Effects Of Sizi Powder With Salt Hot-ironing On Meridians For Spastic Hemiplegia In Stroke Patients

ObjectiveThis study aimed to evaluate the effects of sizi powder with salt hot-ironing on meridians for spastic hemiplegia in stroke patients.Observed changes in the spasticity,motor function,activities of daily living and life quality,so as to provide a simple,inexpensive method for spastic cerebral apoplexy hemiplegia stroke patients rehabilitation.MethodsAccording to the diagnosis,inclusion and exclusion criteria,86 stroke patients with spastic hemiplegia were collected during March 2017 to November 2017 from nerve rehabilitation department in Fujian University of Traditional Chinese Medicine Subsidiary Rehabilitation Hospital and were randomly divided into two groups by computer randomized grouping method,namely,the experimental group(sizi powder with salt hot-ironing group)and the control group,43 cases in each group.The participants in the experimental group received standard treatment and routine rehabilitation training,plus the sizi powder with salt hot-ironing treatment(along the back of the Du meridians Da-Zhui acupoints to Yao-Yang-Guan Acupoints and the affected side of Bladder meridians Da-Zhu acupoints to Da-Chang-Shu acupoints),the participants in the control group received standard treatment and routine rehabilitation training only.Routine rehabilitation training was applied for 45 minutes one day,5 days a week,4 weeks.Sizi powder with salt hot-ironing treatment was applied for 30 minutes one day,5 days a week,4 weeks.The spasticity,motor function and activities of daily living were measured at the pretest,2 weeks after intervention and 4 weeks after intervention by the Modified Ashworth Scale(MAS),Clinical Spasm Index(CSI),simplify Fugl-Meyer Assessment Scale(FMA),Modified Barthel Index rating scale(MBI),respectively.Life quality in stroke patients was estimated by Patient-Reported Outcome(PRO)before and after the intervention.Results1 Test completion of research objectA total of 77 stroke patients with spastic hemiplegia completed the research after intervention,38 cases in the experimental group completed the research,1 case was excluded,3 cases falling off,1 case suspended.39 cases in the control group finished the research,1 case excluded and 3 cases falling off.2 Baseline comparison of research objectThere was no statistically significant difference in the general condition(age,gender,marriage status,educational level,health care type),drug use(improving circulation drugs,neurotropic drugs),clinical characteristics data(drinking,smoking,hypertension,diabetes,coronary heart disease),and basic situation after stroke(course of disease,onset frequency,type of stroke,paralysis side of stroke and brunnstrom stage)between the two groups before the test(P>0.05).Baseline of evaluation indexes(MAS,CSI,FMA,MBI,PRO)were compared before test.There was no statistically significant difference between the two groups(P>0.05).It showed that baseline information of the two groups was comparable.3 The clinical effect of sizi powder with salt hot-ironing on meridians for spastic hemiplegia in stroke patients3.1 Comparison of the spasticity of the two groups before and after the test3.1.1 Modified Ashworth Scale(MAS)Comparied with pretest and 2 weeks after intervention,there was no statistically significant difference on the spasticity of upper limb and lower limb in both groups.Comparied with pretest and 4 weeks after intervention,the spasticity of upper limb and lower limb in the experimental group were improved with statistically significant(P<0.05),the spasticity of lower limb in the control group was significantly improved(P<0.05),but there was no statistically significant difference on the spasticity of upper limb in the control group(P>0.05).Generalized estimating equation analysis showed that the main effect of time and the main effect of intervention of upper limb were no statistically significant(P>0.05),the main effect of time of lower limb was statistically significant(P<0.05),but the main effect of intervention of lower limb was no statistical significance(P>0.05).3.1.2 Effective rate of spasticity improvement The effective rate of spasticity improvement of the two groups after intervention,2 weeks after intervention,the effective rate of upper limb and lower limb of the two groups were not significantly improved(P>0.05).4 weeks after intervention,the effective rate of spasticity improvement in upper limb and lower limb in the experimental group were significantly higher than that in the control group,the difference was statistically(P<0.05).3.1.3 Clinical Spasm Index(CSI)Comparied with pretest and 2 weeks after intervention,only the score of clonus in the experimental group has significantly reduced(P<0.05),the total score of CSI,tendon reflex and muscle tension score were not significantly improved(P>0.05).There was no statistically significant difference in total score and each dimension of CSI scale in the control group(P>0.05).Comparied with pretest and 4 weeks after intervention,the score in each dimension of CSI scale was significantly reduced in both groups,with statistically significant(P<0.05).Before the intervention,2 weeks after intervention and 4 weeks after intervention,CSI score were collected and analysing by repetitive measurement and analysis of variance.The results showed that the main effect of time was statistically significant(P<0.05)in the score of CSI and each dimension scores,the interaction effect of intervention and time were statistically significant(P<0.05)in the CSI score and tendon reflex,while the muscle tension and clonus had no statistical significance(P<0.05)in the interaction effect of intervention and time.Moreover,the main effect of intervention in clonus was statistically significant(P=0.007).There was no statistically significant difference in the main effect of intervention in the CSI total score,tendon reflex and muscle tension.3.2 Simplify Fugl-Meyer assessment(FMA)Comparied with pretest and 2 weeks after intervention,there was no statistically significant difference on the motor function of upper limb and lower limb of patients in both groups.Comparied with pretest and 4 weeks after intervention,there was statistically significant improvement in the upper and lower extremity motor function of patients in the experimental group(P<0.05),but there was no statistical significant difference on the upper and lower extremity motor functions of patients in the control group(P>0.05).The FMA comparison of the two groups after intervention,FMA was analysed by repetitive measurement and analysis of variance.It showed that the main effect of time and the interaction effect of groups and time were statistically significant(P<0.05),but the main effect of intervention was no statistical significance(P>0.05).3.3 Modified Barthel index rating(MBI)Comparied with pretest and 2 weeks after intervention,the MBI score in the experimental group statistically improved(P<0.05).The MBI score in control group had no obvious improvement,and there was no statistically significant difference(P>0.05).Comparied with pretest and 4 weeks after intervention,theMBI score of the two groups was significantly improved(P<0.05).The MBI comparison of two groups after intervention,the results of repetitive measure analysis of variance showed that the main effect of time and the interaction effect of groups and time were statistically significant(P<0.05),but the main effect of intervention was no statistical significance(P>0.05).3.4 Patient-reported outcomes(PRO)Comparied with before and after intervention,the PRO score of the two groups were statistically significant(P<0.05).After 4 weeks of interventions,there were statistical difference between the two groups(P<0.05).4 Safety observationThere were no obvious adverse reactions occurred in this research.The patients in both groups showed no scald,breakage or blister in the back.And no palpitation,panic,dyspnea and other discomforts occurred during the operation.1 case was aborted due to suffering from food allergy with back itchy,which had nothing to do with hot iron therapy.ConclusionThe results of this study showed that sizi powder with salt hot-ironing on meridians for spastic hemiplegia in stroke patients may had an effect on spasticity to some extent,improving the patient's motor function and activities of daily life,also had the effect to improve patient's quality of life.