| Spastic paralysis after stroke is the most muscle group appeared after stroke hypermyotonia, tendon reflexes, movement resistance increased, stiff, limb often pulled muscle spasm, cannot produce a coordinated movement, and can cause limb muscle atrophy and joint contracture and deformation is one of a series of clinical symptoms. The most common manifestation of the presence of disability in stroke patients, but also the most difficult in the treatment of sequelae of rehabilitation. With increasing levels of medicine, stroke survival rate after rising, highlighted the growing problem of the recovery of upper limb after stroke, stroke after limb spastic paralysis not only seriously affected the daily lives of patients, but also brings heavy burden to the family and society.ObjectiveJin’s 3-needle therapy in the treatment of spastic paralysis after stroke has carried out a number of clinical research work, has accumulated rich experience in the treatment of the disease, clinical curative effect is exact for sure. For further observation of acupuncture intervention time needle therapy treatment of spastic paralysis after stroke and the selection of acupoints, obtain evidence more rigorous, we adopt the method of multivariate analysis, two important factors to influence the curative effect (acupuncture timing and point compatibility) 2*2 factorial group, to explore the therapy the optimal treatment of spastic paralysis acupoint and acupuncture combined with time. To seek a new breakthrough in the two key technical points, acupoints acupuncture time, the therapy for further application and provide a theoretical basis for the.MethodIn this study, in strict accordance with the method of evidence-based medicine, large sample, randomized, standard compatibility, timing and acupuncture point selection and unified drug treatment, and the diagnosis and curative effect of unified criteria, with 2*2 factorial statistical analysis for data analysis, which belongs to the large sample, randomized, prospective clinical study. Post stroke spastic hemiplegia patients as the research object. The method is:the two important factors that influence the needle therapy (acupuncture timing and point compatibility) of 2*2 factorial combination, take time, acupuncture point selection combined with two factors, divided into 2 levels (1-14 days after stroke after stroke in 15-30 days, niesanzhen+ three pin/niesanzhen twin brothers three+foot needle) two two combinations were compared, subjects were divided into four groups (1-14 days after stroke, three foot+niesanzhen twin needle stroke group,1-14 days after+niesanzhen, hand foot three needle stroke group,15-30-days after+niesanzhen, three foot twin needle group, after 15-30 days+temporal stroke three foot three needle, needle group) and. The treatment time is 1 times daily,30min each time, a week of continuous acupuncture for 5 days, every 2 days, again next week for 2 weeks for 1 courses, a total of 2 courses of treatment, indexes related to end the evaluation before and after treatment were observed in patients with modified Ashworth spasticity scale (MAS), clinical spasticity index (CSI) scale, clinical neurological impairment score (NDS), transport simplified limbs Fugl-Meyer movement function score and daily life ability (AQL index, Barthel), were assessed after entering the statistical analysis.Results1 Clinical Effect1.1 in the aspect of clinical curative effect, the clinical cure rate from high to low:1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) the highest rate of clinical cure was 19.0%,2 groups (1-14 days after stroke+niesanzhen, hand foot three needle group (15-30) 3 days after stroke +niesanzhen, hand and foot three twin needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) the clinical cure rates were 9.8%, 8.5% and 5.0%, compared the efficacy of abnormal statistical significance (P<0.01); the 1 group and the other three groups the clinical cure rate compared with abnormal significant difference after statistics processing (P<0.01); 2,3 and two groups of clinical cure rates similar statistically, there was no significant difference (P>0.05).The total efficiency of 1 groups (1-14 days after stroke, three foot+ niesanzhen twin needle) the total efficiency of 95%; the 2 group (1-14 days after stroke+niesanzhen, hand foot three needle), group 3 (15-30 days after stroke, three foot+niesanzhen twin needle), group 4 (15-30 days after stroke +niesanzhen, three foot twin needle) the total effective rate was 91.25%, 87.50% and 86.25%, compared the efficacy of abnormal statistical significance (P<0.01); the 1 group compared with the other three groups of the total efficiency, abnormal statistical significance (P<0.01, P<0.05); 2,3, two group the total efficiency is similar, after statistical treatment, no significant difference (P>0.05).In conclusion:Based on conventional treatment of Department of internal medicine and the same, in the acupuncture intervention 1-14 days after stroke, by Jin Sanzhen (three+foot niesanzhen twin needle) to improve the treatment of spastic paralysis after stroke patients with spasticity best clinical curative effect.2 clinical spasticity index (CSI) score2.1 after the end of treatment, the acupuncture time under the same premise, comparison of spasticity index (CSI) score:1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 2 (1-14 days after stroke+ niesanzhen, hand foot three needle) compared to the two groups, with 1 group was better, abnormal significant differences (P<0.05); group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 3 group was better, with significant difference (P<0.01) anomaly. Tip: in the premise of acupuncture under the same time, to improve spasticity index (CSI) score, the three+foot niesanzhen twin needle group clinical efficacy (P<0.01ã€P<0.05).2.2 after the end of treatment, in the premise of acupoint compatibility under the same spasticity index (CSI) score comparison score:1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) two compared to the 1 group., there is significant difference (P<0.05); group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 2 group was better, with significant difference (P<0.01) anomaly. Tip:in the premise of selected acupoints are the same, in improving spasticity index (CSI) score, early intervention of acupuncture treatment group (1-14 days after stroke) in better efficacy (P<0.01ã€P<0.05).3 the ability of daily life (ADL Barthel index) score3.1 after the end of treatment, the acupuncture time under the same premise, compared the ability of daily life (ADL Barthel index) showed:1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 1 groups was excellent. There was significant difference (P<0.01); group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 3 group was better, with significant difference (P<0.01) anomaly. Note:in the factor of time fixed under the premise, in improving the ability of daily life (ADL Barther index), the three+foot niesanzhen twin needle group clinical efficacy (P<0.01).3.2 after the end of treatment, in the premise of acupoint compatibility is same, comparing the ability of daily life (ADL Barther index) showed:1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) two groups compared to 1 group excellent, abnormal significant difference (P<0.01); group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 2 group was better, with significant difference (P<0.01). Tip:in the premise of selected acupoints are the same, in the daily life ability (ADL index Barther), early intervention of acupuncture treatment group (1-14 days after stroke) in better efficacy (P<0.01).4 neurological deficit score (NDS)4.1 after the end of treatment, the acupuncture time under the same premise, the comparison of neural function defect score (NDS) showed that the 1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 1 group was better, there are abnormal significant difference (P<0.01); group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 3 group was better, with significant difference(P<0.05) anomaly. Tip:interventional acupuncture time under the same premise, to improve the neurological deficit score (NDS), the three+ foot niesanzhen twin needle group clinical efficacy (P<0.01ã€P<0.05)4.2 after the end of treatment, in the premise of acupoint compatibility is same, the comparison of neural function defect score (NDS) showed that the 1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) two compared to the 1 group. There is abnormal, significant difference(P<0.01); group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 2 group was better, with significant difference (P<0.05) anomaly. Tip:in the premise of selected acupoints are the same, to improve the neurological deficit score (NDS), early intervention of acupuncture treatment group (1-14 days after stroke) in better efficacy (P<0.01ã€P<0.05).5 simplified Fug l-Meyer movement function evaluation5.1 after the end of treatment, in the premise of interventional acupuncture time under the same Fugl-Meyer movement function score:1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 1 group was better, with significant the difference(P<0.01) group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 3 group was better, with significant difference(P<0.01) anomaly. Tip:interventional acupuncture time under the same premise, in the improvement of Fugl-Meyer score, the three+foot niesanzhen twin needle group clinical efficacy (P<0.01).5.2 after the end of treatment, in the premise of acupoint compatibility under the same Fugl-Meyer score showed that 1 groups (1-14 days after stroke, three foot+niesanzhen twin needle) and group 3 (15-30 days after stroke, three foot+niesanzhen twin needle) two groups compared to 1 group was better, with significant abnormal the difference (P<0.01); group 2 (1-14 days after stroke+niesanzhen, hand foot three needle) and group 4 (15-30 days after stroke+niesanzhen, hand foot three needle) compared to the two groups, with 2 group was better, with significant difference (P<0.01) anomaly. Tip:in the premise of selected acupoints are the same, in the improvement of Fugl-Meyer score, early intervention of acupuncture treatment group (1-14 days after stroke) in better efficacy (P<0.01).6 Analysis of the effect of acupuncture and acupoint selection and combination intervention time6.1 spasm index (CSI) scoreAcupuncture time and choose matching points (1-14 days after stroke early acupuncture intervention+niesanzhen, hand, foot and twin needle in the treatment of post-stroke spastic hemiplegia spasticity index (CSI) score in although there is no have obvious synergistic and interactive intervention effects in the statistical analysis, but the root according to the interaction graph (see Figure eight, figure 9), should have a good cross function trends; according to choose matching points, acupuncture time fixed factors analysis, combined effect can significantly reduced post stroke spasm of hemiplegia patients with spasticity index CSI score (P<0.01) effectively alleviate the hemiplegic limb muscle tension tension, improve the hemiplegic limb spasticity.6.2 the ability of daily life (ADL Barthel index) scoreAcupuncture and acupoint selection and timing combined effects (stroke after 1-14 days of early acupuncture intervention+niesanzhen, twin three foot acupuncture stroke patients with spastic hemiplegia in the ability of daily life (ADL Barthel index) score showed good synergistic interaction and intervention effect; combined effects can significantly improve stroke patients with spastic hemiplegia of ability of daily life (ADL Barthel index) score (P<0.01) can effectively improve the ability of daily life of patients, improve the quality of life of patients.6.3 neurological deficit score (NDS)Acupuncture time and matching points (1-14 days after stroke early acupuncture intervention+niesanzhen, hand, foot and twin needle in the treatment of post-stroke spastic hemiplegia patients in the neurological deficit scores (NDS) score although there is no have obvious synergistic and interactive intervention effects in the statistical analysis, but according to the figure of interactions (see Figure 14 and Figure 15), should have a good cross function trends; according to choose matching points, acupuncture time fixed factors analysis, combination effect can.be decreased significantly after stroke patients with spastic hemiplegia of neural function defect score (NDS) effectively promote partial paralysis neurological function recovery, and improve the quality of life of patients.6.4 simplified Fugl-Meyer movement function evaluationAcupuncture and acupoint selection and timing combined effects (stroke after 1-14 days of early acupuncture intervention+niesanzhen, twin three foot needle) in the treatment of post stroke patients with spastic hemiplegia in the presence of a simplified Fugl-Meyer motor function good collaborative and interactive intervention; combined effects can significantly improve stroke patients with spastic hemiplegia of simplified Fugl-Meyer motor function score (see Figure 17ã€Figure 18), effectively improve the ability of limb motor function after stroke patients with spastic hemiplegiadays (interventional needle therapy+three twin brothers temporal three needle needle or niesanzhen+hand foot three needle) treatment in patients with spastic hemiplegia after stroke patients with hemiplegia can effectively alleviate tensions, reduce neurological deficits, improve limb movement ability, improve the ability of daily life and it can obtain good clinical curative effect.Treatment of post-stroke spastic hemiplegia after stroke:the priority for 1-14 days with niesanzhen, three foot twin needle... |
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