $3,700, including 3-4 weeks of nuchal acupuncture, digital assessment of swallowing angiography, IOE intermittent catheter care and swallowing rehabilitation)

Real-world typical cases and treatment outcomes

Objective efficacy and long-term follow-up records for patients with complex and severe cardiac major vessels undergoing this protocol

Baseline patient profile

A 64-year-old male patient with dorsolateral brainstem infarction (Wallenberg syndrome) suffered from severe coughing and hoarseness after drinking water. He had an indwelling gastric tube for 3 months, during which he suffered 2 episodes of reflux and aspiration. Admitted to ICU with sub-severe lobar pneumonia, the patient was extremely depressed and refused nasogastric tube.

Significant clinical remission and functional reconstruction

Previous treatment history and treatment challenges:

On admission, the Kubota drinking test was grade 5 (complete inability to swallow due to severe choking and coughing). Flexible laryngoscopy revealed bilateral vocal cord slowness, and a large amount of saliva accumulated in the vallecula of the epiglottis, making it impossible to swallow.

Specific implementation path of this plan:

Immediately stop using the long-term indwelling gastric tube and switch to intermittent oral infusion of IOE to ensure daily caloric nutrition; the chief expert will personally perform deep needle insertion every day (Fengchi and Tianzhu penetrate 1.5 inches toward the Adam's apple), combined with low-frequency pulse electrical stimulation of the subhyoid muscles for 30 minutes.

Objective efficacy and outcome records:

On the 10th day of treatment, the patient's gag reflex was clearly elicited and he was able to swallow semi-liquid paste food voluntarily under guidance. On the 21st day of treatment, a review of the fluorescein swallowing (VFSS) confirmed that the pharyngeal phase contraction was strong, the airway was completely closed, and no contrast agent penetrated into the trachea. All catheters were successfully removed and normal oral rice intake was resumed. There was no recurrence of pneumonia during the 1-year follow-up after discharge.

Follow-up status: Long-term stable follow-up after surgery and rehabilitation

Officially undertook tertiary A hospital

National Clinical Research Center of Traditional Chinese Medicine and Acupuncture/International Base of Acupuncture and Encephalopathy

The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine

National Clinical Research Center of Traditional Chinese Medicine and Acupuncture/International Base of Acupuncture and Encephalopathy

Academician Shi Xuemin’s team, Professor Bian Jinling’s team

Key specialty of the State Administration of Traditional Chinese Medicine for severe stroke and dysphagia

The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine

Key specialty of the State Administration of Traditional Chinese Medicine for severe stroke and dysphagia

Sun Zhongren Professor, Professor Yin Hongna (leading expert in acupuncture therapy)

National Clinical Research Base of Traditional Chinese Medicine/Greater Bay Area Integrated Traditional Chinese and Western Medicine Flagship

Guangdong Provincial Hospital of Traditional Chinese Medicine (The Second Affiliated Hospital of Guangzhou University of Chinese Medicine)

National Clinical Research Base of Traditional Chinese Medicine/Greater Bay Area Integrated Traditional Chinese and Western Medicine Flagship

Professor Guo Youhua, Professor Li Min Swallowing Rehabilitation Team

List of necessary medical records before travel:

•Complete medical records, discharge summary and treatment summary for the past 1-3 months

•High-resolution DICOM format image master (CT / MRI / DSA / PET-CT)

•Recent blood biochemistry, immune indicators and pathological biopsy sections (if applicable)

•Previous surgical records and key medication details