The Clinical Study Of Hemiplegia Spasm After A Stroke Treated By Acupuncturing The Points In Spasm Side And Non-Spasm Side

Objective: To study the impact of myodynamia, spasm degree, limb function and activities of daily living of hemiplegia spasm after a stroke treated by acupuncture Spasm side and Non-Spasm side point respectively in the strong and weak way.Methods: 120 cases of the patients conformed to spastic hemiplegia After the stroke diagnostic criteria and inclusion criteria were randomly divided into four groups, namely the acupuncture spasm side group respectively by the strong and weak way and the acupuncture non-spasm side group respectively in the strong and weak way. The two non-spasm side groups stimulates Jianyu, Binao, Tianjing, Sidu, Waiguan, Yangxi, Pianli, Zhongzhu on the upper limbs ;lower limbs were admitted Yinmen, Yinbao, Zusanli, Juegu, Shenmai, Qiuxu,, Qiuxu, Zulinqi. Needle method is used by normal reinforcement and normal reduction. Strong stimulation is that holding-twisting angle is more than 180 degrees and the inserted depth greater than 0.5 cm; weak stimulation is that holding-twisting angle is less than 90 degrees and the inserted depth less than 0.3 cm; Both spasm side groups stimulates Jiquan, Chize, Quze, Quchi, Shousanli, Neiguan, Daling, Laogong on the upper limbs; lower limbs were admitted Biguan, Futu, Weizhong,, Chenshan, Sanyinjiao, Zhaohai, Yongquan . Strong and weak stimulation is as foregoing. Once a day, every six days rest one day, four weeks for a course of treatment, the efficacy is evaluated after a course of treatment. Myodynamia is evaluated by Robert Lovett measure, with improved Ashworth score and clinical spasm index muscular tone is evaluated, simplified Fugl-Meyer scale is used to evaluate limbs function, and Barthel index is used to evaluate activities of daily living.Results: 1. Both the strong or weak non-spasm side stimulation and the strong or weak spasm side stimulation can improve Myodynamia, and there is significantly difference after treatment than before treatment (P< 0.05) , but no significant difference among the four groups(P> 0.05). 2. There is significantly difference of ashworth scale in the strong and weak non-spasm side groups after treatment than before treatment (P< 0.05), but no significantly difference in the strong and weak spasm side groups after treatment than before treatment (P>0.05). ashworth scales of both strong and weak non-spasm side groups is better than strong and weak spasm side groups. The difference of discrepancy is significant before and after the treatment in spasm side groups and non-spasm side groups (P <0.05 or 0.01). There is no significantly difference between the strong and weak non-spasm side groups (P> 0.05). 3.the CSI scale of the strong and weak stimulation non-spasm side groups on the upper and lower limb reduced significantly than before treatment (P <0.05). There is no significant difference in the the strong and weak stimulation spasm side groups before and after treatment. (P> 0.05). Among 4 groups, the CSI scale of the two non-spasm side groups is lower than the two spasm side groups after treatment. The difference of discrepancy is significant before and after the treatment in stimulated- spasm side groups and stimulated non-spasm side groups (P <0.05). There is no significantly difference between the strong and weak stimulated non-spasm side groups (P> 0.05). 4. The FM scale of the two non-spasm side groups and the two spasm side groups is higher than s before treatment (P <0.05) . There is no significant difference of discrepancy before and after treatment P >0.05). That means all groups can improve the limbs function. 5. The ADL scale of the two non-spasm side groups and the two spasm side groups is higher than before treatment (P <0.05) . There is no significant difference of discrepancy before and after treatment (P >0.05). that means all groups can improve the limbs function.Conclusion: All the four groups can improve myodynamia, FM scale, ADL scale, but no significant difference among each other. The CSI scale and ashworth scale is improved significantly in Acupuncture non-spasm side groups by strong and weak stimulation, but the other two insignificantly. Acupuncturing non-spasm side by strong and weak stimulation both can improve spasm and decrease muscular tone, but no significant difference between strong and weak stimulation. The four methods all can improve limbs function, activaties daily life, myodynamia, but no significant difference among four methods. The study of acupuncture points non-spasm side may reduce the limb muscle tension.