| Ischemic stroke is the main type of stroke, its high incidence, high mortality, and thigh morbidity, making it to be a disease which has done great harm in the world-wide and difficult to be overcome. Thereby, the study and treatment of ischemic stroke is an important issue of basic medicine and clinical medicine. The prevention of ischemic stroke by Chinese medicine has certain advantages and acupoint application through specific drugs stimulating specific acupoint, it plays a dual therapeutic effect. However, there never been having a systematic clinical and experimental researchs about it. This study aimed at an objective assessment of acupoint application therapy for ischemic stroke hemiplegia, clinical efficacy, and experimental methods and mechanisms.ObjectiveThe subject used the clinical epidemiology, clinical research methodology and statistical analysis of mathematical methods, and randomized controlled study. The electric acupuncture is control group, and rehabilitation is a basis of treatment. Through the observation of the clinical effect of electroacupuncture combined with acupoints application on treating hemiplegia due to ischemic stroke, to investigate the differences among electroacupuncture combined with acupoints application, electric acupuncture, and their curative mechanisms, so as to provide a clinical basis for treating hemiplegia due to ischemic stroke.MethodsThe patients were selected from clinic and hospital during October2009to January2012.72patients who suffered cerebral infarction after two weeks to six months left over from hemiplegia were collected, the ration of l:lwere randomly allocated to the electroacupuncture combined with acupoints application, electric acupuncture groups, which included36patients in electroacupuncture combined with acupoints application group,36patients in electric acupuncture group. Western diagnostic criteria issued referred to the ischemic cerebravascular disease diagnostic criteria in Neurology Volume of the clincal practice guideline which agreed by Chinese Medical Associationin2009. TCM diagnostic criteria referred to the stroke diagnosis and evaluation standard which agreed by the State Administration of Traditional Chinese Medicine encephalopathy acute collaborative research group. All patients met the inclusion criteria according to design requirements observation and treatment. Treatment for a course of28days, electroacupunture:3times a week,4weeks a course; acupoint application: once a day,4weeks a course; rehabilition:5times a week, continue the treatmen after2d rest,4weeks a course. Efficacy of specific items include: the main symptoms of stroke disease classification quantization table established by the guiding principles of Traditional Chinese Drug treatment of stroke clinical research, neurological deficit score, the score of the Fugl-Meyer motor function, activities of daily living(BI index) and functional comprehensive assessment (FCA). Efficacy evaluation standars referred to TCM syndrome efficacy criteria in the guiding principles of Traditional Chinese Drug treatment of stroke clinical research and the clinical neurologic impairment score in the4th National Cerebravascular Disease Conference (1995).Data analysis used SPSS17.0software for statistical analysis. Measurement data used in forming the mean±standard deviation (χ±S), and the count data used in forming ration (%); Measurement data groups were compared using t test, before and after their use paired t test or Wilcoxon paired rank sum test. Segment information is used to compare groups χ~2test, ranked data was used to compare between the two groups Kruskal-Wallis H rank sum test.Results1. Chinese medicine symptoms of the scoreThe Chinese medicine symptoms of the score of electroacupuncture combined with acupoint application group was statistically significant compared to treatment before(P<0.05), especially in improving hemiplegia, limbs numbness, aphasia, dizziness and headache. Ecept for irritability, the chinese medicine symptoms of the score of electroacupuncture group was statistically significant compared to treatment before (P<0.05)2. TCM symptoms total scoreAfter14days treatment, the TCM symptoms total score of electroacupuncture combined with acupoint appl ication group was significantly reduced compared with before treatment (P<0.05). EA group compared with before treatment was also statistically significant (P<0.05). But the TCM symptoms total score of the rehabilitation group didn't reduce so much (P>0.05).After14days treatment, the TCM symptoms total score of electroacupuncture combined with acupoint application group was obviously reduced compared with before treatment (P<0.01). It suggested that after14days treatment, the electroacupuncture combined with acupoint application can lower the TCM symptoms total score of hemiplagia patients due to ischemic stroke. After28days treatment, the therapeutic effect of electroacupuncture combined with acupoint application got better. Eletric acupuncture treatment can ameliorate hemiplagia patients'TCM symptoms after14days treatment, but after28days treatment there was not prominent changes.3. Neurological deficit scoreFor decreasing the neurological deficit score of hemiplagia patient by ischemic stroke, the neurological deficit degree was improved in electroacupuncture combined with acupoint application group after14days treatment, and it was more statistically significant after28days treatment. The neurological deficit score of electroacupuncture group and rehabilitation group was not statistically significant after14days treatment, but it was significant reduced after28days treatment.After14days treatment, the differences among three groups were not tatistically significant (P>0.05). However, the differences among three groups were tatistically significant (P<0.05). It illustrated that after28days treatment, two groups all had the therapeutic effect on reduce the neurological deficit score of hemiplagia patient by ischemic stroke, and the effect of electroacupuncture combined with acupoint application was the best.4. The score of the Fugl-Meyer motor functionFor increasing the score of the Fugl-Meyer motor function of hemiplagia patient by ischemic stroke, electroacupuncture combined with acupoint application group got the obvious therapeutic effect after14days treatment, and it was more statistically significant after28days treatment. The electric acupuncture can ameliorate limbs motor function after14days treatment. However, for the observation of long-term efficacy, the degree of limb motor function improvement is not obvious.After14days treatment, the score difference of the Fugl-Meyer motor function among two groups was not statistically significant (P>0.05). After28days treatment, compared to electric acupuncture group, the score of the electroacupuncture combined with acupoint application group was statistically significant (P<0.05). It suggested that for the observation of long-term efficacy, compared to electric acupuncture group, the electroacupuncture combined with acupoint application can get the better effect than simple electroacupuncture treatment for improving limbs motor function.5. Activities of daily living (BI index)For improving the activities of daily living of hemiplegia patients due to ischemic stroke, the electroacupuncture combined with acupoint application group was statistically significant after28days treatment. After14days treatment, electroacupuncture treatment can increase BI index of hemiplegia patients due to ischemic stroke (P<0.05), and was obviously significant after28days treatment.After14days treatment, activities score of daily living (BI index) among electroacupuncture combined with acupoint application, electroacupuncture was not statistically significant (P>0.05). After28days treatment, compared to electroacupuncture group, electroacupuncture combined with acupoint application group can improve activities score of daily living better (P<0.05). It suggested that after28days treatment, electroacupuncture combined with acupoint application group can improve activities score of daily living better.6. Functional comprehensive assessment (FCA)For improving functional comprehensive assessment (FCA), electroacupuncture combined with acupoint application got certain therapeutic effect after14days treatment, electroacupuncture was not statistically significant(P>0.05). After28days treatment, electroacupuncture can improve functional comprehensive assessment (FCA) better(P<0.05).It suggested that electroacupuncture combined with acupoint application group electroacupuncture combined with acupoint application group can can improve functional comprehensive assessment (FCA) better than electroacupuncture.7. TCM syndromeTwo groups by Kruskal-Wallis H rank sum test,H=14.31, P=0.026, was statistically significant (P<0.05), in which the number of the electroacupuncture combined with acupoint application group cured2people,8.3%, recovered9people,37.5%,50.0%(12people) improvement in the number, invalid number of4.2%(1people). The total effective rate was95.8%. The number of the EA group cured1people,4.2%, recovered12.5%(3people),45.8%(11people) improvement in the number, invalid number of37.5%(9people). The total effective rate was62.5%. It demonstrated that compared to the electric acupuncture, the electroacupuncture combined with acupoint application was better therapy for improving the TCM syndrome of hemiplagia due to ischemic stroke.8. Two groups by Radit analysis, Z=3.45, was statistically significant (P <0.05), in which the number of The ectroacuputure combined with acupoint application group cured3people,8.33%, recovered15people,44.4%(16people) improvement in the number, invalid number of8.3%(2people). The total effective rate was94.4%. The number of the EA group cured1people,0.0%, recovered19.44%(7people),61.11%(23people) improvement in the number, invalid number of19.44%(7people). The total effective rate was80.55%. It demonstrated that compared to the electricacupuncture treatment, the electroacupuncture combined with acupoint application was better therapy for improving the nerve function of clinical efficacy of hemiplagia due to ischemic stroke.ConclusionStroke is a common disease, frequently-occurring disease, is today one of the highest of the three diseases in human mortality, but also the fastest three disease incidence, recovery of the slowest, deathmost disabling the heaviest disease. Many patients often can not insist as a result of treatment failure. Therefore looking for an effective and sustained for a long time, the role of patient compliance and good therapy, has an important significance.This study is based on acupuncture and traditional Chinese medicines on the basis of previous studies, the combination of ischemic stroke patients with hemiplegia, integration and optimization of acupuncture, Chinese and Western previous researche results, through rigorous epidemiology/evidence-based medicine methodsdesign, using the principles of the randomized controlled study of ischemic stroke hemiplegia system and in-depth study, to explore the relationship of point selection, methods of operation, treatmen efficacy more accurately reflect the effectiveness of the law.Electroacupuncture combined with acupoint application the organic combination of the two treatmens, after the accumulation of a certain amount of time to treatment, better able to promote the improvement of neurologic impairment, improve the quality of life in patients with EA alone or rehabilitation statistically significant, indicated that electroacupuncture combined with acupoint application in the treatment of ischemic stroke hemiplegia can promote each other and complement each other. Electroacupuncture combined with acupoint application without medication, less pain, a significant effect in patients with easy to accept, is an effective, efficient, economic, lasting effect, non-toxicside effects of treatment. |
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