| Aim:To clinically explore the mechanism of Jin-three-point therapy on the patients with limb dysfunction as a result of stroke by using electroencephalogram (EEG) signals and surface electromyogram(SEMG) signals, and to observe the impact of Jin-three-point therapy on the patients with motor function, brain function, daily life function, etc., in the hope of further understanding the level of recovery that the patients are able to attain while comprehending the impact that the Jin-Three-point therapy’s mechanism has on the patients through electrophysiological methods. Furthermore, the practice is also expected to be conducive in providing some clinical advice for better adjuvant therapy on the patients with limb dysfunction after stroke and assisting clinicians to optimize therapeutic plans and improve curative effect, thus, further reduce the suffering of the patients and improve the survival quality and prognosis of the patients.Method:(1)According to the diagnostic criteria stipulated by the Fourth National Cerebrovascular Disease Academic Conference in 1995,220 eligible stroke patients(44 to 80 years old)are selected, and divided randomly into the experimental group(Jin San Zhen acupuncture treatment) which includes 120 patients and the control group (normal acupuncture treatment) where the other 100 patients are set. The whole treatment has two periods, each of which lasts for four weeks. The acupuncture treatment is manipulated once a day, each treatment lasts for half an hour. Before and after the whole treatment, we are required to do as following: ①We use modified Barthel index(MBI) and modified Rankin scale (MRS) as evaluation tools to assess patients’basic daily activities and curative effect. ②Fugl-Meyer evaluation is used to evaluate the limbs’ motor function equilibrium function、sensory function of limbs joints’ mobility and pain. ③NIHSS scale of National Institutes of Health(NIH) is used as the nervous system evaluation tool. And it is required to observed the patients’ motor function、sensory function、 self-care ability and the recovery situation of the nerve injury, and finally to evaluate the therapeutic effect of two different treatments.(2)Among those stroke patients who are chosen in our clinical research, those who are in the experimental group are selected to participate in electroencephalogram (EEG) detection process which lasts for 20 to 30 minutes. Before the EEG detection, patients are required to close their eyes and relax. Five minutes after the EEG detection being operated the acupuncture treatment(last for 15 minutes) is started. The EEG detection is ended five minutes after the treatment has been finished. During the whole detection, patients’ movement、nvironmental changes inside the ward and nursing procedure are all under observation in order to. provide references for the final computer analysis. The average power and amplitude of α、θ、δ、 β wave in three different periods should be recorded respectively.(3) Among those stroke patients who are under our clinical research,30 patients from two different groups are selected respectively to accept limb surface electromyogram (SEMG) signal detection. It still needs to observe the changes of muscle root mean square (RMS)rate targeting both injured and uninjured side of the patients.Result:(1) By chi-square test of gender for patients in two groups, to detect the difference between these groups, x2=1.117, P=0.291>0.05, therefore, there is no statistically significant gender difference between two groups, then, the two groups are comparable. By U test of age for patients in two groups, to detect the difference between these groups, U=5202.00, P=0.292>0.05, that is to say that there is no statistically significant age difference between two groups, then, the two groups are comparable.(2) To compare the difference of former evaluation for patients in two groups, independent sample t test is used, P>0.05, there is no statistically significant difference between two groups, then, the two groups are comparable.In treatment group, to compare the difference of evaluation for patients between the condition before treatment and the condition after treatment, paired sample t test is used, P<0.05, there is statistically significant difference between two conditions, that is, there is obvious statistically significant curative effect in the treatment group.In control group, to compare the difference of evaluation for patients between the condition before treatment and the condition after treatment, paired sample t test is used,P<0.05, there is statistically significant difference between two conditions, that is, there is obvious statistically significant curative effect in the control group.To compare the difference of evaluation for patients after treatment in two groups, independent sample t test is used, P<0.05, there is statistically significant difference between two groups, that is, the efficacy difference between the treatment group and the control group is statistically significant.(3) To compare the difference of a rhythm average power, a rhythm amplitude between three stages:the resting stage before acupuncture treatment, the acupuncture needle retention stage and the stage of after removing needles, the single factor analysis of variance is used, P<0.05, there is statistically significant difference between three stages, that is ① a rhythm average power increases more in the acupuncture needle retention stage and the stage of after removing needles than the resting stage before acupuncture treatment. ② a rhythm amplitude increases more in the stage of after removing needles than the resting stage before acupuncture treatment.To compare the difference of θ rhythm average power,8 rhythm amplitude between three stages:the resting stage before acupuncture treatment, the acupuncture needle retention stage and the stage of after removing needles, the single factor analysis of variance is used,P<0.05, there is statistically significant difference between three stages, that is, ①θ rhythm average power decreases in the stage of after removing needles and is lower than the resting stage before acupuncture treatment. ② θ rhythm amplitude decreases in the acupuncture needle retention stage and the stage of after removing needles, and it is lower than the resting stage before acupuncture treatment.To compare the difference of δ rhythm average power,δ rhythm amplitude between three stages:the resting stage before acupuncture treatment, the acupuncture needle retention stage and the stage of after removing needles,the single factor analysis of variance is used,P<0.05, there is statistically significant difference between three stages, that is, ①δ rhythm average power decreased in the acupuncture needle retention stage and the stage of after removing needles, and it is lower than the resting stage before acupuncture treatment. ②δ rhythm amplitude decreases in the stage of after removing needles and is lower than the resting stage before acupuncture treatment.To compare the difference of 0 (LF) rhythm average power, β (LF) rhythm amplitude between three stages:the resting stage before acupuncture treatment, the acupuncture needle retention stage and the stage of after removing needles, the single factor analysis of variance is used.①The conditions ofβ (LF) rhythm average power:In the F4、C3、CZ leads, it shows P>0.05, while, in other leads, it shows P<0.05, there is statistically significant difference between three stages, that is,β (LF) rhythm average power decreases in the acupuncture needle retention stage and the stage of after removing needles,and it is lower than the resting stage before acupuncture treatment, furthermore,β (LF) rhythm average power in the stage of after removing needles is lower than it in the acupuncture needle retention stage.②the conditions of β (LF) rhythm amplitude:In the T3、T4、T5、T6、 F7、02、CZ、C3、FZ、F4、FP2 leads, it shows p<0.05, there is statistically significant difference between three stages, that is,β (LF) rhythm amplitude decreases in the acupuncture needle retention stage and the stage of after removing needles, and it is lower than the resting stage before acupuncture treatment, furthermore,β (LF) rhythm amplitude in the stage of after removing needles is lower than it in the acupuncture needle retention stage.To compare the difference of β (HF) rhythm average power,β (HF) rhythm amplitude between three stages:the resting stage before acupuncture treatment, the acupuncture needle retention stage and the stage of after removing needles, the single factor analysis of variance is used. ①the conditions of 3 (HF) rhythm average power:it shows p<0.05, there is statistically significant difference between three stages, that is, (I)in the stage of after removing needles,β (HF) rhythm average power in the FZ lead obviously increases more than other stages, while,β (HF) rhythm average power in other leads decrease, which ones are lower than in the resting stage before acupuncture treatment; (Ⅱ) in the acupuncture needle retention stage, β (HF) rhythm average power in the T4 lead obviously increases more than other stages, however,β (HF) rhythm average power in other leads is lower than in the resting stage before acupuncture treatment, while higher than in the stage of after removing needles.①The conditions of β (HF) rhythm amplitude:in the T3、T4、T5、T6、F8、F7、O1、PZ、P3、FZ、FP2、FP1 leads, it shows P<0.05, there is statistically significant difference between three stages, that is, (Ⅰ)β(LF) rhythm amplitude in the stage of after removing needles is lower than in the resting stage before acupuncture treatment; (Ⅱ) in the acupuncture needle retention stage, β (HF) rhythm amplitude in the F8、T5 leads increase more than other stages,while,β (HF) rhythm amplitude in other leads are higher than in the stage of after removing needles.(4) To compare the difference of the ratio of muscle root mean square amplitude of the dysfunction limb side and the healthy side between treatment group and control group before remedy, independent sample t test is used, P>0.05, there is no statistically significant difference between two groups, then,the two groups are comparable.In treatment group, to compare the difference of the ratio of muscle root mean square amplitude of the dysfunction limb side and the healthy side between the condition before treatment and the condition after treatment, paired sample t test is used, P<0.05, there is statistically significant difference between two conditions, that is, there is obvious statistically significant curative effect in the treatment group.In control group, to compare the difference of the ratio of muscle root mean square amplitude of the dysfunction limb side and the healthy side between the condition before treatment and the condition after treatment, paired sample t test is used, P<0.05, there is statistically significant difference between two conditions, that is, there is obvious statistically significant curative effect in the treatment group.To compare the difference of the ratio of muscle root mean square amplitude of the dysfunction limb side and the healthy side between treatment group and control group after remedy in two groups, independent sample t test is used, P<0.05, there is statistically significant difference between two groups, that is, the efficacy difference between the treatment group and the control group was statistically significant.Conclusion:(1) In clinical efficacy evaluation:Both the Jin-three-point therapy and the normal acupuncture treatment not only can improve the score of modified Barthel index (MBI) and Fugl-Meyer evaluation which includes the limbs’motor function、equilibrium function、sensory function of limbs joints’mobility and pain but also can reduce the assessment scale MRS score for detecting the degree of functional disability of daily life and the assessment scale NIHSS score for evaluating the extent of nerve damage. Futhermore, the efficacy of Jin-three-point therapy is proved to be better than normal acupuncture treatment.(2)According to the EEG signal detection, it shows that in the implementation of Jin-three-point acupuncture, a rhythm amplitude and average power increased, when the θ,δ rhythm amplitude and average power decreased. Therefore, it indicates that Jin-three-point acupuncture can improve the cerebral cortex excitability and promote the recovery of the cerebral function.(3)The observation indicator of SEMG signal, the ratio of muscle RMS of the dysfunction limb side and the healthy side increased significantly than that before the remedy, which could be attributed to the fact that the motoneurons of the dysfunction limb side have been restored compared to that before the remedy; Futhermore, the efficacy of Jin-three-point therapy is better than normal acupuncture treatment.(4)The innovations:①This study is the first one which has the detection method by synthesizing the EEG signal testing results and the SEMG signal testing results. And it is the preliminary exploration of the electrophysiological mechanism for Jin-three-point therapy on the patients with limb dysfunction as a result of stroke in clinic, furthermore, it also lays the foundation for the method of further investigation what is based on clinical electrophysiological mechanism for the curative effect of Jin-three-point therapy.②In clinical, the evaluation of therapeutic effects of the limb dysfunction as a result of stroke is almost measured by many kinds of the clinical symptoms scales. While, this study is the first one which has the detection method by synthesizing the EEG signal testing results and the SEMG signal testing results. Its aim is to further refine and grade the evaluation methods for the recovery degree and the curative effect of the limb dysfunction as a result of stroke by the method of electrophysiological mechanism of EEG and EMG. |
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