经筋刺血对脑卒中后患者上肢痉挛状态的影响

Objective:To observe effects of pricking blood therapy at meridian sinews on upper limb spasm of poststroke patients.Methods:A total of 72 patients with post-stroke upper limb spasm were randomly divided into a comprehensive group of pricking blood therapy at meridian sinews with rehabilitation training(comprehensive group)and the simple rehabilitation training group(rehabilitation group),and there were 36 patients in each group.On the basis of routine therapy,the patients of the two groups received rehabilitation therapy for 6 consecutive days and 1-day rest,for 4 weeks in total.On the above basis,the patients in the comprehensive group received pricking blood therapy at meridian sinews,once every other day,3 times per week,for 4 weeks in total.Before treatment,after the first treatment,and after 4-week treatment,the patients were observed for changes of upper limb spasticity(Modified Ashworth Scale,MAS),upper limb movement function(Fugl-Meyer Assessment,FMA),activity of daily living(Modified Barthel Index,MBI),and biceps and triceps integrated electromyogram(IEMG)values were observed as well as the therapeutic effects.Results:(1)After the first treatment,there were statistically significant differences of the MAS scale grades in patients of the two groups(P<0.05).The FMA scores in the comprehensive group were increased than that before treatment(P<0.05),and the MBI scores of the two groups were increased than those before treatment(both P<0.05).The FMA and MBI scores in the comprehensive group were higher than those of the rehabilitation group(both P<0.05).The biceps and triceps IEMG values were not improved than those before treatment(all P>0.05).(2)After 4-week treatment,there were statistically significant differences of MAS grades in patients of the two groups(P<0.05).The FMA and MBI scores in the two groups were increased than those before treatment(all P<0.05),and the FMA and MBI scores in the comprehensive group were higher than those in the rehabilitation group(both P<0.05).Through comparison of the differences of FMA and MBI scores of the two groups,the difference values in the comprehensive group were higher than those of the rehabilitation group(both P<0.05).The biceps and triceps IEMG values in the two groups were decreased than those before treatment(all P<0.05),and those in the comprehensive group were lower than those in the rehabilitation group(both P<0.05).The biceps and triceps IEMG values in patients of the comprehensive group were higher than those before treatment(both P<0.05).(3)After 4-week treatment,the total effective rate in the comprehensive group was 83.3%(30/36),and that was 58.3%(21/36)in the rehabilitation group.The total effective rate in the comprehensive group was higher than that in the rehabilitation group(P<0.05).Conclusions:The pricking blood therapy at meridian sinews can release affected upper limb flexor muscle spasticity and movement function of the patients with post-stroke upper limb spasm,decrease biceps IEMG values of the affected side,and improve activities of daily living.

吞咽五穴联合康复训练治疗脑卒中后假性延髓麻痹:随机对照试验

Objective:To compare the clinical effects of needling at "five acupoints for swallow function" combined with rehabilitation training and only rehabilitation training in the treatment of dysphagia due to pseudobulbar paralysis after stroke.Methods:Seventy-six patients were randomized into rehabilitation group and combination group,with 38 cases in each.Both groups were treated with basic treatment of western medicine.The rehabilitation group was treated with routine rehabilitation training,and the combination group was treated with acupuncture at "five acupoints for swallow function" based on treatment in the rehabilitation group.Patients in the two groups were treated once a day,6 days a week,1 day for rest,for 3 weeks in succession.The changes in the grades and scores of water swallow test(WST),video fluoroscopic swallowing study(VFSS),and swallowing quality of life questionnaire(SWAL-QOL) in the two groups were observed before and after treatment,and the clinical effects of the two groups were compared.Results:After treatment,the WST grades of the two groups were statistically different from that of before treatment(both P<0.05),and the WST grade of the combination group was statistically different from that of the rehabilitation group(P<0.05).After treatment,the VFSS and SWAL-QOL scores of the two groups were increased in comparing with those of before treatment(all P <0.05),and the VFSS and SWAL-QOL scores of the combination group were higher than those of the rehabilitation group(both P <0.05).The total effective rate of the combination group was 92.1%(35/38),higher than 60.1%(23/38) of the rehabilitation group.Conclusion:The acupuncture combined with rehabilitation training for pseudobulbar paralysis after stroke is more effective than rehabilitation training only.The combination of the two can significantly relieve the dysphagia and improve the patients' quality of life.

Preservation of Equilibria for Symplectic Methods Applied to Hamiltonian Systems

In this paper, the linear stability of symplectic methods for Hamiltonian systems is studied. In par- ticular, three classes of symplectic methods are considered： symplectic Runge-Kutta （SRK） methods, symplectic partitioned Runge-Kutta （SPRK） methods and the composition methods based on SRK or SPRK methods. It is shown that the SRK methods and their compositions preserve the ellipticity of equilibrium points uncondi- tionally, whereas the SPRK methods and their compositions have some restrictions on the time-step.

Structure-Preserving Algorithms for a Class of Dynamical Systems

In this paper, we study structure-preserving algorithms for dynamical systems defined by ordinary differential equations in R^n The equations are assumed to be of the form y^· = A（y） ＋ D（y） ＋ R（y）, where A（y） is the conservative part subject to （A（y）, y） = 0; D（y） is the damping part or the part describing the coexistence of damping and expanding; R（y） reflects strange phenomenon of the system. It is shown that the numerical solutions generated by the symplectic Runge-Kutta（SRK） methods with bi 〉 0 （ i = 1,..., s） have long-time approximations to the exact ones, and these methods can describe the structural properties of the quadratic energy for these systems. Some numerical experiments and backward error analysis also show that these methods are better than other methods including the general algebraically stable Runge-Kutta（RK）methods.