Study On The Efficacy Of Zi Wu Liu Zhu Acupuncture Therapy For Treatment Of Stroke And The Correlation Between The Onset Of Stroke And The Circadian Rhythm Of Endogenous Factors

Background:Stroke,as a common and frequent cerebrovascular disease,has a high rate of disability,mortality and recurrence.It is the second leading cause of death in the world and the leading cause of death in China.Among them,ischemic stroke accounts for about 60%-80% of strokes,and belongs to the category of "stroke" in Chinese medicine.A number of domestic and foreign studies have shown that the onset of ischemic stroke has obvious time clustering,that is,the morning peak phenomenon.Therefore,modern research believes that the incidence of ischemic stroke is related to the circadian rhythm,and this periodicity is the same as the fatality of stroke.Compared with strokes that occur in the afternoon,strokes that occur in the morning are more lethal.Endogenous factors such as hypertension,diabetes,hyperlipidemia,and high homocysteine blood lipids are recognized risk factors for stroke.Modern studies have found that blood pressure,blood sugar,blood lipids,Hcy and other related factors have obvious circadian rhythms.Time-varying,and ultimately affect the susceptibility of stroke,so circadian rhythm disturbance may be part of the reason for the high incidence of stroke.The theory of Ziwu Liuzhu has the same connotation as the rhythm of the twelve meridians of the day and night.Ziwu Liuzhu acupuncture is one of the representative time therapies in Chinese medicine.There are many clinical studies using Ziwu Liuzhu acupuncture to treat stroke and have achieved remarkable results.Curative effect,but other points are not uniform during treatment.The curative effect of Xingnao Kaiqiao acupuncture is a great method for the treatment of stroke in our hospital,and its clinical curative effect has been certified.Ischemic stroke is the dominant disease in the Department of Acupuncture and Moxibustion in our hospital.Objective:1.To study the effect of Ziwu Liuzhu acupuncture method combined with Xingnao Kaiqiao acupuncture method on the improvement of neurological deficit in the treatment of ischemic stroke;2.To explore the relationship between morning susceptibility to stroke and the circadian rhythm of endogenous factors such as blood pressure,blood glucose,blood lipid and Hcy;at the same time,to study the relationship between morning onset and neurological deficit and prognosis of stroke.Method:1.The effect of Ziwu Liuzhu acupuncture combined with Xingnao Kaiqiao acupuncture on the degree of neurological deficit in patients with ischemic stroke Sixty patients in the recovery period were randomly entered into the observation group(Ziwu Liuzhu acupuncture method + Xingnao Kaiqiao acupuncture method)and control group(Xingnao Kaiqiao acupuncture method),30 cases in each group.The observation group performed acupoint opening and operation at Chenshi(7-9 o’clock)or Sishi(9-11 o’clock)according to the Ziwu Liuzhu Najia method,and the control group followed the daily refreshing and resuscitation acupuncture method.The degree of neurological deficit was evaluated by NIHSS score.。2.The correlation between the onset period of stroke and the circadian rhythm of endogenous factors,the degree of neurological impairment,and short-term prognosis Patients2 weeks after the onset of disease were taken as the research objects,and were divided into morning onset group and non-morning onset group according to the time of onset.Binary logistic regression was used to analyze the correlation between morning onset and sex,age,course of disease,BP,TCM syndrome,positive abnormalities of glycosylated hemoglobin,fasting blood glucose,LDL,HDL,TG,TC,Hcy;Mann-Whitney U test was used Whether the difference in the degree of neurological impairment and short-term prognosis between the two groups is statistically significant.Result:1.There is no significant difference in the degree of neurological deficits between the two groups before treatment,and they are comparable.2.The neurological deficits of the two groups were improved before and after treatment,suggesting that both treatment methods have curative effects.3.Improvement of neurological impairment: the mean of the observation group was2.17±1.663,and the median was 2;the mean of the control group was 1.63±1.586,and the median was 1,the difference between the two groups was not statistically significant(P=0.138).4.Comparison of NIHSS scores before treatment between the two groups,the mean of the morning onset group was 7.63±3.737,and the median was 8.00;the mean of the non-morning onset group was 6.93±4.970,and the median was 6.00.There was no statistically significant difference in the degree of neurological deficits in different time periods(P=0.156);comparison of changes in NIHSS,the median of the morning-onset group was 2,the interquartile range was(0.5,3),and the non-morning-onset group The median was1,the interquartile range was(0,3),and the difference between the two groups was not statistically significant(P=0.092).5.Sex,age,TCM syndrome type,course of disease,positive abnormalities of glycosylated hemoglobin,fasting blood glucose,Hcy value,LDL,HDL,TG,TC are not significantly correlated with the time of onset,and blood pressure is correlated with morning onset(P=0.026).The binary logistic regression analysis of morning onset and blood pressure was performed separately,and the model logit P=-0.751+0.397 X,the OR value was 1.488,95% CI=1.019～2.172,and the accuracy rate of the model detection was 55.2%.Conclusion:1.Ziwu Liuzhu acupuncture method combined with Xingnao Kaiqiao acupuncture method and simple Xingnao Kaiqiao acupuncture method can effectively reduce the degree of neurological deficit in patients with stroke recovery.2.Compared with the simple Xingnao Kaiqiao acupuncture group,the efficacy of Ziwu Liuzhu acupuncture combined with Xingnao Kaiqiao acupuncture on the degree of neurological deficits in patients with stroke recovery is not statistically significant,except that the sample size is too small.The false negatives are possible.3.The onset of stroke has obvious time clustering,with the most onset in the morning(6-12 o’clock),followed by the afternoon(12-18 o’clock).4.The morning high incidence of stroke is related to blood pressure.