目的比较电针手部经筋结点疗法与电针传统穴位疗法治疗脑卒中后(痉挛期)手运动功能障碍的临床疗效差异。方法纳入64例脑卒中后痉挛期手运动功能障碍患者,随机分为经筋结点组和传统穴位组,每组32例,其中经筋结点组脱落1例,传统穴位组脱落...目的比较电针手部经筋结点疗法与电针传统穴位疗法治疗脑卒中后(痉挛期)手运动功能障碍的临床疗效差异。方法纳入64例脑卒中后痉挛期手运动功能障碍患者,随机分为经筋结点组和传统穴位组,每组32例,其中经筋结点组脱落1例,传统穴位组脱落2例。两组均加电针,每次治疗30 min,每天2次,每周6 d,共4周。经筋结点组针刺指伸肌结点和指外展结点,传统穴位组针刺外关和合谷、阳池、后溪、大陵。通过改良Ashworth痉挛评定量表(modified Ashworth scale,MAS)、临床神经功能缺损程度评分、腕手部关节主动活动度(active range of motion,AROM)、简化Fugl-Meyer运动功能评分法(Fugl-Meyer assessment,FMA)(手部分)进行疗效判定。结果治疗后经筋结点组和传统穴位组AROM、FMA较治疗前均有提高(P<0.05),临床神经功能缺损程度、MAS评分均较治疗前降低(P<0.01,P<0.05),且治疗后经筋结点组MAS、AROM、FMA、临床神经功能缺损程度评分均优于传统穴位组(P<0.05);电针针刺经筋结点组总有效率为87%(27/31),电针传统穴位组总有效率为70%(21/30),两组比较结果有统计学意义(P<0.05)。结论电针手部经筋结点疗法对脑卒中后痉挛期手运动功能障碍治疗有效,且疗效优于电针传统穴位疗法。展开更多
Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we p...Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle te展开更多
Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in pat...Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.展开更多
文摘目的比较电针手部经筋结点疗法与电针传统穴位疗法治疗脑卒中后(痉挛期)手运动功能障碍的临床疗效差异。方法纳入64例脑卒中后痉挛期手运动功能障碍患者,随机分为经筋结点组和传统穴位组,每组32例,其中经筋结点组脱落1例,传统穴位组脱落2例。两组均加电针,每次治疗30 min,每天2次,每周6 d,共4周。经筋结点组针刺指伸肌结点和指外展结点,传统穴位组针刺外关和合谷、阳池、后溪、大陵。通过改良Ashworth痉挛评定量表(modified Ashworth scale,MAS)、临床神经功能缺损程度评分、腕手部关节主动活动度(active range of motion,AROM)、简化Fugl-Meyer运动功能评分法(Fugl-Meyer assessment,FMA)(手部分)进行疗效判定。结果治疗后经筋结点组和传统穴位组AROM、FMA较治疗前均有提高(P<0.05),临床神经功能缺损程度、MAS评分均较治疗前降低(P<0.01,P<0.05),且治疗后经筋结点组MAS、AROM、FMA、临床神经功能缺损程度评分均优于传统穴位组(P<0.05);电针针刺经筋结点组总有效率为87%(27/31),电针传统穴位组总有效率为70%(21/30),两组比较结果有统计学意义(P<0.05)。结论电针手部经筋结点疗法对脑卒中后痉挛期手运动功能障碍治疗有效,且疗效优于电针传统穴位疗法。
基金supported by a grant from the Supporting Program of the"Eleventh Five-year Plan"for Science&Technology Research of China,Ministry of Science and Technology of China,No.2006BAI12B02a grant from the Scientific Research Fund for Talent Introduction in the Gansu University of Chinese Medicine of China,No.2012-11
文摘Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui（GV20） and Taiyang（EX-HN5）. We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave（Hmax/Mmax）, muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of ＂Deficiency and Excess＂. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was 〉 0 or 〈 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle te
基金supported by a grant from the Construction of Traditional Chinese Medicine Prevention and Treatment of Apoplexy Comprehensive System,No.201007002
文摘Tongguan Liqiao acupuncture therapy has been shown to effectively treat dysphagia after stroke-based pseudobulbar paralysis. We presumed that this therapy would be effective for dysphagia after bulbar paralysis in patients with brainstem infarction. Sixty-four patients with dysphagia following brainstem infarction were recruited and divided into a medulla oblongata infarction group（n = 22）, a midbrain and pons infarction group（n = 16）, and a multiple cerebral infarction group（n = 26） according to their magnetic resonance imaging results. All patients received Tongguan Liqiao acupuncture for 28 days. The main acupoints were Neiguan（PC6）, Renzhong（DU26）, Sanyinjiao（SP6）, Fengchi（GB20）, Wangu（GB12）, and Yifeng（SJ17）. Furthermore, the posterior pharyngeal wall was pricked. Before and after treatment, patient swallowing functions were evaluated with the Kubota Water Test, Fujishima Ichiro Rating Scale, and the Standard Swallowing Assessment. The Barthel Index was also used to evaluate their quality of life. Results showed that after 28 days of treatment, scores on the Kubota Water Test and Standard Swallowing Assessment had decreased, but scores on the Fujishima Ichiro Rating Scale and Barthel Index had increased in each group. The total efficacy rate was 92.2% after treatment, and was most obvious in patients with medulla oblongata infarction（95.9%）. These findings suggest that Tongguan Liqiao acupuncture therapy can repair the connection of upper motor neurons to the medulla oblongata motor nucleus, promote the recovery of brainstem infarction, and improve patient＇s swallowing ability and quality of life.
