[Effect of Mendelsohn maneuver combined with heat-sensitive moxibustion at Lianquan (CV23) on swallowing function and complications in patients with post-stroke dysphagia].
Liu Y, Jiao Q, Bai Y, Chen Q • Zhen ci yan jiu = Acupuncture research • 2026
The Mendelsohn maneuver combined with heat-sensitive moxibustion at CV23 can effectively activate the pharyngeal constrictor muscles, improve sEMG signals, promote the recovery of swallowing function in patients with post-stroke dysphagia, and exert positive effects in reducing related complications, improving nutritional status and quality of life.
Key Findings
Results
The combination of Mendelsohn maneuver and heat-sensitive moxibustion at CV23 produced a higher total effective rate than either intervention alone.
Total effective rate in the observation group (combination) was 94.29%.
Total effective rate in control group 1 (Mendelsohn maneuver alone) was 71.43%.
Total effective rate in control group 2 (heat-sensitive moxibustion alone) was 68.57%.
Differences were statistically significant (P<0.05).
All groups were treated continuously for 4 weeks; n=35 per group.
Results
All three groups showed significant improvements in lateral pharyngeal wall movement and hyolaryngeal complex mobility after 4 weeks of treatment, with the combination group showing greater improvements than either monotherapy group.
Lateral pharyngeal wall movement, superior and anterior displacement of the hyoid bone, and superior and anterior displacement of the thyroid cartilage all increased significantly from baseline in all three groups (P<0.05).
The observation group's values for these measures were higher than those of both control groups after treatment (P<0.05).
These measures reflect activation and strengthening of the pharyngeal constrictor muscles.
Treatment duration was 4 weeks across all groups.
Results
Surface electromyography (sEMG) signals improved significantly in all groups, with the combination group showing higher maximum amplitude and shorter swallowing duration than monotherapy groups.
Maximum amplitude of sEMG increased from baseline in all three groups (P<0.05), with the observation group showing higher values than control groups 1 and 2 (P<0.05).
Swallowing duration on sEMG decreased from baseline in all three groups (P<0.05), with the observation group showing lower values than both control groups (P<0.05).
sEMG was used as an objective measure of swallowing muscle activity.
Results
Swallowing function as measured by WST, SSA, and VFSS improved in all groups after 4 weeks, with the combination group performing significantly better than monotherapy groups.
Water swallowing test (WST) grades and Standardized Swallowing Assessment (SSA) scores decreased (improved) from baseline in all groups (P<0.05), with the observation group showing lower values than control groups 1 and 2 (P<0.05).
Videofluoroscopic swallowing study (VFSS) scores increased from baseline in all groups (P<0.05), with the observation group scoring higher than both control groups (P<0.05).
VFSS provides objective imaging-based assessment of swallowing physiology.
Results
Swallowing-related quality of life (SWAL-QOL) scores improved significantly in all groups, with the combination group achieving higher scores than either monotherapy group.
SWAL-QOL scores increased from baseline in all three groups after 4 weeks (P<0.05).
The observation group's SWAL-QOL scores were higher than those of both control groups (P<0.05).
The SWAL-QOL is a swallowing disorder-specific quality of life questionnaire.
Results
Nutritional status markers improved in all groups after treatment, with the combination group showing greater improvements than monotherapy groups.
Serum levels of albumin (ALB), transferrin (TRF), and prealbumin (PA) all increased from baseline in all three groups (P<0.05).
The observation group had higher levels of ALB, TRF, and PA than both control groups after treatment (P<0.05).
Improved nutritional status is consistent with better swallowing function and reduced aspiration risk.
Results
The complication rate at 3-month follow-up was significantly lower in the combination group than in either monotherapy group.
Complication rate in the observation group at 3-month follow-up was 5.71%.
Complication rate in control group 1 (Mendelsohn maneuver alone) was 25.71%.
Complication rate in control group 2 (heat-sensitive moxibustion alone) was 31.43%.
Differences were statistically significant (P<0.05).
Results
The combined and monotherapy interventions were safe, with only one minor adverse event recorded across all 105 patients.
Only 1 patient, in control group 2 (moxibustion alone), developed small blisters at the moxibustion site during the intervention period.
No significant abnormalities were found in general vital signs or routine examinations in any of the three groups before or after intervention.
No adverse reactions were reported in the Mendelsohn maneuver group or the combination group.
What This Means
This research suggests that combining two treatments—the Mendelsohn maneuver (a swallowing exercise where patients hold their throat muscles raised during swallowing) and heat-sensitive moxibustion at a specific acupuncture point on the throat called Lianquan (CV23)—is more effective for stroke patients who have difficulty swallowing than using either treatment alone. The study enrolled 105 post-stroke patients with swallowing difficulties, divided equally into three groups: one receiving only the swallowing exercise, one receiving only the moxibustion, and one receiving both. After four weeks of treatment, the combination group had a 94% overall effectiveness rate, compared to about 71% and 69% for the individual treatments. Objective measures including muscle activity recordings, X-ray swallowing studies, and physical measurements of throat movement all confirmed greater improvements in the combination group.
This research also suggests that the combined treatment led to better nutritional outcomes—measured by blood protein levels—and a substantially lower rate of complications (such as aspiration pneumonia) at three months after treatment. Only 5.7% of patients in the combination group developed complications, compared to about 26–31% in the single-treatment groups. The treatments were found to be safe, with only one minor skin blister from moxibustion reported across all participants.
These findings matter because difficulty swallowing after stroke is common and can lead to serious problems including malnutrition, dehydration, and lung infections from accidentally inhaling food or liquid. This research suggests that adding traditional Chinese medicine techniques such as heat-sensitive moxibustion to standard rehabilitation exercises may offer meaningful additional benefit for stroke patients struggling with swallowing, potentially reducing serious complications and improving quality of life.
Liu Y, Jiao Q, Bai Y, Chen Q. (2026). [Effect of Mendelsohn maneuver combined with heat-sensitive moxibustion at Lianquan (CV23) on swallowing function and complications in patients with post-stroke dysphagia].. Zhen ci yan jiu = Acupuncture research. https://doi.org/10.13702/j.1000-0607.20250739