| Objective:Cerebral ischemic stroke (CIS) is one of the most serious common and frequently-occurring diseases, which is harmful to lives and health. Both the mortality and the disability rate of the disease are high. It is also one of the primary causes for disability and death among the middle and old-aged people. Because of the improvement of both the diagnostic and the emergency treatment, the mortality of CIS has been on great decrease. However, their family members still have to bear heavy mental and economic burdens, since most patients are incapacitated in various degrees. Therefore, studies on more effective treatments and rehabilitation for CIS, especially studies on decreasing disability rate, are still important tasks in medical domain. By observing the clinical efficacy of treating CIS with the combination of acupuncture and Chinese medicine, the study tried to improve symptoms of CIS so as to alleviate injury of cranial nerves, and it also tried to eliminate dangerous factors quickly. With such efforts, CIS patients'quality of life would be improved. For the reasons above, the author attempted to do further observation and differentiate patterns with Chinese medicine in order to find better answers to treating TanYuZuluo CIS. Meanwhile, the paper further discussed the mechanism to provide scientific evidence for clinical applications.Methods:The selected fifty cases in the study were randomly divided into two groups:one was the treatment group with combination of Chinese medicine and acupuncture (average age: 65.64±8.93 years old), which included 25 TanYuZuluo patients (16 male patients,9 female patients) the other was the control group with just Chinese medicine (average age:68.04±8.08 years old), which consisted of 25 TanYuZuluo patients (18 male patients and 7 female patients). The treatment group (the group using Chinese medicine combined with acupuncture): Acupuncture treatment was added on basis of the control group. Needling instruments used in the study were disposable aseptic acupuncture needles (specification: 0.30-50mm filiform needle) manufactured by Suzhou Global Medical Instrument of Acupuncture and Moxibustion, Co., Ltd. Point selections were based on major acupuncture points were Baihui, Neiguan, Xuehai, Tsu-San-Li, Yinlingquan, Fenglong, Pishu, Keshu, and adjunct acupuncture points were Heku, Quchi, and Taichong, Taixi, Sanyinjiao Acupoints were mainly selected along the meridian of foot taiyang, the meridian of hand-yangming, the meridian of foot-yangming, the Du Meridian, the meridian of foot-shaoyang, and the meridian of foot-jue yin.Manipulation methods:the supine lying posture was assumed. Besides, A 75% v/v solution of alcohol in water is used for skin's routine sterilization. On the healthy side, Baihui and Chengling were penetrated points, while on the affected side, needles were inerted in Neiguan, Xuehai, Hegu, Zusanli, Fenglong and Sanyinjiao with patients' feelings of vague aching and swelling as the ending signal. As for the needling manipulation, one puncture was done every ten minutes, and needles were retained for thirty minutes.The twisting and reinforcing method was used in puncturing Zusanli, Taixi, Sanyin. The lifting, thrusting, twisting and reducing method was in puncturing Neiguan, Fenglong. The even-movement method was used in puncturing the rest acupuncture points. The patients were advised again to assume the prone posture; moreover, a 75% v/v solution of alcohol in water is used for skin's routine sterilization. Needles were inserted into Pishu, with patients'feelings of vague aching and swelling at this point as the ending signal. one puncture was done every ten minutes, ten times were one treatment course, the interval between two treatment courses was one day, and there were three treatment courses in all.Control group(the group using Chinese medicine):the conventional therapy in addition to the treatment of Chinese medicine. Principles of treatment: it was suitable to regulate qi, disperse phlegm, promote blood circulation and remove blood stasis. In this treatment, Tongnao decoction and HuaTanTongLuo decoction were used in treating stroke, and detailed medicines in the two were added or reduced according to specific cases. The clinical efficacy of the treatment was definite. Prescription: angelica 15g, safflower 10g, rhizome of Sichuan lovage 9g,roasted astragalus root 15g, dried rehmannia root 30g, lilyturf root 12g, earthworm pheretima 2g (take drug following its infusion), achyranthes root 15g, parched white atractylodes rhizome 15g, batryticated silkworm 10g, acorus 6g;for patients with heat evil, add some gypsum, for patients with abundant phlegm, change dried rehmannia root into arisaema with bile; for patients with blood deficiency, add some prepared rehmannia root, leatherleaf milletia. Methods of administration: add 600ml of water per portion of Chinese medicine, and take the decoction twice daily in the morning and evening after 400 ml of mixed liquid mixture was left. Treatment course: ten times was one treatment course, and there were three treatment courses in all.According to Evaluation Criteria of Stroke on Diagnosis and Efficacy (additional list 1),the two groups were marked before and after the treatment. Both were marked in terms of physical signs and cerebral apoplexy patients'neurologic impairment degrees (additional list 2), and the two were also marked in light of activities of daily living scale (additional list3).The patients' language, rehabilitation and improvement of motor function were observed and assessed. Meanwhile, the differences between the two were analyzed in order to find out if it had statistical significance.Results:1) Comparing efficacy of treating CIS symptoms: after treatment, total effective rates' of improving symptoms were 96.0% (the treatment group) and 84.0% (the control group) respectively. Variance analysis of repeated measurement data showed p<0.05.2) Comparing amelioration of neurologic impairment: after treatment, the total effective rates of the two groups' were 92.0% and 80.0% respectively in terms of symptom improvement. Variance analysis of repeated measurement data showed p<0.05.3) Comparing scores' differences of activities of daily living: Independent T Test showed p<0.05, Variance analysis of repeated measurement data showed p<0.05, which meant that the treatment group got better results than the control group.Conclusion:1)Acupuncture and Chinese Medicine on treating Cerebral TanYuZuluo Ischemic Stroke were synergistic in clinical, and the combination was beneficial for the rehabilitation of hemiplegia 2) Compared with the treatment using only Chinese medicine, the treatment combining acupuncture with Chinese medicine could improve Ischemic Strokers' neurologic impairment indexes obviously, p<0.05, which could be substantial foundation of the combination to improve clinical efficacy.3) the treatment combining acupuncture with Chinese medicine adopted a multidisciplinary approach, which had some advantages of treating CIS. The approach could also enhance the curative effect and have a good influence on CIS patients'prognosis. |
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