| Objective: To observe the clinical effect of the "complementary acupoints" in the treatment of limb hypertonia in stroke sequelae and to propose a better treatment strategy for stroke sequelae by acupuncture.Methods:1.GroupingThe 90 patients who met the criteria were grouped according to the order of consultation using a random number table,with 45 patients in each group in the general acupuncture with complementary acupoints group and 45 patients in the general acupuncture group.2.Treatment2.1 Control group:(ordinary acupuncture group)2.1.1 Acupuncture point selectionUpper limb on the affected side: Jiquan,Chize,Jianyu,Quchi,Shou sanli and Hegu points.Affected lower limb: Weizhong,Huantiao,Zusanli,Taichong,Fengshi,Sanyinjiao points.2.1.2 OperationThe patient is placed in a supine position and the needling site of the affected limb is fully exposed.After the practitioner has disinfected the area where the acupoint is located and both hands,different needles(Hua Tuo brand specifications 0.30 x 40 mm and 0.30 x 25mm)are selected according to the muscle hypertrophy at the site of entry for needling treatment.First set the point with the thumb of the left hand,hold the needle handle in the right hand and stab the needle vertically into the point.When needling the Jiquan point,care is taken to avoid the axillary artery.The needle is then twisted and rotated in a flat complementary and flat diarrhoeal way.After obtaining Qi,the needle is left in place for 30 min,and every 10 minutes a lifting,twisting,flattening,flattening and diarrhoea technique is applied.Remove the needle by lifting and twisting evenly to the subcutaneous level.2.2 Test group:(general acupuncture plus complementary acupoints group)2.2.1 Acupuncture point selectionOn the basis of the acupuncture points selected for the general acupuncture group + the affected side of Neiguan acupoint,Waiguan acupoint,Yinlingquan and Yanglingquan.2.2.2 OperationOn the basis of the treatment in the general acupuncture group,the upper limb of the affected side is treated with "tonifying Waiguan and dipping Neiguan";the lower limb is treated with "tonifying Yinlingquan and dipping Yanglingquan".The acupuncture techniques used are "lifting and inserting to complement and diarrhea","twisting and turning to complement and diarrhea","welcoming and following to complement and diarrhea","quick and slow to complement and diarrhea" and "opening and closing to complement and diarrhea".The technique is a combination of "open and close complement and diarrhoea".When stabbing the Neiguan point,the needle tip is quickly inserted in the direction of the circulation of the Hand Jueyin Xinbao meridian,and the needle is lifted and twisted after Qi is obtained.When removing the needle,slowly lift the needle to the subcutaneous level and remove it without pressing on the needle hole.When stabbing the Waiguan point,the needle tip is slowly inserted in the direction of the circulation of the Hand Shaoyang Sanjiao meridian,and the needle is lifted and twisted after Qi is obtained.When the needle is removed,the needle is quickly lifted to the subcutaneous level,withdrawn and the needle hole pressed.When stabbing Yanglingquan,the tip of the needle is inserted rapidly in the direction of the flow of the foot Shaoyang Bile Meridian,and the needle is lifted and twisted after Qi is obtained.When the needle is withdrawn,the needle is slowly lifted to the subcutaneous level without pressing on the needle hole.When stabbing Yinlingquan,the needle tip is slowly inserted in the direction of the foot Taiyin Spleen meridian,and the needle is lifted and twisted after Qi is obtained.When the needle is removed,the needle is quickly lifted to the subcutaneous level,removed and the needle hole pressed.3.Treatment: 1 time/day,6 times/week,rest on the 7th day,4weeks/treatment,total 1 course of treatment.4.Observation index: Changes in patients’ MAS,FMA and MBI scale scores before treatment,after the first treatment and at the end of the treatment course were compared and all data collected were processed and analysed using SPSS 26.0 software.Results.1.Before treatment,the general status and MAS,FMA,and MBI scores of the two groups were statistically validated at P > 0.05.The results showed no statistical differences in stroke type,gender,age,duration of illness,distribution of hemiplegic sites,and the three index scores for subsequent comparison.2.MAS score(1)MAS scores of the upper and lower limbs in the study group decreased after the first treatment with complementary acupoints compared to those before treatment(P < 0.05),whereas MAS scores of the upper and lower limbs in the control group who received only general acupuncture intervention did not change significantly compared to those before treatment(P > 0.05).This indicates that general acupuncture plus complementary acupoints intervention can immediately reduce the increase in muscle tone in the limbs after stroke.Intervention with general acupuncture alone was not immediately effective in improving increased muscle tone in the limbs after stroke.(2)In the study group,MAS scores of the upper and lower limbs decreased after 4 weeks of general acupuncture with complementary acupoints compared to those before treatment(P < 0.05),while in the control group,MAS scores of the upper and lower limbs decreased even after general acupuncture alone compared to those before treatment(P > 0.05).This suggests that both general acupuncture with complementary acupoints intervention and general acupuncture alone were able to improve the increased muscle tone in the limbs after stroke.(3)In addition,when the MAS scores of the upper and lower limbs at the end of the treatment period were compared between the two groups,the MAS score of the group treated with general acupuncture plus complementary acupoints was lower than that of the group treated with general acupuncture alone,indicating a more pronounced effect in reducing the tension in the limbs after stroke.3.FMA scores(1)The FMA scores of the patients who were given the complementary acupoints intervention in addition to regular acupuncture improved after the first acupuncture treatment compared to those before treatment(P <0.05),whereas the FMA scores of the patients who were given only regular acupuncture did not change significantly compared to those treatment(P >0.05).This suggests that general acupuncture with complementary acupoints immediately improved the limitation of motor function in the limbs.The effect of regular acupuncture alone did not have an immediate effect on limb limitation.(2)After 4 weeks of treatment,the FMA scores of the patients who were given the complementary acupoints intervention in addition to regular acupuncture improved compared to those before treatment(P < 0.05),while the FMA scores also improved with general acupuncture alone compared to those before treatment(P > 0.05).This suggests that both the general acupuncture with complementary acupoints intervention and the general acupuncture intervention alone improved the motor function limitation of the limbs.(3)The FMA scores of the patients in both groups were also compared at the end of treatment,and the FMA scores of the group given regular acupuncture plus complementary acupoints were higher than those of the group given only regular acupuncture,indicating a more significant improvement in the limitation of motor function of the limbs.4.MBI scores(1)The MBI scores of the patients who were given the complementary acupoints intervention in addition to regular acupuncture improved after the first acupuncture treatment compared to those before treatment(P <0.05),whereas the MBI scores of the patients who were given only regular acupuncture did not change significantly compared to those treatment(P >0.05).This suggests that general acupuncture plus complementary acupoints treatment immediately improved limitations in activities of daily living.General acupuncture alone did not have an immediate effect on the limitation of activities of daily living.(2)After 4 weeks of treatment,the MBI scores of the patients who were given the complementary acupoints intervention in addition to regular acupuncture improved compared to those before treatment(P < 0.05),while the MBI scores also improved with general acupuncture alone compared to those before treatment(P > 0.05).This suggests that both the general acupuncture plus complementary acupoints intervention and the general acupuncture intervention alone improved the limitation in activities of daily living.(3)The MBI scores of the patients in both groups were also compared at the end of treatment,and the MBI scores of the group given regular acupuncture plus complementary acupoints were higher than those of the group given only regular acupuncture,indicating a more significant improvement in the limitation of activities of daily living.5.Clinical efficiencyThe total effective rate after 4 weeks of treatment for patients who received complementary acupoints intervention in addition to regular acupuncture treatment was 88.89% for the upper extremity and 86.67% for the lower extremity.On the other hand,for patients who received only regular acupuncture intervention,the total effective rate after 4 weeks of treatment was 64.44% for the upper extremity and 62.22% for the lower extremity.These results indicate that there was a difference in the effectiveness of the two interventions in treating hypertonia of the extremities in patients recovering from stroke,with the study group that received the complementary acupoints intervention being more effective in treatment.Conclusion.1.Both general acupuncture plus complementary acupoints and general acupuncture alone have better efficacy in treating increased limb tone in patients recovering from stroke.2.In terms of the immediate effect,after the first treatment,general acupuncture plus complementary acupoints had a clear advantage in improving the degree of spasticity,the motor function of the limb and the ability to perform daily activities,and its immediate effect was better than that of general acupuncture alone.3.At the end of the course of treatment,acupuncture plus complementary acupoints was superior to acupuncture alone in terms of improving muscle tone,motor function and daily living ability of the spastic limb. |
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