Clinical Observation Of Acupuncture At Seven Points Of Skull Base Combined With Bobath Rehabilitation Training In The Treatment Of Limb Movement Disorders After Cerebral Infarction

1 ObjectiveTo systematically evaluate the effectiveness of acupuncture at seven points of skull base combined with Bobath rehabilitation training in the treatment of limb motor dysfunction after cerebral infarction,so as to provide objective basis for clinical application.2 MethodsThe study was a prospective randomized controlled clinical trial involving patients in outpatient and ward departments of acupuncture and moxibustion(neurology),rehabilitation and emergency department from Wangjing Hospital of CACMS.72 patients with limb motor dysfunction after cerebral infarction who met the inclusion criteria were randomly divided into two groups with 36 patients in each group.The experimental group received Bobath rehabilitation training by acupuncture at seven points of skull base(Yamen,Fengchi,Tianzhu and Wangu),while the control group received sham acupuncture with Bobath rehabilitation training.The two groups were treated 5 times a week for 4 weeks.NIHSS score,FMA score,BI score and TCD score were observed and recorded before and after treatment in the two groups,respectively,to evaluate the condition of patients.SPSS25.0 statistical software was used for statistical analysis.3 Results3.1 Baseline dataThis study fell off because 1 patient in the experimental group could not insist on completing the study,and 1 patient in the control group received other treatments on their own and was excluded.Finally,a total of 70 patients completed the treatment.The basic information of all patients before treatment(gender,age,course of disease,affected side)and disease status(NIHSS score,FMA score,BI score,TCD)were obtained.The differences were not statistically significant.3.2 Main evaluation indexThere was no statistically significant difference between the NIHSS scores of the experimental group and the control group before treatment,indicating comparability.Intra-group comparison between the two groups after treatment showed a decrease in NIHSS score,and the difference was statistically significant(p<0.05),indicating that intervention in both groups could improve the degree of neurological impairment in patients.After treatment,inter-group comparison between the two groups showed that NIHSS score of the experimental group decreased more significantly than that of the control group,and the difference was statistically significant(p<0.05),indicating that the treatment method of the experimental group was superior to the control group,and acupuncture at seven points of skull base combined with Bobath rehabilitation training could effectively improve the neurological impairment of the patients.3.3 Secondary evaluation indexesThere was no statistical significance in FMA score and BI score between the two groups before treatment,and there was no statistical significance in upper limb score and lower limb score between the two groups before treatment,which was comparable.Intra-group comparison between the two groups 1 month after treatment showed that the FMA upper limb score,lower limb score,total score and BI score were increased compared with before,and the difference was statistically significant(p<0.05),indicating that the intervention in both groups could improve the motor function of the upper and lower limbs and the ability of daily living.Comparison between the two groups after treatment showed that the increases in FMA scores of upper limbs,lower limbs,total scores and BI scores of the experimental group were greater than those of the control group,and the differences were statistically significant(p<0.05),indicating that the seven points of skull base combined with Bobath rehabilitation training method of the experimental group was superior to the control group,which could improve the motor function of the patients.Improve patients’ quality of life.There was no significant difference between the experimental group and the the control group in LVA,RVA,BA and MCA Vm on the affected side before treatment,which was comparable.After treatment,the Vm of LVA,RVA,BA and MCA on the affected side were compared between the two groups.The results showed that the Vm of LVA,RVA,BA and MCA on the affected side were increased compared with that before treatment,and the difference was statistically significant(p<0.05),indicating that intervention in both groups could improve the cerebral blood flow of LVA,RVA,BA and MCA on the affected side.Comparison between the two groups after treatment showed that the increase of Vm in LVA,RVA,BA and MCA on the affected side of the experimental group was more obvious than that of the control group,the difference was statistically significant(p<0.05),indicating that the treatment method of the experimental group was superior to the control group,and the seven points of skull base combined with Bobath rehabilitation training could effectively improve cerebral blood flow.3.4 Clinical effective rateThe results showed that after the treatment,1 patient in the experimental group was cured,17 patients were significantly effective,14 patients were effective,3 patients were ineffective,and the total effective rate was 91.43%.In the control group,0 patients were cured,9 patients showed obvious effect,16 patients were effective,and 10 patients were ineffective.The total effective rate was 71.43%.The difference between the two groups was statistically significant,indicating that acupuncture at seven points of skull base combined with Bobath rehabilitation training was superior to false acupuncture combined with Bobath rehabilitation training therapy,and it had a definite effect on limb motor dysfunction after cerebral infarction.3.5 Safety evaluationDuring the study,no serious adverse events happened in all patients.4 Conclusion(1)Acupuncture at seven points of skull base combined with Bobath rehabilitation training and false acupuncture combined with Bobath rehabilitation training can improve the degree of neurological impairment,upper and lower limb motor function and daily living ability of patients with limb movement disorder after cerebral infarction.Acupuncture at seven points of skull base combined with Bobath rehabilitation training is superior to false acupuncture combined with Bobath rehabilitation training in improving nerve function defects,upper and lower limb motor function and daily living ability,and has good clinical application value.(2)Acupuncture at seven points of skull base combined with Bobath rehabilitation training and sham acupuncture combined with Bobath rehabilitation training can both improve the average blood flow velocity of bilateral vertebral artery,basilar artery and middle cerebral artery in patients with limb movement disorders after cerebral infarction,but the former has obvious advantages and has a greater effect on cerebral blood flow and patients’ recovery.