Mendelsohn maneuver plus heat-sensitive moxibustion at Lianquan (CV23) improves swallowing after s

Background and objectives

Dysphagia is a common sequela of stroke. This randomized controlled trial evaluated whether adding heat-sensitive moxibustion at Lianquan (CV23) to the Mendelsohn maneuver improves swallowing recovery and reduces complications in patients with post-stroke dysphagia.

The stated objective was to investigate the effect of combining the Mendelsohn maneuver with heat-sensitive moxibustion at CV23 on swallowing function, electrophysiologic measures, nutrition, quality of life, and complication rates.

Study design and participants

The trial enrolled 105 patients with post-stroke dysphagia between January 2024 and February 2025. Patients were randomized by random number table into three groups of 35 participants each. The publication is reported in Zhen Ci Yan Jiu and the abstract is available in English and Chinese on PubMed. The full text is in Chinese; additional methodological details beyond the abstract were not provided in the PubMed record.

Interventions

• Control group 1: Mendelsohn maneuver alone.
• Control group 2: Heat-sensitive moxibustion at Lianquan (CV23) alone.
• Observation group: Mendelsohn maneuver combined with heat-sensitive moxibustion at CV23.

All groups received continuous treatment for 4 weeks. The abstract does not report exact session frequency, duration per session, or operator qualifications; these details were not provided in the PubMed abstract.

Outcome measures

The trial compared multiple domains before and after treatment:

• Clinical efficacy (total effective rate).
• Structural and kinematic measures: lateral pharyngeal wall movement; superior and anterior displacement of the hyoid bone and thyroid cartilage (hyolaryngeal mobility).
• Electrophysiology: surface electromyography (sEMG) maximum amplitude and swallowing duration.
• Instrumental and clinical swallowing assessments: videofluoroscopic swallowing study (VFSS), Water Swallowing Test (WST), and Standardized Swallowing Assessment (SSA).
• Patient-reported and nutritional outcomes: SWAL-QOL score, serum albumin (ALB), prealbumin (PA), and transferrin (TRF).
• Safety: adverse reactions during intervention, vital signs, routine laboratory and other examinations.
• Three-month follow-up for complication rates.

Results: clinical efficacy and objective swallowing measures

The combined-intervention (observation) group achieved a total effective rate of 94.29%, which was statistically higher than both the Mendelsohn-alone group (71.43%) and the moxibustion-alone group (68.57%) (P < 0.05).

After 4 weeks of treatment, all three groups showed significant improvement versus baseline across multiple measures (P < 0.05). Improvements reported in the abstract included:

• Increased lateral pharyngeal wall movement.
• Increased superior and anterior displacement distances of the hyoid bone and thyroid cartilage, indicating greater hyolaryngeal excursion.
• Increased maximum sEMG amplitude.
• Higher VFSS scores.

Crucially, the observation group showed greater improvements than either control group across these structural, electrophysiologic, and imaging endpoints (P < 0.05).

Additionally, the combined group demonstrated a shorter sEMG-measured swallowing duration and lower (improved) WST grade and SSA score compared with either control group after treatment (P < 0.05).

Results: quality of life, nutrition, and safety

• SWAL-QOL scores increased in all groups after 4 weeks, with the combined-intervention group reporting higher scores than the other two groups (P < 0.05).
• Serum nutritional markers—ALB, TRF, and PA—rose in all groups compared with baseline (P < 0.05), and levels in the combined group were higher than in either control group (P < 0.05), indicating improved nutritional status.

Safety findings reported in the abstract were favorable: during the intervention period only one adverse event occurred — a small blister at the moxibustion site in one patient from the moxibustion-only group. There were no significant abnormalities in general vital signs or routine examinations before and after intervention across the three groups.

Three-month follow-up and complications

At 3-month follow-up the complication rates differed substantially between groups. The observation group had a complication rate of 5.71%, which was lower than 25.71% in the Mendelsohn-only group and 31.43% in the moxibustion-only group (P < 0.05). The abstract does not enumerate the specific complications recorded; those details were not reported in the PubMed summary.

Study conclusions and limitations

The authors conclude that combining the Mendelsohn maneuver with heat-sensitive moxibustion at Lianquan (CV23) can: strengthen pharyngeal constrictor activity, improve sEMG signals, promote recovery of swallowing function in patients with post-stroke dysphagia, reduce related complications, and improve nutritional status and quality of life.

Limitations evident from the PubMed record include that the full trial report is in Chinese and the abstract does not provide procedural details such as session frequency, exact moxibustion technique parameters, blinding, or comprehensive adverse-event listing. Those methodological and safety details would need to be confirmed by consulting the full text.

Conflict of interest: all authors declared no conflict of interest.