Randomized Controlled Study On Periodical Acupuncture And Tertiary Rehabilitation For The Treatment Of Ischemic Cerebral Apoplexy Hemiplegia

Background and Purpose:Modern rehabilitation medicine began in the early 1980 s in China.Although it was a late start,it has a rapid development in the construction of rehabilitation medical subject and rehabilitation medical system in recent years,along with the development of medicine enterprises and the development of modern science and technology.In China,the country with a population of 1.3 billion,cerebral apoplexy has become the leading causes of death,bringing heavy economic and mental burden to patients' families and even the whole society.The prevention of cerebral apoplexy,treatment of cerebral apoplexy and rehabilitation of cerebral apoplexy have become a systematic project.They supplement each other and are closely linked to each other.It will not work out without any of them.And the basic principles are: to prevent cerebral apoplexy,to treat it in time,to rehabilitate in time and to return to society.In recent years,the mortality rate of cerebral apoplexy has obviously lowered,but the morbidity has still remained high.According to statistics,among the survivors of cerebral apoplexy,about 70% of the patients have different degrees of dysfunction,among which the patients with severe morbidity can run up to 40%.Thus it has laid heavy economic burden on the social security system,the patients' families and patients themselves.Therefore,it is a need to actively carry out timely,effective and normative and systematic rehabilitation treatment,to promote the patient's neurologic recovery,to improve their self-care ability,to reduce the morbidity of cerebral apoplexy,and eventually to make patients back to family and society.It has very important and realistic significance.To achieve this goal,people have been contributing to researching a new treatment strategy,in order to improve the aftermath of dysfunction caused by cerebral apoplexy faster and more effectively.It is one of the current clinical research hotspot and focus to combine the theory of traditional Chinese medicine acupuncture with a new theory of modern neurological rehabilitation,to attach great importance to the improvement of myodynamia and to pay much attention on changing the mobility mode of patients.Based on the ideas,studies and clinical observation on periodical acupuncture and tertiary rehabilitation for the treatment of ischemic cerebral apoplexy hemiplegia,as well as on the comparison with a single tertiary rehabilitation training,this paper aims at studying clinical curative effect of periodical acupuncture and tertiary rehabilitation for the treatment of ischemic cerebral apoplexy hemiplegia,for the purpose of providing scientific methods for the treatment and curative effect of cerebral apoplexy hemiplegia.Method:130 cases of standard patients with ischemic cerebral apoplexy hemiplegia were collected.They were randomly classified into comprehensive rehabilitation group(n = 65)and single rehabilitation group(n = 65).Both two groups were given tertiary rehabilitation training and comprehensive rehabilitation group was given periodic acupuncture treatment additionally.In the first month,the third month and the sixth month before and after the treatment,multiple scales were used respectively to evaluate the ability of daily life(ADL)in patients with(Barthel index scale),mobility function scale(Fugl-Meyer movement),the degree of nerve defect(NIHSS scale),and quality of life(simple health survey scale,SF-36).Through the evaluation above,functional recovery of patients were observed.Result:(1)Periodic acupuncture combined with tertiary rehabilitation training and a single tertiary rehabilitation training can effectively improve the ischemic limb dysfunction in patients with cerebral apoplexy,daily life ability and nerve function defect degree.From the observation on clinical curative effect after treatment,periodic acupuncture combined with tertiary rehabilitation training was significantly better than the single rehabilitation training.So it is worthy of popularization and application in clinic.(2)The curative effect of periodic acupuncture in combination with the three levels of rehabilitation training method on brain dysfunction after cerebral apoplexy is more significant than a single rehabilitation training.And a combination of treatment has synergistic effect.(3)Patients in single tertiary rehabilitation group at the end of the first month and the third month,have improved a lot in their physical dysfunction,daily life ability,neurologic deficits,which shows that tertiary rehabilitation training can promote the rehabilitation of cerebral apoplexy.(4)The use of multiple scales to evaluate the limb function recovery has increased the credibility of the scientific research and results.(5)Acupuncture method is relatively safe.And patients' compliance are high,operation is easy,curative effect is good and efficiency is high.I addition,no obvious adverse reaction has been found in the process of treatment.Conclusion:The periodic tertiary rehabilitation and acupuncture for the treatment of ischemic cerebral apoplexy hemiplegia can significantly improve the patients' mobility function,daily activity ability and life quality,and can reduce the patient's neurologic deficits.