| ObjectiveTo discuss the effects of the opposing moxibustion on the upper limb motor function,neurological function,activities of daily living(ADL),and the quality of life in patients,whom were suffered from cerebral infraction with upper extremity motor dysfunction.To compare the difference effects between the opposing moxibustion and general moxibustion,to discuss the validity,scientific and safty of the opposing moxibustion.To discuss whether the opposing moxibustion can decrease/avoid the adverse nursing events such as burns leaded by general moxibustion,and to supply the theoretical evidence for its clinical application.At the same time,verify the clinical nursing effect of moxibustion on cerebral infarction patients.MethodSelection of subjects:75 cases was subjected to criteria of Patients with upper limb motor dysfunction after Cerebral Infraction were randomized into A group(N=25),B group(N=25),C group(N=25).Interventions:Based on the basic treatment and nurse for the three groups,gave rehabilitation nursing for all the three group,besides gave the general moxibustion(Select the lateral acupoints)for the B group,gave the opposing moxibustion for the C group(Select the healthy acupoints).The rehabilitation nursing were given 1 time a day,45 minutes a time;and The moxibustion were given 1 time a day,30 minutes a time;the interventions were given 5 days a week,lasted for 4 week.Evaluation of nurse effect:before intervention,after intervention,1 month after the intervention,upper extremity motor function,neurologic function deficits,activities of daily living,and the quality of life were evaluated by relevant scales:upper extremity motor function was evaluated with Fugl-Meyer Assessment upper-extremity section,FMA-UE;neurologic function deficits was evaluated with China Stroke Scale,CSS;activities of daily living was evaluated with Modified Barthel Index,MBI;and the quality of life was evaluated with Stroke Specific Quality of Life Scale,SS-QOL.Besides,conduct security evaluation for the intervention.Statistical methods:statistical methods used ITT and PPs.If the data match the conditions of ANOVA for repeated measurement,the ANOVA for repeated measurement was used.If not,GEE was used.ResultsA total of 75 cases joined our study,63 cases finished the whole study,and 12 cases fell off or were eliminated.Three were 5 cases in A group,3 cases in B group,4 cases in C group.The comparison showed no significantly differences among the groups(P>0.05).1.Baseline comparisonAt baseline,there were no significantly differences among the groups on age,gender,marital status,occupation,education,blood pressure,history of smoking,history of drinking,course of disease,hemiplegia parts,the frequency of disease,Brunnstrom movement stage,muscle tension,FMA score,CSS score,MBI score,and SS-QOL score,indicating that the groups could be compared.2.FMA scaleThe PPs analysis suggested:three groups could all advance the total score of FMA scale.The total FMA score in before intervention,after intervention and 1month after follow-up of the three groups were,A group:18.45±11.34,16.40±9.91,14.00±8.40(F=52.835,P<0.05);B group:17.32±7.10,9.77±5.79,7.18±5.52(F=72.371,P<0.05);C group:13.80±8.44,7.10±9.40,5.62±8.79(F=65.012,P<0.05).Before intervention,after intervention and follow-up,in all the three groups,the comparison did show a significantly trend toward improvement in FMA(P<0.05).After intervention and follow-up,there were a significantly difference between A group and B group(P<0.05).There also were a significantly difference between A group and C group(P<0.05),but there were no difference between B group and C group(P>0.05).Besides,the ITT analysis made a same result with the PPs analysis.3.CSS scaleThe PPs analysis suggested:three groups could all reduce the total score of CSS scale.The total CSS score in before intervention,after intervention and 1 month after follow-up of the three groups were,A group:18.45±11.34,16.40±9.91,14.00±8.40(F=22.864,P<0.05);B group:17.32±7.10,9.77±5.79,7.18±5.52(F=104.25,P<0.05);C group:13.80±8.44,7.10±9.40,5.62±8.79(F=76.624,P<0.05).Before intervention,after intervention and follow-up,in all the three groups,the comparison did show a significantly trend toward reduce in CSS(P<0.05).After intervention and follow-up,there were a significantly difference between A group and B group(P<0.05).There also were a significantly difference between A group and C group(P<0.05),but there were no difference between B group and C group(P>0.05).Besides,the ITT analysis made a same result with the PPs analysis.4.MBI scaleThe PPs analysis suggested:three groups could all advance the total score of MBI scale.Time comparison results:Wald~2=181.035,P<0.05.Before intervention,after intervention and follow-up,in all the three groups,the comparison did show a significantly trend toward improvement in MBI(P<0.05).Group comparison results:Wald?~2=6.704,P=0.035.After intervention and follow-up,there were a significantly difference between A group and B group(P<0.05).There also were a significantly difference between A group and C group(P<0.05),but there were no difference between B group and C group(P>0.05).Besides,the ITT analysis made a same result with the PPs analysis.5.SS-QOL scaleThe PPs analysis suggested:three groups could all advance the total score of SS-QOL scale.The total SS-QOL score in before intervention,after intervention and1 month after follow-up of the three groups were,A group:116.90±31.48,135.85±36.31,160.30±28.28(F=75.382,P<0.05);B group:112.14±30.92,169.23±32.53,200.05±23.27(F=187.949,P<0.05);C group:125.76±38.37,187.00±40.88,210.33±42.52(F=119.322,P<0.05).Before intervention,after intervention and follow-up,in all the three groups,the comparison did show a significantly trend toward improvement in SS-QOL(P<0.05).After intervention and follow-up,there were a significantly difference between A group and B group(P<0.05).There also were a significantly difference between A group and C group(P<0.05),but there were no difference between B group and C group(P>0.05).Besides,the ITT analysis made a same result with the PPs analysis.6.SafetyThe total incidence of adverse events was 4%.the adverse events were burns.There were no case about adverse events in A and C group,and 3 cases had burns in B group,but there were no difference in A,B and C group(P>0.05).ConclusionBoth of the opposing moxibustion and the general moxibustion can improve the the upper limb motor function,the neurological function,the activity of daily life and the quality of life,for the patients with upper limb motor dysfunction after Cerebral Infraction.There was no difference between the general moxibustion and the opposing moxibustion in improving the upper limb motor function,neurological function,activities of daily living(ADL),and the quality of life of patients,whom were suffered from cerebral infraction with upper extremity motor dysfunction.So the opposing moxibustion has validity,scientific and safety.There is no case of nursing adverse events such as burns during the operation of Opposing Moxibustion.It can effectively reduce or avoid the occurrence of nursing adverse events such as burns. |
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