| The rising living standard of the people, along with the effect of certain factors such as inheritance, environment, diet, emotion etc., has led to significant changes of disease spectrum, disability and dysfunction spectrum in our country, and the rate of cerebrovascular disease rose annually. According to the study of epidemiology, the world’s average prevalence is500-600among100,000people, and the’ average prevalence of Guangzhou, Changsha, Yinchuan and other3cities has reached917among100,000people. The features of stroke, which is a frequently-occurring disease, are high mortality, high rate of relapse and high morbidity, leaving50%-80%of the survivors enduring dyskinesia. How to lower down morbidity and improve the survival quality of patients has become the emphasis of recoveries. Shoulder-hand syndrome is one of the most common complications among hemiplegic patients, accounting for74.1%. It mostly comes up with1-3months after the stroke. At the earliest, it may occur3days after the stroke which6months later at the latest. The major clinical manifestations of shoulder-hand syndrome are unilateral shoulder hand pain, erubescence, skin temperature rise, pain in the hand, limited in finger varicose. Shoulder-hand syndrome after stroke may severely hinder the recovery. If not treated in time, it may also result in distortions of hands and fingers, both economically and psychologically, on patients and families.ObjectivesWith the purpose of providing evidence of evidence-based medicine for clinical treatments of shoulder-hand syndrome after stroke, this dissertation is to verify the effectiveness of musculature acupuncture by means of comparisons of clinical efficacy of musculature acupuncture and common acupuncture in treating shoulder-hand syndrome after stroke, which will be based on randomized controlled trials.MethodsAs clinical experiment methods, prospective randomized trial has been adopted conducting this research. The research object is Stage I and Stage II patients of shoulder-hand syndrome after stroke, satisfying diagnostic criteria and inclusive criteria,. chosen from hospitalized patients in Acupuncture and Rehabilitation Department of Guangdong Second Provincial TCM Hospital. The research object is randomly divided into experimental group and control group, each with30examples. Both groups shall conduct neurology treatments regarding blood pressure control, blood sugar, fat adjustments, mottle stabilization, cranial nerve nutrition etc., while regular recovery training is given at the same time. Under the aforesaid premise, musculature acupuncture is conducted on the experimental group while common acupuncture is conducted to control group. The patients are given2courses of treatment, with each course lasting for6days and1treatment every day. The patients’ changes of edema, pain, upper limb movement function and abilities of daily living are recorded based on observations. At the end of the research, evaluations will be given to both groups with respect to the comprehensive therapeutic effect and security.ResultsGeneral data60. examples among60examples have been actually completed. There is no statistical difference (P>0.05) between two groups in age, age constituent ratio, sex constituent ratio, course and diagnostic upstaging, therefore the two groups are comparable. Moreover, there is no significant difference (P>0.05) between two groups in the degree of edema and pain, upper limb movement function and abilities of daily living, so the two groups are comparable. Evaluation of comprehensive therapeutic effectThe total effective rate of experimental group is90%while the total effective rate of control group is80%. Upon rank-sum test for the total effective rate of two groups, Z=-1.805, P=0.071, P>0.05. The distinction does not prove a statistical significance, which means both groups are effective in treating shoulder-hand syndrome after stroke and comparable in total effective rate. Comparison of observation indexes After two courses of treatment, the pain score of experimental group has decreased from5.93±1.44before treatment to2.5±1.81after treatment, while comparatively the pain score of control group has decreased from5.47±1.25to2.87±1.66; the edema score of experimental group has decreased from2.8±1.54before treatment to1.13±1.25after treatment, while comparatively the edema score of control group has decreased from2.47±1.63to1.07±1.36; the Fugl-meyer score of experimental group has increased from21.37±15.52before treatment to34.60±19.03after treatment, while comparatively the Fugl-meyer score of control group has increased from22.93±14.32to29.8±16.50; the Barthel score of experimental group has increased from43.17±17.49before treatment to63.83±20.58after treatment, while comparatively the Barthel score of control group has increased from42.8±17.80to55.67±20.54. Both groups have improved side upper limb score, edema visual analogy score, Fugl-meyer score and Barthel score. Upon examination, distinctions between the two groups before and after treatment have proved a statistic significance (P<0.05), which stating that both musculature acupuncture and common acupuncture can improve patients’side upper limb score, edema, upper limb movement function and abilities of daily living. On the other hand, based on comparisons of pain VAS score, upper limb movement function score, abilities of daily living score between two groups and upon examination, the distinctions have proved a statistic significance (P<0.01), which indicates that the experimental group is better regarding improvements of pain degree, upper limb movement function and abilities of daily living. Further, comparisons and examinations of degree of edema between two groups have proved no statistic significance (P=0.41, P>005), which indicates that treatments for each group can both lower the degree of edema and both effective in clinical cure.ConclusionMusculature acupuncture, as a treatment for patients suffering from shoulder-hand syndrome after stroke, can significantly improve the pain degree, upper limb movement function and abilities of daily living. In this regard, it is better than common acupuncture. However, it has not yet proved more effective than common acupuncture in lightening edema and total effective rate. Both treatments have shown effectiveness for curing shoulder-hand syndrome after stroke and better security. |
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