Timeliness of the analgesic effect of superficial needling on shoulder-hand syndrome after stroke

Objective To observe the correlation between analgesic effect and duration of analgesic effect of superficial needling for shoulder pain of shoulderhand syndrome（SHS） after stroke, so as to screen the best time period of analgesia. Methods A total of 120 patients with SHS after stroke（stage I） were recruited and superficial needling therapy was applied. Two obvious tenderness points on the affected shoulder of patients were found out. The site 80–100 mm down each tenderness point was selected for superficial needling. Bimanual needling technique was applied after inserting needles. The surrounding of tenderness points was pinched and grasped by left hand above the needling, and the technique of green dragon swaying tail was applied by right hand. The needles at each acupoint were manipulated for3 min and retained for 30 min. The analgesic effect was evaluated dynamically by visual analogue scale（VAS） in 120 patients before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The analgesic effects at different time were statistically analyzed by generalized estimating equation. Results The mean values of VAS were 7.483, 3.950, 4.767, 5.917 and 7.217, respectively, before treatment, immediately after treatment, 30 min after treatment, 1 h after treatment and 24 h after treatment. The difference of analgesic effect at different time was statistically significant（P〈0.01）; the difference of analgesic effect of superficial needling in treatment of SHS after stroke was significant between immediately after treatment and 30 min after treatment（both P〈0.05）, while there was no significant difference between 1 h after treatment and 24 h after treatment（both P〈0.05）. Conclusion Analgesic effect of superficial needling for shoulder pain of SHS after stroke was different at different time points and decreased over time; analgesic effect was the most significant immediately after treatment and the optimal duration of analgesic effect was from immediately to 30 min after superficial needling therapy.

Effect of kinetic needling combined with blood-letting puncturing and cupping on functions of upper limbs of patients with shoulder-hand syndrome after apoplexy

Objective To observe influence of kinetic needling on functional restoration of upper limbs of patients with apoplexy-induced shoulder-hand syndrome. Methods Ninety patients were randomly divided into an observation group （45 cases） and a control group （45 cases）. Basic treatments selected according to corresponding stroke units were applied to both groups. Besides, scalp acupuncture at Dingnie Qianxiexian （MS 6, 顶颞前斜线）, Dingnie Houxiexian （MS 6, 顶颞前斜线） and Dingzhongxian （NS 5, 顶中线）, was applied in the treatment group. In the observation group, active and passive movement was carried out during the process of scalp acupuncture, and then needling plus bloodletting puncturing and cupping was applied. In the control group, only needling plus blood-letting puncturing and cupping was given. Therapeutic effects, pain scoring obtained by visual analogue scales （VAS）, FugI-Meyer and FugI-Meyer＇s scoring reflecting moving functions of upper limbs were made after 4 courses of treatments in both groups. Results The total effective rate was 95.5% and 91.1% in the observation group and control group, respectively, showing superiority of the former to the latter （P〈0.05）. After treatment, VAS scores were all obviously reduced in both groups （P〈0.01）, and the reduction in the former was significantly more than that in the latter （P〈0.01）. Moving functions of upper limbs shown by Fugl-Meyer＇s scoring were improved after 2 courses of treatment in both groups （P〈0.01）. The improvement was more obvious after 4 courses of treatment than that after 2 courses of treatment in both groups （P〈0.05）. After 4 courses of treatment, moving functions shown by FugI-Meyer＇s scoring were more remarkably improved in the observation group than those in the control group（t=3.9, P〈0.01）. Conclusion Both kinetic needling combined with needling plus blood-letting puncturing and cupping and simple needling plus blood-letting puncturing and cupping are effective in treating shoulder-hand syndrome after apoplexy, and the former is better than the latter.

Clinical Observation on Electroacupuncture Treatment of Shoulder-Hand Syndrome in Apoplectic Hemiplegia

Objective： To investigate the therapeutic effect of electroacupuncture on shoulder-hand syndrome in apoplectic hemiplegia. Methods： One hundred and sixty patients were randomly divided into two groups. 80 cases in the control group was treated by conventional acupuncture by filiform needles and 80 cases in the treatment group were treated by electroacupuncture. The therapeutic effects were evaluated after two courses of treatment. Results： After two courses of treatment, the therapeutic effect for edema on back of the hand and hand pain in digital flexion and the total effective rate were better in the treatment group than in the control group （P〈0.05）. Conclusion： Electroacupuncture is of significant importance for relieving pain on back of hand, preventing the muscular atrophy of hand and promoting recovery from apoplexy.

Treatment of 40 Cases of Poststroke Shoulder-Hand Syndrome by Acupuncture

Acupuncture and rehabilitation therapies were used to treat 40 cases of shoulder-hand syndrome, the results show that integration of acupuncture and rehabilitation can increase therapeutic effects and shorten treatment courses to accelerate recovery.

Muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in the treatment of shoulder-hand syndrome after stroke

Objective To observe the effect of muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in improving nail fold microcirculation in the patients with shoulder-hand syndrome(SHS)after stroke,and the effects on hemorrheology,calcitonin gene-related peptide(CGRP)and serum substance P(SP).Methods A total of 72 patients were randomized into an observation group and a control group by the random number table method,with 36 cases in each group.The control group was treated with physical rehabilitation training,and the observation group was treated with additional muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting treatment.The treatment course lasted for 4 weeks.After treatment,the clinical efficacy of the two groups was compared.The changes in shoulder-hand syndrome scale(SHSS),simplified Fugl-Meyer assessment-upper extremity(FMA-UE),visual analog scale(VAS),activities of daily living(ADL),traditional Chinese medicine(TCM)syndrome score,nail fold microcirculation hemorheology indictors[whole blood viscosity(high-shear,low-shear),hematocrit,erythrocyte sedimentation rate(ESR)],CGRP and SP levels were observed.Results The total effective rate in the observation group was 86.1%,higher than 63.9%in the control group(P<0.05).The overall curative effect in the observation group was better than that in the control group(P<0.05).After treatment,the scores of pain sensation,edema,external turn and rotation of the arm in SHSS,and the total score were significantly decreased in both groups(all P<0.05),and each score in the observation group was lower than that in the control group(all P<0.05).After treatment,the scores of VAS and TCM syndrome in both groups decreased significantly(all P<0.05),and the scores of FMA-UE and ADL increased significantly(all P<0.05).The scores of VAS and TCM syndrome in the observation group were lower than those in the control group(both P<0.05),and the scores of FMA-UE and ADL were higher than those in the control group(both P<0.05).After treatment,the whole blood viscosity(high-shear and low-shear)and hematocrit in both groups decreased obviously(all P<0.05),and ESR increased obviously(both P<0.05),and the whole blood viscosity(high-shear and low-shear)and hematocrit in the observation group were lower than those in the control group(all P<0.05),and ESR was higher than that in the control group(P<0.05).After treatment,the peritubular state,loop shape,blood flow and total score of nail fold microcirculation in both groups decreased significantly(all P<0.05),and each score in the observation group was lower than that in the control group(all P<0.05).After treatment,SP in both groups decreased obviously(both P<0.05),CGRP increased obviously(both P<0.05),and SP in the observation group was lower than that in the control group(P<0.05),CGRP was higher than that in the control group(P<0.05).Conclusion Compared with conventional physical rehabilitation training,muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting treatment can significantly reduce the clinical symptoms of SHS,promote the recovery of physical functions,improve the nail fold microcirculation and hemorrheology indictors,and regulate the serum cytokine levels such as CGRP and SP.