| Background:Ischemic stroke is the type of stroke with the highest incidence,and accounts for approximately 60-80%of strokes.With the rising of aging population in our country,the incidence of ischemic stroke has also increased year after year.Due to its extremely high mortality rate,disability rate and incidence,it poses a great threat to the health of the people.The incidence of spastic hemiplegia in post-stroke physical disabilities ranks first.About 80-90%of patients with hemiplegia after stroke are associated with mild or severe spasms.Because of the high incidence and high morbidity of the paraplegic state after stroke,timely and reasonable intervention can greatly improve the paralysis state,thereby improving the quality of life of patients and reducing the burden on families.The systematic and comprehensive rehabilitation of spastic hemiplegia is a problem that needs to be solved urgently in the current Chinese medicine rehabilitation science.Objective:Compare the effectiveness and safety of traditional Chinese medicine rehabilitation training methods in the treatment of stroke with spastic hemiplegia with modern rehabilitation techniques of Western medicine;compare the differences in efficacy of traditional Chinese medicine rehabilitation training methods in the treatment of stroke with spastic hemiplegia in different degrees;provide data support for follow-up clinical research,promotion and application of TCM rehabilitation techniques.Methods:In this study,patients who met the criteria for apoplectic hemiplegia were randomly assigned to a treatment group and a control group in a 2:1 ratio using a random number table.The treatment group applied traditional Chinese medicine rehabilitation training method(point massage with massage manipulation,combined with traditional Chinese medicine soaking),while the control group applied modern Western rehabilitation techniques.In this study we also introducted rehabilitation medicine evaluation indicators.It is a kind of research which is prospective,randomized controlled clinical studies.We took one visit when patients were assigned,following one visit per week,a total of 3 weeks in the study period,and a total of 4 visits.During the statistical data processing stage,based on the NHISS score,the patients included were divided into the lighter group and the heavier group,and stratified comparison was performed.Results:1 Before and after stratification,the baseline information of age,sex,occupation,past medical history and other basic information were not statistically different between the two groups.There was no significant difference in the baseline of the main efficacy indicators,so the test group and the control group have good comparability.2 After the 21-day rehabilitation training between the treatment group and the control group,in the PPS,treatment group and the control group had significant effect on improving the NIHSS score.Of the test group and the control group,the difference in efficacy was not statistically significant.NIHSS scores of the lighter group after the stratification and control group were significantly improved compared with themselves before the treatments,but there was no significant difference between the groups.The heavier group after stratification,NIHSS scores were significantly improved compared with the pre-rehabilitation group both in the test group and the control group.There was no statistical difference in the efficacy between the experimental group and the control group.3 In PPS,3 weeks after treatment,there was a significant improvement of spastic degree(MAS scores)in both the test group and the control group.There was no significant difference in efficacy between the two groups.After stratification,patients in the lighter group,the test group and the control group were significantly improved compared to their pre-treatment levels.There was no significant difference between groups.After stratification,MAS was significantly improved in the test group compared with the pre-treatment group.MAS in the control group showed no statistical difference.There was no statistical difference in efficacy between the test group and the control group.4 After 3 weeks of rehabilitation training,the total scores of FMA scores in the experimental group and the control group were significantly improved compared with the pre-treatment levels.No statistical difference was found between the two groups.After stratification in the lighter group,the test group and the control grouphad significantly improved in FMA scores compared with the pre-treatment levels.There was no statistical difference between the two groups.After the stratification in the heavier group,the total FMA scores of the test group and the control group were significantly improved compared with those before the treatment.There was no statistical difference between the two groups.5 After 3 weeks of rehabilitation treatment,the BI scores in the experimental group and the control group improved significantly compared with those before treatment.No significant difference was found between the two groups.After the stratification in the lighter group,the test group showed a significant improvement in BI scores compared with those before treatment.The control group showed a significant improvement in BI scores compared with those before treatment.No statistically significant difference was found between the two groups After the stratification in the heavier group,the BI scores of the test group and the control group were significantly improved compared with those before the treatment.No statistically significant difference was found between the two groups.6 Patients in the experimental group did not see any patients who had fallen off due to a failure to adapt to the TCM rehabilitation training program.There were no reports of adverse events.Conclusion:The NIHSS scores,MAS scores,FMA scores,and BI scores of the experimental group(TCM treatment group)and the positive control group(Western treatment control group)were significantly improved before and after treatment.No statistical comparison was made between the treatment group and the control group before and after stratification.The results reflect the satisfying effectiveness of the TCM rehabilitation training method in relieving the spastic hemiplegia state of post-stroke patients.The therapeutic effect is comparable to Western rehabilitation methods,both for patients with mild or severe neurological impairment.After the stratification in the heavier group,at the MAS evaluation site,there was a significant difference after treatment in the experimental group.There was no statistical difference in the control group.However,there was no statistical difference in the efficacy between the experimental group and the control group,which reflects that for the patients with severe neurological deficits,Chinese medicine rehabilitation training shows a better improvement trend.According to the analysis of the safety of the enrolled patients,the safety of the TCM rehabilitation training method also was confirmed. |
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