| Purpose:Guided by the theory diagnosis by inspecting eyes of Peng’s eye-acupuncture,the characteristics of the left eye of collaterals in conjunctiva on the liver and gallbladder region between healthy volunteers group and the group of patients in stroke with upper limb flexor spasm were observed with bulbar conjunctiva microcirculation detector.The differences of the indexes after quantification of collaterals in conjunctiva on the liver and gallbladder region in the two groups were compared,and by studying the changes of collaterals in conjunctiva on the liver and gallbladder region,traditional Chinese medicine syndrome score,upper limb spasm,upper limb motor function,Activities of Daily Living(ADL),surface electromyography(s EMG),and serum levels of γ-aminobutyric acid(GABA),Glutamic acid(Glu),Brain-derived Neurotrophic Factor(BDNF),Nerve Growth Factor(NGF)in patients with upper limb flexor spasm of stroke were treated by eye-acupuncture with rehabilitation therapy.In order to provide objective clinical evidence for the theory of diagnosis by inspecting eyes,to explore the feasibility of using the collaterals in conjunctiva as the evaluation index of the curative effect of eye-acupuncture with rehabilitation therapy,and to explore the curative effect and mechanism of eye-acupuncture with rehabilitation therapy in the treatment of flexor spasm of the upper limb in stroke.Material and method:This paper was divided into three parts.Paper one,from July2020 to November 2021,eligible apoplexy patients hospitalized in the Rehabilitation Center of Liaoning University of Traditional Chinese Medicine Affiliated Hospital with upper limb flexor spasm were incorporated into the disease group.Healthy volunteers were recruited and selected from the hospital staff and the family members of patients.76 cases per group,Gender and age of subjects were registered respectively in the bulbar conjunctiva microcirculation detector.There were no statistical significant difference in age and gender between two groups.According to the division of the acupoint area,we chose the liver and gallbladder region of left eye of patients and healthy people to observe.Observing collateral in conjunctiva on morpholog and blood color by using TR8000 D microcirculation detector.By referring to the method of bulbar conjunctiva microcirculation(BCM)quantitative analysis made professor Tian,the collaterals in conjunctiva sub-indexes were quantified in definition,network structure,the number of microvascular,the diameter of arteriole and venule,arteriolar-venular ratio,margin irregularity,uneven thickness,cystic dilatation,irregular distribution of vessels,micro hemangioma,ischemia area and blood color.To compare the two groups of research objects after quantization of the collaterals in conjunctiva of the total integral and the integral of each item.In the second paper,patients in the disease group in the first paper were incorporated and divided into experimental group and control group according to the randomized control method,38 cases per group,at the end of the test,3patients in the experimental group fell off due to incomplete treatment.In the control group,there were 2 patients who fell off due to incomplete treatment and 1 patient whose data were not complete,leaving 35 patients in each group.Conventional medical treatment and body-acupuncture were used in the two groups.At the same time,rehabilitation therapy was applied in the control group,the experimental group was treated with eye-acupuncture during simultaneous rehabilitation therapy.Treatment five days a week,four weeks for a course of treatment.Before and after the treatment,we observed the patients from two groups of collaterals in conjunctiva on the liver and gallbladder region.The specific methods was the same as paper one.Before and after treatment,the change law of collaterals in conjunctiva on the liver and gallbladder region was observed of the two groups.Paper three,The subjects were the same subjects in paper two.Before and after treatment,the scores of traditional Chinese medicine syndrome,upper limb spasm,upper limb motor function,Activities of Daily Living of the two groups of subjects were evaluated,and surface electromyography data were collected.At the same time,blood samples before and after treatment in both groups were collected,taking out the serum with ELISA method to detect serum γ-aminobutyric acid,Glutamicacid,Brain-derived Neurotrophic Factor,Nerve Growth Factor levels.To assess the clinical curative effect of eye-acupuncture with rehabilitation therapy for stroke patients with upper limb flexor muscle spasm by conventional scale of traditional Chinese medicine syndrome score,modified Ashworth scale,Fugl-Meyer assessment,Activities of Daily Living,and objective evaluation methods of surface electromyography,and with ELISA method to detect serum γ-aminobutyric acid,Glutamic acid,Brain-derived Neurotrophic Factor,Nerve Growth Factor levels of change to investigate the mechanism of eye-acupuncture with rehabilitation therapy in the treatment of flexor spasm of the upper limb in stroke.All the statistical analysis was done by the software of SPSS22.0.Results:Paper one:1.There was no significant difference in age and gender between the disease group and the healthy group(P>0.05).Two groups could be compared.2.There was a difference between the disease group and the healthy group in the total integrate of the left eye in the liver and gallbladder region of collaterals in conjunctiva,the disease group was higher than the healthy group,and the difference was statistically significant(P<0.05).3.The definition,network structure,the number of microvascular,arteriolar-venular ratio,margin irregularity,uneven thickness,cystic dilatation,irregular distribution of vessels,micro hemangioma,ischemia area and blood color in the liver and gallbladder region of collaterals in conjunctiva were difference between the disease group and the healthy group,and the difference was statistically significant(P<0.05).There was no significant difference in the diameter of arteriole and venule between the disease group and the healthy group(P>0.05).Paper two:1.There was no statistically significant difference in age,gender,course of disease,type of stroke,affected side and other general clinical data between the experimental group and the control group before treatment(P>0.05).Two groups could be compared.2.Experimental group and control group before treatment the liver and gallbladder region total integrate,collaterals in conjunctiva sub-indexes including the definition,network structure,the number of microvascular,the diameter of arteriole and venule,arteriolar-venular ratio,uneven thickness,margin irregularity,irregular distribution of vessels,cystic dilatation,micro hemangioma,ischemia area and blood color,the difference was not statistically significant(P>0.05).Two groups could be compared.3.After the treatment,the total integrate of collaterals in conjunctiva on the liver and gallbladder region of the experimental group was lower than the control group,and the difference was statistically significant(P<0.05).4.After the treatment,sub-indexes of all the components including the definition,network structure,margin irregularity,irregular distribution of vessels,cystic dilatation,uneven thickness,micro hemangioma and blood color after treatment,the experimental group was lower than the control group,the differences were statistically significant(P<0.05).There was no significant difference in the number of microvascular,the diameter of arteriole and venule,arteriolar-venular ratio and ischemia area(P>0.05).Paper three:1.Experimental group and control group before treatment of traditional Chinese medicine syndrome score,upper limb spasm score,upper limb motor function score,activities of daily living,surface electromyography and serum levels of γ-aminobutyric acid,Glutamicacid,Brain-derived Neurotrophic Factor,Nerve Growth Factor had no difference in statistical significance(P>0.05).Two groups could be compared.2.Traditional Chinese medicine syndrome: Both treatments could improve the traditional Chinese medicine syndromes of patients with upper limb flexor spasm of stroke,and the experimental group was better than the control group,the differences were statistically significant(P<0.05).3.Modified Ashworth Scale: Both treatments could improve the upper limb flexor spasm of stroke patients,and the experimental group was better than the control group,the differences were statistically significant(P<0.05).4.Upper limb motor function score: Both treatments could improve upper limb motor function in patients with upper limb flexor spasm of stroke,and the experimental group was better than the control group,the differences were statistically significant(P<0.05).5.Activities of Daily Living score: Both treatments could improve activities of daily living of patients with upper limb flexor spasm of stroke,and the experimental group was better than the control group,the differences were statistically significant(P<0.05).6.Surface electromyography: Both treatments could reduce i EMG and CR of biceps for patients with upper limb flexor spasm of stroke,and the experimental group was better than the control group,the differences were statistically significant(P<0.05).7.After the treatment,the total effective rate of the experimental group was 91.43%,the control group was 71.43%,and the experimental group was better than the controlgroup,the difference was statically significant(P<0.05).8.Both treatments could increase serum levels of γ-aminobutyric acid,Brain-derived Neurotrophic Factor,Nerve Growth Factor,and reduce the level of Glutamic acid of patients with upper limb flexor spasm of stroke,and the experimental group was better than the control group,the differences were statistically significant(P<0.05).Conclusion:1.There were characteristic changes of collaterals in conjunctiva on liver gallbladder region in stroke patients with upper limb flexor spasm.Poor definition of collaterals in conjunctiva,collaterals slightly darker blood color,mostly dark color or dark red,collaterals were uneven in proportion of thickness,there was local dilation and even hemangioma,shape was not soft,local visible margin irregularity,the proliferation area of collaterals coexisted with the ischemia area,the distribution of collaterals in the proliferation area changed from a normal tree to a network and the distribution was limited,there was an area of ischemia in the collaterally reduced area.2.The characteristic changes of collaterals in conjunctiva on the liver and gallbladder region of stroke patients with upper limb flexor spasm showed that there was sufficient objective basis for diagnosis by inspecting eyes,and also proved evidence for eye-acupuncture therapy.3.The morpholog and color of collaterals in conjunctiva on the liver and gallbladder region of stroke patients with upper limb flexor spasm changes with the change of the disease.4.The integrate of collaterals in conjunctiva could be used not only for disease diagnosis but also for evaluation index of traditional Chinese medicine curative effect.5.Eye-acupuncture with rehabilitation therapy could improve traditional Chinese medicine syndrome,relieve the flexor spasm of the upper limb,improve the motor function of the upper limb and activity of daily living ability of stroke patients with upper limb flexor spasm.6.Eye-acupuncture with rehabilitation therapy was effective in improving spasm of upper limb flexor spasm in patients with stroke.7.Eye-acupuncture with rehabilitation therapy could improve spasm of upper limb flexor spasm in stroke patients by increasing the serum levels of γ-aminobutyric acid,Brain-derived Neurotrophic Factor,Nerve Growth Factor,and reducing the serum level of Glutamic acid,and promote the recovery of the upper limb motor function and the patients’ activities of daily living. |
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