The Clinical Research On Treatment Of The Spasticity Of Upper Limb In Patient With Stroke By Heat-Sensitive Moxibustion With Acupuncture

Objective:To observe the clinical therapeutic effect of the combination therapy of heat-sensitive moxibustion and acupuncture for the Spasticity of upper limb after stroke, and provide an empirical basis for the treatment plan of post-stroke spasticity.Methods:This study used a randomized controlled method,60 stroke patients who met the inclusion criteria were randomly divided into treatment group(treated by heat-sensitive moxibustion with acupuncture) and control group(treated by acupuncture). Actually, There were 30 patients in each group. The patients in treatment group was treated by acupuncture with heat-sensitive moxibustion, and the patients in the control group were treated by acupuncture merely. The two groups acupunctured the same point(DU20、GB20、LU5、LI15、LI11、LI10、PC6、LI4、 EX9) and heat-sensitive point area exploration around LI10、LI4、EX9.All the patients were given rehabilitation treatment and the basic treatment of Western medicine during the treatment. The treatment cycle was defined as 3 weeks and 6 times per week of treatment. The two groups were evaluated before and after treatment. The evaluation indexes included:(1)modified Ashworth scale(MAS) for the level of the convulsion of the upper limb; (2)the simplified Fugl-Meyer assessment (FMA) scale for the motor function of the upper limb; (3)Modified Barthel index(MBI) scale for activities of daily life.ResuIts:Analysis of the baseline:1.There were 28 patients in treatment group (2 patients were lost during the treatment) and 30 patients in control group.2.General information analysis before treatment:There were no significant differences in gender, age, time of symptom onset, stroke subtype and affected limb between the two groups(P>0.05).Analysis of the therapeutic effect:1. Comparison of the efficiency of two groups, first,the total effective rate of treatment group was higher than control group. Second, the clinical therapeutic effect of treatment group is superior to the control group with the spastieity of the flexor of eblow (P<0.05), but no statistic difference (P>0.05) between the two groups with the spasticity of the flexor of wrist and fingers. Third;there were no statistic difference among the the spasticity of the three flexores (P>0.05).2. the degree of upper limb flexor spasticity:after treatment,the degree of MAS were significantly different (P<0.05) from which before treatment, and the clinical effect of treatment group was significantly higher than control group with the flexor of eblow(P<0.05), the two groups showed no statistic difference after treatment with the flexor of wrist and fingers (P>0.05); there were no statistic difference among the the spasticity of the three flexores.3. The motor function of upper limb:two groups had curative effect(P<0.05),and the clinical effect of treatment group was significantly higher than control group by FMA (P<0.05).4. ADL:two groups had curative effect(P<0.05),but no statistic difference between the two groups with MBI(P>0.05).Conclusion:1.In the aspect of the flexor spasm of the upper limb:Both therapeutic methods were help to relieve the spasticity of the upper limb, and the combination therapy of heat-sensitive moxibustion and acupuncture are more help to reduce the spasm of upper limbs in patients with stroke, and the clinical effect was significantly higher than control group with the flexor of eblow.There were no statistic difference among the the spasticity of the three flexores with the same therapy.2. In the aspect of the motor function of the upper limb:Both therapeutic methods were help to improve the motor function of upper limb,and clinical effect of the combination therapy of heat-sensitive moxibustion and acupuncture was significantly higher than acupuncture merely.3. In the aspect of the ability of daily life:Both therapeutic methods have the same effect to improve the the ability of daily life of patients with stroke.The results showed that a synergistic effect between heat-sensitive moxibustion and acupuncture would further contribute to relieve the spasticity of the upper limb and improve the motor function of upper limb, effectively promoted the limb function recovery of the paralytic.