Clinical Study On Treatment Of Hemiplegic Shoulder Pain By Acupuncture And Moxibustion Combined With Rehabilitation Training Based On Data

Objective: Based on the data mining technique,this thesis studied the rule of point selection in acupuncture treatment of hemiplegic shoulder pain in modern literature and observed the clinical efficacy and safety of acupuncture and moxibustion combined with rehabilitation training in the treatment of hemiplegic shoulder pain.Method: In terms of literature research: Extensive collection of modern literature related to acupuncture treatment of shoulder pain after stroke,literature sources are commonly used Chinese medical databases: Literatures on acupuncture treatment of hemiplegic shoulder pain were published from January 2011 to January 2021 by CNKI,Wanfang Data Knowledge Service Platform(WF),VIP database(VIP)and China Biomedical Literature Service(Sino Med).In terms of clinical research: According to the random number table method,78 patients who met the criteria for HSP were divided into two groups in the ratio of 1:1,39 patients in each group.Both groups were given the conventional clinical treatment of secondary prevention of ischemic stroke,and the control group was given comprehensive rehabilitation training on this basis,while the observation group was treated with electroacupuncture and moxibustion shoulder on top of the control group.The treatment was carried out 4 times a week for 2 weeks,and a total of 3 courses of treatment were given.The clinical efficacy was judged by observing the VAS score of shoulder pain,FMA score,and shoulder function score before and after treatment,as well as the total clinical efficiency and safety evaluation.Result:I.Analysis results based on modern literature research(i)General information: a search of four databases resulted in 79 literature articles,yielding 79 prescriptions involving 68 acupoints and a total frequency of 646 uses of acupoints.(ii)Frequency analysis:(1)Frequency analysis of acupoints: a total of 68 acupoints are involved,of which the first 14 are high-frequency acupoints whose times of use are greater than the average(9.50times),the order is Jianyu,Jianzhen,Quchi,Jianliao,Waiguan,Hegu,Ashi Point,Jianqian,Binao,Shousanli,Tianzong,Jianjing,Neiguan,Houxi.(2)Frequency analysis of acupoints attributed to meridians: a total of 14 meridians and extra-meridians are involved.The order of the top 5 frequency of use is: large intestine meridian of hand Yangming,small intestine meridian of hand Taiyang,san jiao meridian of hand Shaoyang,non-meridian extra acupoint,and gallbladder meridian of foot Shaoyang.(3)Frequency analysis of specific points: a total of 40 specific points were retrieved,and the top 5 types of frequency of use were in sequence: crossing point,five-shu point,eight confluence points,luo-connecting point,and yuan-primary point.(4)Frequency analysis of acupuncture point sites: there were five body parts involved,which were in order of frequency: upper extremity,lower extremity,shoulder,and back,head,face and neck,chest,and abdomen.(iii)Association rule analysis: analyze the association rules of 68 included acupoints,and rank the compatibility association of acupoints according to the degree of support.The top five are: Jianzhen (?) Jianyu ? Quchi (?) Jianyu ? Jianliao (?) Jianzhen ? Jianliao (?) Jianyu ?Waiguan(?)Quchi.(iv)Acupoint cluster analysis: cluster analysis was performed on 14 high-frequency acupoints and the results were grouped into 5 categories according to the clinical theory of TCM: Category I: Jianyu,Jianliao,Binao;Category Ⅱ: Quchi,Waiguan,Hegu,Shousanli;Category III: Jianzhen,Jianqian,Houxi,Ashi Point;Category IV: Tianzong,Jianjing;Category V: Neiguan.II.Results of clinical study analysis(i)There is no significant difference in gender,age,course of the disease,and location between the two groups(P>0.05),which is comparable.(ii)VAS score results: VAS scores showed that there was no significant difference in VAS scores before treatment between the two groups(P>0.05).VAS scores of the two groups were significantly decreased after treatment and during the follow-up period,and the downward trend had statistical significance(P<0.01),suggesting that the treatment methods in both groups could reduce the symptoms of shoulder pain in patients,but the observation group was better,and the curative effect was more stable and long-lasting.(iii)FMA score and shoulder function score results: The difference in FMA score and shoulder function score of patients between the two groups was not significant before treatment(P>0.05).The FMA score and shoulder function score of patients between the two groups after treatment were significantly improved,and the score difference between the two groups was statistically significant(P<0.01),suggesting that the treatment methods in both groups had exact curative effects on upper limb motor function and shoulder function of patients with HSP,but the observation group was superior to the control group.(iv)Efficacy evaluation results: the total effective rate of the observation group was97.30%,and the healing rate was 86.49%;the total effective rate of the control group was86.49%,and the healing rate was 67.57%,and the difference between the two groups was statistically significant(p<0.05).This indicates that the overall efficacy of the observation group was better than that of the control group.(v)Safety evaluation results: the interventions in both groups were safe and feasible.Conclusion:(i)The rules of acupuncture in the treatment of hemiplegic shoulder pain are mostly based on regulating yang-qi,dredging collaterals and removing arthralgia;the rules of acupuncture are mostly based on taking acupuncture points of the upper limb hand three Yang meridians,combining local acupuncture points and near acupuncture points,and emphasizing the use of specific acupuncture points,with the rendezvous points and five transfusion points.(ii)Rehabilitation training alone can reduce the shoulder pain symptoms of HSP patients to a certain extent,and it also has a good safety effect on the improvement of upper limb motor function and shoulder joint function.(iii)The clinical efficacy of acupuncture and moxibustion combined with rehabilitation training in the treatment of HSP is precise,and its efficacy is better than that of rehabilitation training alone and more stable and durable.