Clinical Study of Acupotomy Trinity Lysis Combined with Rehabilitation Training for Spastic Paralysis after Stroke

Objective:To study the clinical efficacy of acupotomy trinity lysis combined with rehabilitation training in the treatment of spastic paralysis after stroke,and to provide guidance for clinical diagnosis and treatment.Methods:From July 2019 to November 2020,119 patients with post-stroke spastic paralysis who were admitted to our hospital's encephalopathy department were selected as the research objects,and 61 patients were divided into acupuncture combined with rehabilitation training group as the observation group by random number table method.58 patients were divided into the rehabilitation training group as the control group.After 21 days of treatment,they passed the modified Ashworth Spasm Scale(MAS)grading scale score,Clinical Spasm Index(clinical spasm index,CSI)assessment,Fugl,Meyer exercise function scale(FMA)Score,Modified Barthel Index Score,and compare the clinical efficacy after treatment.Results:After treatment,the total effective rate of the observation group(95.08%)was higher than that of the control group(86.21%),and the difference was statistically significant(P<0.05);Before treatment,the contrast difference of MAS,FMA,CSI scores and modified Barthel index scores of the two groups of patients is not statistically significant;After treatment,the MAS scores and CSI scores of the elbow and knee joints of the observation group[(1.52±0.81)(1.46±0.83)(5.87±2.12)]were significantly lower than those of the control group[(2.17±0.68)(2.03±0.79)(8.36±2.41)];FMA upper limb and lower limb scores and modified Barthel index[(51.87±4.41)(30.21±5.05)(72.41±5.81)]of the observation group were significantly higher than those of the control group[(44.26±4.78)(28.45±4.23)(68.65±6.09)],the difference was statistically significant(P<0.05).Conclusion:Acupotomy trinity lysis combined with rehabilitation training is effective in treating patients with post-stroke spastic paralysis.It provides a safe,reliable and clinically effective new program,which is worthy of popularization and application.

不同针灸疗法治疗中风后痉挛性偏瘫的网状Meta分析

Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.