Objective To observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. Methods Sixty patients with knee pain after stroke were d...Objective To observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. Methods Sixty patients with knee pain after stroke were divided into a group A and a group B by random allocation, with 30 patients in each group. Patients in the group B only received the treatment by Chinese herb, which called Dúhuó Jìshēng Tāng（独活寄生汤 Pubescent Angelica and Mistletoe Decoction, add or remove ingredients depending on conditions）; patients in the group A additionally received warm needling on the basis of Chinese herb. Four knee acupoints were selected as master acupoints and Hèd ng（鹤顶 EXLE 2）, Yánglíngquán（阳陵泉 GB 34） and Zúsānl（足三里 ST 36） as combining acupoints. Perpendicular insertion was conducted on Xuèh i（血海 SP 10） and Liángqiū（梁丘 ST 34） for approximately 1 cun, and oblique insertion on Nèixīy n（内膝眼 EX-LE 4） and Dúbí（犊鼻 ST 35） for approximately 1 cun at 45° in inner and upper direction to push needle tip into joint cavity. After deqi, moxibustion stick was cut to 1.5 cm long, ignited, and inserted into the needle handles in the four knee acupoints. 1–2 strips were applied. After the moxa cones were burned up, needles were retained for 10 min. 7 d was a course of treatment and observation lasted for consecutive four courses. Visual analogue scale（VAS） and Barthel Index（BI） were adopted as observational indices. Clinical efficacy was classified as clinical cured, markedly effective, effective and ineffective according to the standards described in Guidelines of Clinical Research on Chinese New Herbal Medicine. Results After treatment, total effective rate was 93.3% in the group A, including full recovery in 8 cases, markedly effective in 15 cases, effective in 5 cases, and ineffective in 2 cases; while the total effective rate was 73.3% in the group B. The difference between the two groups was statistically significant（P0.05）. In the group A, VAS scores were 6.53 ± 1.39 before treatment and 1.53 ± 0.80 after treatment and BI scores were 58.38±8.67 before treatment and 67.55 ± 12.99 after treatment; in the group B, VAS scores were 6.63 ± 1.81 before treatment and 3.33 ± 0.96 after treatment and BI scores were 57.89 ± 9.65 before treatment and 64.87 ± 12.18 after treatment. Both VAS and BI scores were improved significantly in the two groups after treatment and the improvements were statistically significant（all P0.05）. Furthermore, both VAS and BI scores of group A were superior to that of group B（P0.05）. Conclusion Additional treatment of warm needling on the four knee acupoints on the basis of Chinese herb can enhance the clinical efficacy in treatment of knee pain after stroke, contribute to the rapid recovery of knee function and improve the life quality of stroke patients.展开更多
基金Supported by key laboratory project of Shenzhen technical research and development funding condition and platform construction plan:CXB201111250113A
文摘Objective To observe the clinical efficacy of warm needling on the four knee acupoints in the treatment of knee pain after stroke on the basis of Chinese herb. Methods Sixty patients with knee pain after stroke were divided into a group A and a group B by random allocation, with 30 patients in each group. Patients in the group B only received the treatment by Chinese herb, which called Dúhuó Jìshēng Tāng（独活寄生汤 Pubescent Angelica and Mistletoe Decoction, add or remove ingredients depending on conditions）; patients in the group A additionally received warm needling on the basis of Chinese herb. Four knee acupoints were selected as master acupoints and Hèd ng（鹤顶 EXLE 2）, Yánglíngquán（阳陵泉 GB 34） and Zúsānl（足三里 ST 36） as combining acupoints. Perpendicular insertion was conducted on Xuèh i（血海 SP 10） and Liángqiū（梁丘 ST 34） for approximately 1 cun, and oblique insertion on Nèixīy n（内膝眼 EX-LE 4） and Dúbí（犊鼻 ST 35） for approximately 1 cun at 45° in inner and upper direction to push needle tip into joint cavity. After deqi, moxibustion stick was cut to 1.5 cm long, ignited, and inserted into the needle handles in the four knee acupoints. 1–2 strips were applied. After the moxa cones were burned up, needles were retained for 10 min. 7 d was a course of treatment and observation lasted for consecutive four courses. Visual analogue scale（VAS） and Barthel Index（BI） were adopted as observational indices. Clinical efficacy was classified as clinical cured, markedly effective, effective and ineffective according to the standards described in Guidelines of Clinical Research on Chinese New Herbal Medicine. Results After treatment, total effective rate was 93.3% in the group A, including full recovery in 8 cases, markedly effective in 15 cases, effective in 5 cases, and ineffective in 2 cases; while the total effective rate was 73.3% in the group B. The difference between the two groups was statistically significant（P0.05）. In the group A, VAS scores were 6.53 ± 1.39 before treatment and 1.53 ± 0.80 after treatment and BI scores were 58.38±8.67 before treatment and 67.55 ± 12.99 after treatment; in the group B, VAS scores were 6.63 ± 1.81 before treatment and 3.33 ± 0.96 after treatment and BI scores were 57.89 ± 9.65 before treatment and 64.87 ± 12.18 after treatment. Both VAS and BI scores were improved significantly in the two groups after treatment and the improvements were statistically significant（all P0.05）. Furthermore, both VAS and BI scores of group A were superior to that of group B（P0.05）. Conclusion Additional treatment of warm needling on the four knee acupoints on the basis of Chinese herb can enhance the clinical efficacy in treatment of knee pain after stroke, contribute to the rapid recovery of knee function and improve the life quality of stroke patients.
