| Objective: To evaluate the clinical effect of uniting staging acupuncture and keeping normal limbs in good position to cerebral infarction hemiplegia,and approach the mechanism of action.Methods:The selected cases are randomly divided into three groups,A,B and C.A is treat group,B and C are control groups.Each group contains 80 cases.The group A adopts the treatment of uniting staging acupuncture and keeping normal limbs in good position.The group B adopts the treatment of uniting routine acupuncture and keeping normal limbs in good position.The group C adopts the treatment of routine acupuncture.All groups are gived routine medicial treatment(.1)Routine acupuncture:take acupoints in accordance with "acupuncture and moxibustion medicine" whitch is edited by Guojie Sun.Take acupoints on upper extremity as Jianyu,Quchi, Shousanli,Waiguan,Hegu;take acupoints on lower extremity as Huantiao,Yanglingquan,Zusanli,Jiexi,Kunlun.Give mildreinforcing-reducing method,and keep needles 30 minutes aftergetting the spirit(.2)Staging acupuncture:in the laccid paralysis period,on the foundation of routine acupuncture acupoints add acupoints as Neiguan(two sides),Sanyinjiao,Jiquan,Chize, Weizhong;in the spasm period,on the foundation of routine acupuncture acupoints add acupoints as Tianjing,Yangchi,Juliao, Weizhong,Qiuxu.Give mild reinforcing-reducing method,and keep needles 30 minutes after getting the spirit.(3)keeping normal limbs in good position:keep normal limbs in good position which consistent with the normal mode of rehabilitation medicine theory during the period of lying in bed and acupuncturing at the premise of not affect taking acupoints.Patients who lie in bed keep to turn the body over every two hours,to give the functional position respectively as dorsal position,injured lateral position,uninjured lateral position.The above three groups' treatment all are once every day.Ten times is a course of treatment and end the treatment after three continuous courses.All patients are taken venous blood of prior-treatment and post-treatment to check hemorheology index including blood viscosity and packed cell volum.Give a mark respectively for patients' prior-treatment and post-treatment at the aspect of the clinical neurologic impairment evaluation(NFI),motor function evaluation(FMA),activities of daily living evaluation(ADL),and evaluate the total clinical therapeutic effect,in order to estimate the therapeutic effect of each group.Results:1 Part of hemorheology index1.1 Blood viscosity The prior-treatment of high shear rate of A(5.29±0.10),B(5.25±0.10),C(5.27±0.09)has no significant difference(P>0.05);low shear rate of A(11.14±0.41),B(11.20±0.43),C(11.20±0.43)has no significant difference(P > 0.05).It illustrates that the three groups have comparability.The prior-treatment and post-treatment of each group all have significant difference(P<0.01).It illustrates that the three kinds of treatment plans to improve blood viscosity are all effective.To compare the post-treatment of the three groups,the high shear rate of A(4.32±0.11)is obviously lower than B(4.61±0.14)(P<0.05)and C (4.69±0.10)( P<0.01),and B are obviously lower than C(P<0.05).The low shear rate of A(9.73±0.52)is obviously lower than B(10.38±0.59)(P<0.05)and C(10.71±0.60)(P<0.01),and B is obviously lower than C(P<0.05).It illustrates that among the three kinds of treatment plans,the uniting staging acupuncture and keeping normal limbs in good position is the best to improve blood viscosity.1.2 Packed cell volumThe prior-treatment of A(57.30±2.81),B(58.17±2.93),C(57.17±3.07)has no significant difference(P>0.05).It illustrates that the three groups have comparability.The prior-treatment and post-treatment of each group all have significant difference(P<0.01).It illustrates that the three kinds of treatment plans to improve packed cell volum are all effective.To compare the post-treatment of the three groups,A(53.30±2.91)is obviously lower than B(56.17±2.93)(P < 0.05)and C(56.00±3.23)(P < 0.01),B and C have no significant difference(P > 0.05).It illustrates that among the three kinds of treatment plans,the uniting staging acupuncture and keeping normal limbs in good position is the best to improve packed cell volum.2 Evaluate the therapeutic effect2.1 Total clinical effectAfter treatment,group A has 11 cases recovery,29 cases excellence,38 cases utility,2 cases inefficacy,0 case aggravation, total effective rate is 97.50%.Group B has 7 cases recovery,25 cases excellence,36 cases utility,12 cases inefficacy,0 case aggravation,total effective rate is 85.00%. Group C has 4 cases recovery,20 cases excellence,30 cases utility,26 cases inefficacy, 0 case aggravation,total effective rate is 67.50%.The three groups' total effective rate have significant difference(P<0.05), and the total effective rate of every two groups all have significant difference(P<0.0125).It illustrates that among the three kinds of treatment plans,the therapeutic effect of uniting staging acupuncture and keeping normal limbs in good position is the best,the therapeutic effect of uniting routine acupuncture and keeping normal limbs in good position is better than routine acupuncture's.2.2 The scores of NFIThe prior-treatment scores of A(18.80±9.60),B(18.87±8.52), C (20.03±8.27)has no significant difference(P>0.05).It illustrates that the three groups have comparability.The prior-treatment and post-treatment scores of each group all have significant difference(P<0.01).It illustrates that the three kinds of treatme- nt plan to decrease the neurologic impairment degree are all effective. To compare the post-treatment of the three groups,the scores of A(8.10±4.92) is obviously lower than the scores of B(11.57±5.75) (P<0.05)and C(15.83±8.39) (P<0.01),and the scores of B are obviously lower than the scores of C(P<0.05).It illustrates that among the three kinds of treatment plan,the therapeutic effect of uniting staging acupuncture and keeping normal limbs in good position is the best to decrease the neurologic impairment degree, uniting routine acupuncture and keeping normal limbs in good position is better than routine acupuncture.2.3 The scores of FMAThe prior-treatment scores of A(28.13±17.39),B(27.57±15.20),C (23.53±13.88)has no significant difference(P>0.05).It illustrat- es that the three groups have comparability.The prior-treatment and post-treatment scores of each group all have significant difference(P<0.01).It illustrates that the three kinds of treatme- nt plan to improve motor function are all effective. To compare the post-treatment of the three groups,the scores of A(59.50±14.50) is obviously lower than the scores of B(51.00±16.87)(P<0.05)and C(40.23±16.51)(P<0.01),and the scores of B are obviously lower than the scores of C(P<0.05).It illustrat- es that among the three kinds of treatment plan,the therapeutic effect of uniting staging acupuncture and keeping normal limbs in good position is the best to to improve motor function, uniting routine acupuncture and keeping normal limbs in good position is better than routine acupuncture.2.4 The scores of ADLThe prior-treatment scores of A(43.33±20.94),B(42.67±23.03),C (37.50±20.88)has no significant difference(P>0.05).It illustrat- es that the three groups have comparability.The prior-treatment and post-treatment scores of each group all have significant difference(P<0.01).It illustrates that the three kinds of treatme- nt plan to improve activities of daily living are all effective. To compare the post-treatment of the three groups,the scores of A(75.50±17.97)is obviously lower than the scores of B(64.17±20.47)(P<0.05)and C(53.13±22.47)(P<0.01),and the scores of B are obviously lower than the scores of C(P<0.05).It illustrates that among the three kinds of treatment plans,the therapeutic effect of uniting staging acupuncture and keeping normal limbs in good position is the best to to improve activities of daily living,uniting routine acupuncture and keeping normal limbs in good position is better than routine acupuncture.3 Make one-way linear regression analysis between the difference of NFI scores and the course of diseaseAnalysis the eighty cases of group A.Take the time(days)from morbidity to beginning treatment of uniting staging acupuncture and keeping normal limbs in good position as independent variable.Take the NFI scores difference of prior-treatment and post-treatment as dependent variable.Construct linear regression equation as Y?=14.89-0.22X.The coefficient of regression is -0.22.There is linear correlation between the time(days)from morbidity to the beginning treatment of uniting staging acupuncture and keeping normal limbs in good position and the NFI scores difference, and is negative correlation.It illustrates that the shorter the time(days), the larger the NFI scores difference ,namely,the better therapeutic effect.Conclusions:1 The synthetic evaluation of the change of hemorheology index and therapeutic effect score confirms that the three treatment plans all have sure effect on cerebral infarction hemiplegia.The treat group's(uniting staging acupuncture and keeping normal limbs in good position)therapeutic effect is better than control groups' (uniting routine acupuncture and keeping normal limbs in good position, routine acupuncture).The therapeutic effect of uniting routine acupuncture and keeping normal limbs in good position is better than routine acupuncture's.2 The earlier the intervention of uniting staging acupuncture and keeping normal limbs in good position, the better the functional recovery of patients.
|
PDF Full Text Request