| Objective To obtain an optimum scheme of acupuncture technique improve neurologic impairment that calculated by Markov decision processes,provide evidences for clinical.Methods The electronic health records of patients with apoplexy convalescent hospitalized at the third affiliated hospital of Zhejiang University of Chinese Medicine between January 2012 and January 2017 were collected.Extract infromations according to medical record data and portioned into state-action-reward stages.Then performed a Comparative Effectiveness Research by using Markov decision processes,obtained an optimum scheme of acupuncture technique to improve neurologic impairment.Results A total of 684 records of poplexy convalescent were identified.Its general characteristics coincidence with epidemiology.Firstly,in 684 patients males are more than females,which 421 are males and 263 are females;Secondly,patients which more than 66 years old are 425,between 45 to 66 years old are 213,only 46 persons less than 45 years old;Thirdly,patients with more than one basic diseases are 623,account for 91 percent,there are 404 patients had more than two basic diseases and 0nly 61 patients had no basic diseases.Fourth,542 patients diagonise of Cerebral Infarction and 142 are hemorrhage;Lastly,syndrome of blood stasis phlegm stagnation in collaterals and qi deficiency and blood stasis type are more frequent in stroke,which were 345 and 181.In the patients,the number of 453 patients sufferd stroke with facial paralysis,and 672 with hemiplegia,but person with visual field defect and ataxia are not common,only 63 and 173 patients with them.There are 388 person on level 3,neurologic impairment scores between 6 to 12;then 134 patients are level 2(3-5score),level 4 are 107 patients and 50 person are level 1,only 5 person are on level5.In the study,we obtained kinds of 694 states and 15 actions and confirmed the combination of scalp acupuncture plus body needling and moxibustion are the optimum treatment to improve the motor function on apoplexy convalescent patients with high muscular tension,which calculated by Markov decision processes.However,combination of scalp acupuncture plus body needling are the best project for normal tension.Furthermore we found that for slight limb dysfunction,the best choice of acupuncture treatment is scalp and body needling.For patient who has acial paralysis,dysphagia and motor dysfunction,mainly use the acupuncture method of combination of scalp and body needling plus moxbustion.Lastly,scalp conbine body needling are the best for patien with dysphagia.Conclusion Firstly,the combination of scalp and body needling and moxibustion are the optimum treatment to improve the motor function on Apoplexy convalescent patients with high muscular tension.Combination of scalp and body needling are best for patients with normal muscle tone.Secondly,for slight limb dysfunction,the best choice of acupuncture treatment is scalp and body needling.Thirdly,For patient who has acial paralysis,dysphagia and motor dysfunction,mainly use the acupuncture method combination of scalp and body needling and moxbustion.Lastly,scalp conbine body needling are the best for patien with dysphagia. |
