Clinical Study On Treatment Of Upper Limb Spasm After Stroke With Hui-acupuncture On Acupoints Of Yin Meridians By Thick Needle

Objective:To observe the clinical efficacy and safety of the treatment of upper limb spasm after stroke with Hui-acupuncture on acupoints of Yin meridians by thick needle.Methods:In this study,76 patients with post-stroke upper limb spasm who met the inclusion criteria in the outpatient and ward of the department of acupuncture and moxibustion in Shenzhen Bao ’an Hospital of Traditional Chinese Medicine from March 2020 to February 2021 were randomly divided into two groups using a randomized controlled trial method.In the study,2 patients fell out in each of the two groups.A total of 72 patients were finally included in the analysis,including 36 patients in the treatment group and 36 patients in the control group.The control group was treated with conventional acupuncture on the basis of basic treatment,while the treatment group was treated with Hui-acupuncture on acupoints of Yin meridians by thick needle on the basis of basic treatment.(Thick needles used in this study refer to thick flimsy needles with a diameter of 0.4mm.)The two groups were treated once a day,6 days a week and 1 day rest for 4 weeks.Modified ashworth scale(Modified ashworth scale,MAS),Simplify upper limb Fugl-Meyer assessment(Fugl-Meyer assessment,FMA),Modified barthel index(Modified barthel index,MBI)and Visual pain rating scale(Visual analogue scale,VAS)recorded before and after treatment were observed and compared.Safety records were also observed,and SPSS 23.0 was used for statistical analysis to evaluate the efficacy.Results:1.Modified ashworth scale(MAS):Compared with before treatment,MAS rating in both treatment group and control group was significantly decreased after treatment(P<0.01).After treatment,the improvement of MAS rating in treatment group was better than that in control group(P<0.05).2.Simplify upper limb Fugl-Meyer assessment(FMA):The FMA scores of the treatment group and the control group after treatment were significantly higher than those before treatment(P<0.01);The improvement of upper limb FMA score in the treatment group was better than that in the control group(P<0.05).3.Modified barthel index(MBI):the MBI scores of the treatment group and the control group after treatment were significantly higher than those before treatment(P<0.01),and the MBI scores of the treatment group were better than those of the control group after treatment(P<0.05).4.Visual pain rating scale(VAS):After treatment,the VAS score of the treatment group and the control group decreased significantly compared with that before treatment(P<0.01).There was no significant difference in the decrease of VAS score between the treatment group and the control group after treatment(P>0.05).5.Safety observation:During the study period,none of the subjects reported any serious adverse reactions to acupuncture,such as needle sickness and broken needle,nor any patients with aggravation of spasticity caused by the treatment.No patients in either group reported intolerance of acupuncture therapy.After treatment,the treatment group showed significant effect in 6 cases,effective in 12 cases,improved in 15 cases,and ineffective in 3 cases,with a total effective rate of 91.60%;the control group showed significant effect in 2 cases,effective in 3 cases,improved in 20 cases,ineffective in 11 cases,with a total effective rate of 69.40%.The clinical efficacy of the treatment group was better than that of the control group(P<0.05).Conclusion:Both Hui-acupuncture on acupoints of Yin meridians by thick needle and conventional acupuncture therapy can effectively improve the degree of spasticity in patients with upper limb spasm after apoplexy,improve the motor function of upper limb,the ability of daily living activities and relieve pain.In improving the degree of spasm,improving the upper limb motor function and the ability of daily living activities,the effect of the Hui-acupuncture by thick needle group was better than that of the conventional acupuncture group.The effect of the Hui-acupuncture by thick needle on the improvement of spasticity of patients with upper limb spasm and the improvement of motor function and daily living ability of upper limb spasticity after stroke is obviously better than that of conventional acupuncture,with good safety.It is worthy of clinical promotion and application,and can provide inspiration for the direction and thinking of follow-up research.