Objective: To observe the clinical efficacy of fire needle therapy in treating symptoms of bulbar paralysis such as dysphagia in patients with amyotrophic lateral sclerosis (ALS).

Method: The study included 56 ALS patients with bulbar palsy symptoms such as dysphagia from June 2020 to December 2024, who were randomly divided into a fire acupuncture group and conventional acupuncture group. Based on modern medical treatment, the fire acupuncture group received sublingual three-needle fire acupuncture therapy, while the conventional acupuncture group received conventional acupuncture therapy, with an 8-week treatment period. Fire acupuncture points selected were Lianquan (tongue I acupuncture) and bilateral points 0.8 cun lateral to Lianquan (tongue II and III acupuncture). Efficacy was evaluated using the Water Swallowing Test, Fujimura Swallowing Function Scoring Standard, Amyotrophic Lateral Sclerosis Symptom Score in Integrative Treatments (ALS-SSIT) oropharyngeal function score, modified Amyotrophic Lateral Sclerosis Symptom Functional Rating Scale (ALSFRS-R) and Drooling Severity and Frequency Scale (DSFS).

Results: Fifty-six patients were enrolled, 5 patients dropped out, and 51 patients were finally included in the statistical analysis (26 cases in the fire acupuncture group, 25 cases in the conventional acupuncture group). At the 8th week of treatment, the proportion of patients with mild symptoms according to the Water Swallowing Test in the fire acupuncture group increased compared to before treatment, and the difference was statistically significant (P<0.05). After 8 weeks of treatment, Fujimura Swallowing Function score, ALS-SSIT oropharynx function score and DSFS score in the fire acupuncture group were significantly better than those before treatment (P<0.05), and were significantly better than those after treatment in the conventional acupuncture group (P<0.05). The ALSFRS-R score of the fire acupuncture group after treatment was also significantly better than that of the conventional acupuncture group (P<0.05).

Conclusion: Compared with conventional acupuncture, fire acupuncture can significantly improve the dysphagia and salivation symptoms of ALS patients, and can delay the disease progress to a certain extent. Fire acupuncture may serve as an adjuvant treatment for ALS patients with symptoms of medullary paralysis such as swallowing difficulties and drooling.