Zhou Zhijie’ Academic Thought And The Clinical Research Of "Brain Abdomen Four Needles" Treat Children Spastic Cerebral Palsy

Objective:Learning Mr Zhou’s clinical experience, acupuncture characteristics and "four needle therapy", summing up Mr Zhou’s academic thinking, and on this basis inheriting and carrying forward them.Cerebral palsy are a group of syndromes caused by brain non-progressive damage that occur in the fetus or infant period. These Syndromes perform persistent central movement, developmental disorders of posture and activity limitation. Along with the progress of medical treatment and health care, the mortality rate of newborns is decreasing year by year, while the prevalence of cerebral palsy in children is increasing. Infants are the most rapid period of motor development. Gross motor development, considered to be the foundation of other developmental should be studied as an important part of the rehabilitation of children with cerebral palsy.At present most clinical researches about children with cerebral palsy come from personal experience, and there are less summary of information on the experience and academic thought of the old famous TCM doctor about the acupuncture treatment to cerebral palsy. In most of the present studies the scientific method to random control is not applied, the sample size is insufficient and the repeatability is poor, which can only be applied in a small range and impact on the objective judgment of the therapeutic effect of acupuncture and moxibustion. In this study we applied Mr Zhou’s " brain and abdominal four needle " in the treatment of children with spastic cerebral palsy, and carried on scientific clinical observation and statistical analysis, further verified tutor’s academic thought and the four needles therapy, so that we could provide new, effective and reliable method and academic theory for the treatment of children with cerebral palsy.Methods:1 Theoretical researchOn one hand, we comprehensively reviewed and collected Mr Zhou’s papers, works, research and clinical data, and then summarized them. On the other hand, through daily reading the classic books, listening to the teacher’s education, learning with teacher face to face, observing, analysing, understanding his experience on the use of acupuncture in the treatment of diseases, we abstracted his academic thought of clinical treatment with acupuncture and the "four needle therapy ",and then used them independently in the clinical application.2 Clinical research140 cases of children with spastic cerebral palsy from the neurological rehabilitation clinic and cerebral palsy treatment center of the children’s Hospital of Xi’an City were selected as the objects of observation, then randomly divided them into control group and treatment group,70 cases in each group. The evaluator blind method was used, scale evaluation was executed by fixed assessment physician, who did not understand the treatment situation of the patients. The data was counted by specialized statisticians, who did not understand the statistical classification and evaluation. The control group were treated with single rehabilitation therapy, while treatment group were treated with " brain and abdominal four needle " on the basis of rehabilitation training, for two groups:1 times a day,5 times a week,60 times for 1 course of treatment.We observed the effects of the two groups on GMFM-66 and MAS score, determined their efficacy with Nimodipine method,performed statistical processing by statistical software SPSS17.0,summarized the difference between the two groups, and evaluated its curative effect, at last executed the safety evaluation after the treatment.Results:The theoretical research resultsIn this research we summarized Mr Zhou’s academic thought and its origin, his " four needle therapy " and its acupuncture characteristics, and its application on the clinical experience. " Zhunshengtang " fathers attached great importance to the whole thought, both acupuncture & moxibustion and medicine & food, influenced by his ancestors, other medical peoples, and the traditional classics Mr Zhou’s " academic thought of overall adjustment " was formed, including:1 Academic thought1.1 Paying attention to the whole and adjusting both Yin and Yang.1.1.1 Both left and right:For disease only located on one side of the body, such as hemiplegia, facial paralysis and so on,Mr Zhou used the method of " adjusting both left and right " to reinforce deficiency and reduce the excess to reach the balance between Yin and Yang.1.1.2 Both up and down:Including selection of the lower parts for the disease at top and the upper parts for the disease at low, which reflected the method of adjusting both Yin and Yang on the basis of the overall concept, then achieved the balance of Yin and Yang through the Zang and Fu organs, channels and the connection of Qi up and down.1.1.3 Both anterior and posterior:Mr Zhou believed that the abdomen is in front of the body and it is called Yin, while the back is the opposite. So combining these anterior and posterior points can achieve the effect of adjusting Yin and Yang meanwhile.1.1.4 Both internal and external:The disorder of Yin and Yang channels inner and outer side of the body would lead to muscle strength, muscle tension and abnormal posture. Mr Zhou achieved the effect of adjusting Yin and Yang meanwhile through the method of reinforcing the Yang and reduci-ng the Yin or reinforcing the Yin and reducing the Yang.1.1.5 Regulating both Qi and blood.Qi belongs to Yang, and blood belongs to Yin. They interdepen-dent and effect each other. Mr Zhou usually adjusted both Qi and blood meanwhile when treating beriberi or blood disease.1.2 Thinking highly of inquiry diagnosis, distinguishing three factors and identifying the source of disease.Mr Zhou emphasized to distinguish three factors according to the four methods of diagnosis, understood comprehensively the situation of the human body from such perspectives as seasonal conditions, geographical locations and constitutions of the individual patient so that to treat the disease in accordance with time, place and person and develop the advantage of overall treatment of TCM.1.3 Paying attention to diet, emphasizing the needle, medicine, and diet, showing their effects respectively.That was first diet, then acupuncture and medicine. For the mild illness, Mr Zhou used diet therapy alone,if not be cured,then coordinated the handling of acupuncture and medicine.For chronic or recurrent diseases, therapy was mainly used, combining with acupuncture and medicine. For acute diseases, acupuncture and medicine was mainly used, combining with diet therapy. Usually diet should been pay attention to, then the preference of organs could be corrected. Mr Zhou stressed that in daily life people should nurse back to health by the proper food according to the constitutions of the individual patient. When at the time of illness, the treatment of diet, acupuncture and medicine according to the pattern identification reflected the idea of TCM " preventive treatment of disease ".1.4 Paying attention to pattern identification according to channels, emphasizing to familiar with the nature of points.Mr Zhou believed that the pathways of channels were the foundations of the acupuncture treatment. Pattern identifications according to channels included the symptoms identification and disease identification. The key point of the acupuncture treatment included pattern identifications, point selection, manipulations. The right Pattern identifications, accurate points selection and skilled manipulations would get twice the result with half the effort.2 Mr Zhou’s " four needle therapy "included:djusting both physique and spirit, making good use of " Zang-organs four needles " to adjust five Zang-organs, attaching importance to " Four seas Theory " and adjusting the efficiency and the excess respectively, such as adjusting the sea of marrow with " brain four needles ", adjusting the sea of grain and water with " abdomen four needles " adjusting the Qi and blood with " Triple energizer four needles "3 The characteristic of Mr Zhou’s needling methodsincluded:fast needling so that to make the Qi to reach where the disease located, advocating the finger needling and emphasizing the finger force to be first important; being good at elongated needles with which the plenty points can be selected to treat the relevant disease, advocating governor and conception vessel, and combining the acupuncture, moxibustion, and digital acupoint pressure.4 Mr Zhou’s clinical experience summaryincluded curing intractable abdominal distension by identifying pathogeny, curing intractable facial paralysis by adjusting both left and right, curing foot inversion by adjusting internal and external, curing the Shaoyang headache by adjusting up and down, curing the perimary dysmenorrhea by adjusting anterior and posterior parts, curing Hypochondriac pain by adjusting exterior and interior, curing habitual constipation by both acupuncture and diet. In my independent clinical, I applied Mr Zhou’s academic thought and clinical experience in the treatment of neonatal brachial plexus injury with acupuncture and moxibustion and infantile enuresis and tourette’s syndrome with " brain and abdominal four needle "Clinical researchOn the basis of the comprehensive study and the inheritance of the tutor’s academic thought and experience, the therapeutic effect of the Mr Zhou’s " brain and abdominal four needle " in the treatment of infantile spastic cerebral palsy was observed and the results were as follows: 1130 cases were collected, in which 65 cases in treatment group, and 65 cases in control group. Before treatment there were no differences in age, sex, MAS, GMFM-66 between the two groups and the two groups were comparable (P>0.05)2 After treatment, the GMFM-66 scores of the two groups were increased (P<0.05), in which the treatment group improved more significantly (P<0.05), the effect of the treatment group was better than that of the control group.3 After treatment, the MAS scores of the two groups were lower than before (P<0.05), in which the treatment group decreased more significantly (P<0.05), and the effect of the treatment group was better than that of the control group.4 To compare the MAS efficiency of the two groups, in the treatment group,16 cases with obvious effect,41 cases with effect,8 cases with no effect, totally 57 cases with effect (87.69%); in the control group,9 cases with obvious effect,39 cases with effect,17 cases with no effect, totally 48 cases with effect (73.84%). There was statistical difference (P< 0.05) and the treatment group was better than that of the control group.5 To compare the Nimodipine efficiency of the two groups, in the treatment group,29 cases with obvious effect,27 cases with effect,9 cases with no effect, totally 56 cases with effect (86.15%); in the control group,11 cases with obvious effect,36 cases with effect,18 cases with no effect, totally 47 cases with effect (72.31%). There was statistical difference (P<0.05) and the treatment group was better than that of the control group.6 Nimodipine efficiency of the different age groups were as follows:for the age group of 6 to 12 months it was 85.71%, for 13 to 36 months it was 71.66%. there was statistically difference (P< 0.05), indicating that the effective rate of low age group was higher than that of the high one; the MAS effective rate of low age group was 82.85%, and high age group was 78.33%, there was no statistical difference (P>0.05),indicating that there was no difference in the MAS efficiency between the high and low age groups.Conclusion1 For children with spastic cerebral palsy, the use of " brain and abdominal four needle " combined with rehabilitation training, could reduce the muscle tension, improve limb spastic state, and promote the development of gross motor function.2 The use of " brain and abdominal four needle " could significantly improve the efficient of the clinical treatment of children with spastic cerebral palsy.3 Age is relevant to the efficacy of children spastic cerebral palsy rehabilitation. The younger, the faster progress; the older, the slower progress. The improvement of the degree of spastic cerebral palsy after treatment is not associated with age.4 The pathological changes of children with cerebral palsy is due to such two organs as spleen and kidney, and the treatment focuses on the governor and conception vessel. The clinical presentation of limb contracture of the spastic cerebral palsy is related to the imbalance of Yin and Yang. So the therapy is mainly that dredging governor vessel to support the Yang Qi and benefit Sui sea and adjusting conception vessel to benefit the spleen and kidney. Needling the governor vessel can adjust the Yang Qi and benefit the brain, while needling the conception vessel can adjust the Yin Qi and benefit the spleen and kidney. Needling both governor and conception vessel can balance the Yin and Yang Qi of the human body and smooth the channels & relieve spasm by supporting the weak & inhibiting the strong so that to effectively reduce the muscle tension, reduce muscle spasm ,change abnormal posture, improve motor function, and achieve the purpose of treatment of spastic cerebral palsy.