Clinical Efficacy Of Scalp Acupuncture Combined With Jin's Shoulder Three-needle Method In The Treatment Of Post-stroke Shoulder-hand Syndrome Stage 1 And Its BOLD-fMRI Mechanis

Purpose:1.Evaluate the effect of scalp acupuncture combined with Jin’s shoulder three on the clinical efficacy of stage 1 patients with shoulder hand syndrome after stroke by upper limb motor function score(FMA),VAS pain index score,modified Barthel Index(MBI)and limb swelling index;2.Blood oxygen level dependent functional magnetic resonance imaging(BOLD fMRI)was used to observe the effect of scalp acupuncture combined with Jin’s shoulder three on the central effect of patients with stage 1 shoulder hand syndrome after stroke.Material and method:In this paper,a prospective,randomized controlled study was conducted.The patients were divided into 40 cases in the observation group and 40 cases in the control group.According to the Chinese guidelines for the prevention and treatment of cerebrovascular diseases,the selected patients were given anti platelet aggregation to prevent new plaque or thrombosis,lipid-lowering and plaque stabilization to prevent further enlargement of intravascular plaque;For the basic diseases of patients,follow the treatment principles of relevant diseases,including controlling blood glucose,blood pressure and ventricular rate,and give routine rehabilitation treatment.The control group was treated with Jin’s shoulder three needles,and the observation group was treated with scalp acupuncture combined with Jin’s shoulder three needles.The enrolled patients were treated for 3 weeks,5days a week,once a day,30 minutes each time.The therapeutic effects of the two groups were evaluated.The changes of upper limb motor function score(FMA),VAS pain index score,modified Barthel Index(MBI)and limb swelling degree were observed before and after three cycles of treatment.At the same time,three patients in the two groups were randomly selected for BOLD-fMRI examination.Results:1.Compared with before treatment,the scores of upper limb motor function assessment were significantly improved in both groups after 3 weeks of treatment(P < 0.05);At the same time,through the comparison between the two groups,it was found that the observation group was significantly better than the control group(P < 0.05).2.Compared with before treatment,the pain index scores of the two groups decreased significantly after 3 weeks of treatment,indicating that the pain symptoms of the two groups were significantly improved(P < 0.05);At the same time,through the comparison between the two groups,the pain index score of the observation group was significantly better than that of the control group(P < 0.05).3.Compared with before treatment,the scores of activities of daily living of the two groups were significantly improved after 3 weeks of treatment(P < 0.05);At the same time,by comparing the scores of activities of daily living between the two groups,it was found that the improvement in the observation group was more obvious(P < 0.05).4.Compared with before treatment,the degree of limb swelling in the two groups was significantly reduced after 3 weeks of treatment(P < 0.05);At the same time,by comparing the degree of limb swelling between the two groups,it was found that the degree of limb swelling in the observation group was particularly obvious(P < 0.05).5.BOLD fMRI scanning analysis showed that Jin’s shoulder three needle therapy had different degrees of activation on both cerebellum and brain regions such as frontal lobe,central posterior gyrus,temporal lobe,occipital lobe and basal ganglia.When scalp acupuncture was added,the occipital lobe and central posterior gyrus on the side of the lesion were further enhanced and extended to the pressure part of the corpus callosum on the side of the lesion.After 3 weeks of treatment,the total effective rate of scalp acupuncture combined with Jin’s shoulder three needle therapy was 95.00%,including 8 effective patients and 30 effective patients,while the total effective rate of patients treated with Jin’s shoulder three needle therapy alone was 82.50%,including 4 effective patients and 29 effective patients(P < 0.05);In terms of early pain improvement,the early pain improvement rate of patients treated with combination therapy was 95.0%,and the early pain improvement rate of patients treated with Jin’s shoulder three needle therapy was 87.5%;In terms of the improvement of upper limb function,after 3 weeks of treatment,the improvement rate of upper limb function in patients with combined treatment was 90.0%,and the improvement rate of upper limb function in patients treated with Jin’s shoulder three needle alone was 65.0%(P < 0.05).Conclusion:The effect of scalp acupuncture combined with Jin’s shoulder three needles in the treatment of upper limb pain symptoms in patients with stage 1 shoulder hand syndrome after stroke is significantly better than that in the simple Jin’s shoulder three needles treatment group,and can effectively improve the shoulder function of patients at the same time;The results of BOLD fMRI scanning and analysis suggest that Jin’s shoulder three needle therapy is mainly based on the local action mechanism.After adding scalp acupuncture,some brain functional areas are significantly enhanced.Its mechanism may be related to promoting the activation of neurons in the occipital lobe,central posterior gyrus,pressure part of corpus callosum and other areas of the lesion,and in the links of upper limb signal reception,processing,processing and feedback.