| Objective:To observe the clinical efficacy of Li’s Gua Sha method in the intervention of spastic hemiplegia in patients with ischemic stroke(wind-phlegm obstruction type).Methods:This study is a randomized controlled study,selecting 120 patients with spastic hemiplegia after ischemic stroke in a tertiary hospital in Hunan from July 2021 to November2022,using a random number table to generate random numbers,and randomly divided the patients into copper gua sha group,ordinary gua sha group and control group through blinded grouping.All three groups of patients were treated for 1 month,and the changes of Fugl-Meyer motor function scale(FMA)score,modified Ashworth scale,living activity ability(ADL)score,serum hypersensitivity C-reactive protein,homocysteine,total cholesterol,triglycerides,and LDL cholesterol content before and after treatment were observed.The raw data obtained were entered into Excel 2020,and the SPSS26.0 statistical software was used for statistical analysis,and quantitative results were obtained by statistical methods such as one-way ANOVA,Kruskal-Wallis H-rank sum test,t-test,Wilcoxon rank sum test,and x~2test.Results:(1)In the course of the study,3 cases of refusal of follow-up gua sha,2 cases of active withdrawal,and 2 cases of loss of contact in the middle of the process,a total of 7 cases(3 cases in the copper gua sha group,2 cases in the ordinary gua sha group,and 2 cases in the control group).The results showed that there were no significant differences in age,gender,lesion location,course and whether the three groups were first(P>0.05).(2)At admission,there were no significant differences in the data of upper limbs,lower limbs and total score Fugl-Meyer scores between the three groups(P>0.05),and after one month of intervention,the limb motor function of the three groups was improved(P<0.05),and after the intervention,there were significant differences between the three groups(P<0.05),and the statistical differences in lower limbs were more obvious(P<0.01).(3)The results showed that there were statistical differences between the upper limb score between the copper gua sha group,the ordinary gua sha group and the control group(P<0.05),while there was no statistical difference between the copper gua sha group and the ordinary gua sha group(P>0.05),and in the lower limb score,there were statistical differences between the copper gua sha group and the ordinary gua sha group and the control group,and the ordinary gua sha group and the control group(P<0.05).(4)The results showed that among the dimensions of the upper limb co-movement,wrist stability and finger were statistically different(P<0.05),the remaining dimensions were better than the control group in the two gua sha groups,but there was no statistical difference(P>0.05),and among the lower limb dimensions,there was no statistical difference between the activity dimensions accompanied by coordinated movement(P>0.05),and there were statistical differences between the other dimensions(P<0.05).(5)At admission,there was no significant difference in MAS scores between the three groups(P>0.05),and the MAS scores in each group after the intervention were significantly lower than before the intervention(P<0.05),and there were differences between the three groups after the intervention(P<0.05).(6)At admission,there was no significant difference in Barthel scores between the three groups(P>0.05),and the Barthel scores in the three groups after the intervention were significantly lower than before the intervention(P<0.05),and there were differences between the three groups after the intervention,and the difference was statistically significant(P<0.01).(7)The Barthel scores of the three groups were compared after intervention.The results showed that there were statistical differences in the items of Barthel score after intervention,such as using the toilet,dressing,stool control,urination control and going up and down stairs(P<0.05).Although there was a trend that the two scraping groups were better than the control group,there was no statistical difference(P>0.05).(8)At admission,there was no significant difference between serum hs-CRP and Hcy in the three groups(P>0.05),serum hs-CRP and Hcy levels in each group after intervention were significantly lower than before the intervention(P<0.05),and there was an intergroup difference between the three groups(P<0.05),while the serum Hcy content in the copper gua sha group and the ordinary gua sha group was lower than that in the control group,but there was no significant difference between groups(P>0.05).(9)At admission,there was no significant difference in serum TC,TG and LDL-C levels between the three groups(P>0.05),serum TC,TG and LDL-C levels in each group after intervention were significantly lower than before the intervention(P<0.05),and only serum TC(P<0.05)existed between the three groups after the intervention(P<0.05),while there was no difference between groups(P>0.05).(10)In terms of clinical efficacy of the three groups,the total effective rate of the copper gua sha group was 91.89%(34/37),the total effective rate of the ordinary gua sha group was 86.84%(33/38),and the total effective rate of the control group was 76.32%(29/38),although the total effective rate of the copper gua sha group and the ordinary gua sha group was better than that of the control group,but there was no statistical difference(P>0.05).Conclusion:(1)The Li’s Gua Sha method can improve the symptoms of spastic hemiplegia in patients with ischemic stroke(wind-phlegm obstruction type),improve the range of motion and quality of life of the affected limb.(2)The Li’s Gua Sha method can reduce the serum hs-CRP and TC levels in patients with ischemic stroke(wind-phlegm obstruction type),and there are no adverse reactions during the intervention,which is only manifested as the phenomenon of intolerance to pain in some patients. |
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