补缓泻急法治疗中风偏瘫肌痉挛30例临床观察

目的运用补缓泻急法治疗与电针配合头针组治疗对中风偏瘫肌痉挛的疗效对比。方法将60例患者随机分为治疗组与对照组各30例。治疗组采用补缓泻急法针刺治疗,每日1次,治疗2周;对照组采用电针配合头针治疗,每日1次,治疗2周。结果 Ashworth量表显示治疗后治疗组评分为(2.19±0.7),疗效优于对照组为(2.75±0.81)(P<0.01);CSI痉挛指数显示治疗组为(8.31±1.57),明显优于对照组(9.86±0.81)(P<0.01)。2组较治疗前均有效。结论补缓泻急法治疗中风偏瘫肌痉挛疗效肯定,值得临床推广。

Effect of warm joint needling plus rehabilitation on the balance function and quality of life of patients with spastic hemiplegia after ischemic cerebral stroke

Objective： To observe the effect of warm joint needling plus rehabilitation techniques on the balance function and quality of life （QOL） of patients with spastic hemiplegia after ischemic cerebral stroke. Methods： Ninety patients with spastic hemiplegia after ischemic cerebral stroke were randomized into a rehabilitation group, a warm joint needling group and an observation group, with 30 cases in each group. The rehabilitation group was intervened by Bobath therapy, the warm joint needling group was treated with joint needling on the affected side plus warm needling, and the observation group was given the same rehabilitation treatment as the rehabilitation group together with the same warm joint needling as the warm joint needling group. The three groups were treated once another day, 1 month as a treatment course for 6 months. Before the treatment, and respectively after 2-week, 1-month, 3-month, and 6-month treatment, the modified Ashworth scale （MAS） was used to measure the anti-spasm ability of the lower limb, the Berg balance scale （BBS） was adopted to evaluate the balance function, and the stroke-specific quality of life scale （SS-QOL） was employed to estimate the QOL. Results： After 3-month and 6-month treatment, the lower-limb MAS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group （all P〈0.05）. After 1-month, B-month and 6-month treatment, the BBS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group （all P〈0.05）. After 2-week, 1-month, 3-month and 6-month treatment, the SS-QOL scores in the observation group were markedly better than those in the rehabilitation group and the warm joint needling group （all P〈0.05）. Conclusion： Warm joint needling plus rehabilitation can effectively improve the lower-limb spasticity state, balance function and QOL in patients with spastic hemiplegia after ischemic cerebral stroke.

Applying tuina to exterior-interiorly connected meridians for post-stroke upper limb spasticity

Objective： To observe the effect of applying tuina to exterior-interiorly connected meridians for post-stroke upper limb spasticity. Methods： A total of 150 patients with post-stroke upper limb spasticity were randomly allocated into a treatment group （n=75） and a control group （n=75） by the random number table. Patients in the treatment group received tuina on exterior-interiorly connected meridians, whereas patients in the control group received standard rehabilitation therapy. The therapeutic efficacies in both groups were observed after 3 weeks of treatment. Results： The total effective rate in the treatment group was 89.3%, versus 61.3% in the control group, showing a statistically significant difference （P〈0.05）. After the treatment, the muscle tones by the modified Ashworth scale （MAS） were significantly improved in both groups （both P〈0.05）; and the improvement of muscle tone was more significant in the treatment group than that in the control group （P〈0.05）. Conclusion： Applying tuina to exterior-interiorly connected meridians can obtain an exact efficacy for post-stroke upper limb spasticity.

Clinical observation of tuina plus rehabilitation therapy for lower limb extensor spasticity in recovery stage of stroke

Objective: To observe the clinical efficacy of traditional tuina plus modern rehabilitation in the treatment of lower limb extensor spasticity during stroke recovery. Methods: A total of 93 stroke patients who met the inclusion criteria were randomly divided into an observation group and a control group. Forty-four patients in the observation group were treated with traditional tuina plus modern rehabilitation, and 49 patients in the control group were treated with modern rehabilitation. The modified Ashworth scale (MAS), the Fugl-Meyer assessment scale (FMA) and the modified Barthel index (MBI) were used to evaluate the knee extensors state, lower limb motor function and activities of daily living (ADL) of the two groups. Results: After treatment, the overall efficacy of the observation group was better than that of the control group, and the difference was statistically significant (P<0.05). After treatment, the MAS scores of both groups were significantly lower, FMA and MBI scores were significantly higher, and the differences were statistically significant in each group (P<0.01). After treatment, the MAS score of the observation group was lower than that of the control group, and the differenee between the groups was statistically significant (P<0.01). The MBI score of the observation group was higher than that of the control group, and the differenee between the two groups was statistically significant (P<0.05). There were significant differences in the post-treatment changes in MAS, FMA and MBI scores between the two groups (all P<0.05). Conclusion: Traditional tuina plus modern rehabilitation therapy can effectively alleviate or prevent lower limb extensor spasticity after stroke, and improve limb mobility and ADL. Hence, it is worthy of clinical promotion.

Clinical observation on acupuncture plus motor therapy for postapoplectic spastic hemiplegia

Objective： To observe the clinical efficacy of acupuncture plus motor therapy for postapoplectic spastic hemiplegia and provide reference for rehabilitation care of patients with spastic hemiplegia after stroke. Methods： A total of 87 cases with postapoplectic spastic hemiplegia were randomly allocated into a treatment group and a control group. Patients in both groups received basic treatments to control blood pressure, blood sugar, blood fat and improve circulation. The 43 cases in the treatment group received acupuncture combined with motor therapy, whereas the 44 cases in the control group received motor therapy alone（same as the treatment group）. The treatment was conducted once a day, for a total of 3 sessions. One session consisted of 10 times and there was a 1-day interval between two sessions. Then the changes in modified Ashworth scale（MAS） score and Fugl-Meyer assessment scale（FMA） score and clinical efficacy were observed. Results： After treatment, the MAS scores were significantly decreased in both groups, showing intra-group statistical differences（P〈0.01）. The MAS score in the treatment group was significantly lower than that in the control group, showing a between-group statistical difference（P〈0.01）. The total effective rate was 69.8% in the treatment group, versus 45.5% in the control group, showing a between-group statistical difference（P〈0.05）. After treatment, the FMA scores were significantly increased in both groups, showing intra-group statistical differences（P〈0.01）; and the FMA score in the treatment group was significantly higher than that in the control group, showing a between-group statistical difference（P〈0.05）. Conclusion： Acupuncture combined with motor therapy is better than motor therapy alone in alleviating postapoplectic limb spasticity, improving the limb motor function and increasing the activities of daily living（ADL）.

Clinical observation on acupoint pressure plus long-snake moxibustion for upper-limb spastic hemiplegia after cerebral infarction

Objective To observe the clinical efficacy of acupoint pressure plus long-snake moxibustion for upper-limb spastic hemiplegia after cerebral infarction.Methods A total of 100 patients were randomized into a control group and an observation group,with 50 cases in each group.Both groups were treated with the same conventional internal medicine and rehabilitation training.The control group was treated with additional acupoint pressure therapy,and the observation group was treated with long-snake moxibustion on the basis of the treatment given to the control group.The Ashworth grade,Fugl-Meyer assessment upper limb scale(FMA-UL)and Barthel index(BI)were evaluated,and the root mean square(RMS)values of biceps brachii and flexor carpi radialis on the affected side were measured before and after treatment.The efficacy was evaluated after treatment.Results After treatment,the total effective rate of the observation group was significantly higher than that of the control group(P<0.05).After treatment,the Ashworth grade of the observation group was superior to that of the control group(P<0.05).The scores of FMA-UL and BI in both groups increased compared with those before treatment(all P<0.05),and the scores of FMA-UL and BI in the observation group were higher than those in the control group(both P<0.05).The RMS values of biceps brachii and flexor carpi radialis in both groups decreased compared with those before treatment(all P<0.05),and the RMS values of biceps brachii and flexor carpi radialis in the observation group were lower than those in the control group(both P<0.05).Conclusion Based on conventional internal medicine and rehabilitation training,acupoint pressure plus long-snake moxibustion has great therapeutic efficacy for upper-limb spastic hemiplegia after cerebral infarction.It can improve the degree of spasticity of the affected upper limb,reduce the muscle tone of biceps brachii and flexor carpi radialis on the affected side,and enhance the mobility of the affected limb and the activities of daily living.

CONSORT and STRICTA evaluation of randomized controlled trials of acupuncture and rehabilitation for post-stroke limb spasm in recent 10 years in China

Objective： To evaluate the literature quality of randomized controlled trials of acupuncture plus rehabilitation for post-stroke limb spasm in the recent ten years in China.Methods： By searching four databases of China National Knowledge Internet（CNKI）, Wanfang Academic Journal Full-text Database（Wanfang）, Chongqing VIP Database（CQVIP） and Chinese Biomedical Literature Database（CBM）, randomized controlled trial（RCT） of acupuncture plus rehabilitation for the treatment of post-stroke limb spasm were screened and selected. In accordance with 2010 edition of the consolidated standards of reporting trials（CONSORT） and standards for reporting interventions in clinical trials of acupuncture（STRICTA）, the quality evaluation was processed for RCT documents. Results： Finally, 50 documents were selected. The issues of titles, sample size calculation, application of randomization and blind method, subject＇s procedure, conclusion and estimated value, explanation of trial limitation, auxiliary intervention measures and therapeutic plans, and background of therapists exist in most documents. Conclusion： Currently, RCT documents about acupuncture plus rehabilitation for the treatment of post-stroke limb spasm are generally of low quality. In the future, it is necessary to standardize the reports of the clinical trials based upon CONSORT and STRICTA, in order to enhance the document quality.