| Aim:To evaluate the clinical therapeutic effect of acupuncture therapy using purging Yin andtonifying Yang method for the treatment of apoplexy spastic paralysis, and explore thepossible acting mechanism.Literature analyze:Summarize about the mechanism and the progress of west-traditional Chinese medicineabout stroke and apoplexy spastic paralysis.Method:1. Subjects:From December 2005 to February 2007, a total of 60 patients received acupuncturetherapy in Acupuncture and Moxibustion department in Beijing TCM Hospital were enrolledin this research, these patients were randomized into treatment group (acupunctured usingpurging Yin and tonifying Yang method) and controlled group (acupunctured using hand-foot12 needling method), 30 cases in each group.2. Therapeutic methods:2.1 Controlled group: Point selection and needling techniques: Upper limbs: Qu-chi (LI11),Nei-guan (PC6),H e-gu (LI4), lower limbs: Yin-ling-quan (SP9), Zu-san-li (ST36),San-yin-jiao (SP6). Using equal tonifying and purging method. The needles remain for 30minutes.2.2 Treatment group: Point selection and needling techniques: The lesion part: Ji-quan (HT1),Qu-ze (PC3), Da-ling (PC7), Nei-guan (PC6) at Yin lateral of upper limbs; Xue-hai(SP10),Yin-ling-quan (SP9), San-yin-jiao (SP6), Tai-xi (KI3) at Yin lateral of lower limbs; Jian-yu(LI15), Nao-hui (SJ13), Shou-san-li (LI10), Wai-guan (SJ5), He-gu (LI4) and Hou-xi (SI3) atYang lateral of upper limbs; Huan-tiao (GB30), Feng-shi (GB20), Xi-yang-guan (GB33),Yang-ling-quan(GB34), Cheng-shan (BL57) and Qiu-xu (GB40) at Yang lateral of lowerlimbs; using purging techniques of lifting-thrusting-swirling-rotating methods for points atYin lateral; Using tonifying techniques of lifting-thrusting-swirling-rotating methods forpoints at Yang lateral and the needles remain for 30 minutes.Duration: 28 days for both groups. 3.Observing index:3.1 Spastic degree measurement: Using the modified Ashworth scale instrument.3.2 Extremity kinesis function measurement: Using the Fugl-Meyer instrument to measurethe motoring function of upper and lower limbs.3.3 ADL evaluation: Applying the Barthel index grading scale.All the measuring work was performed by the same physician. These indexes weremeasured at first day before the treatment beginning, and then at the fourteenth andtwenty-eighth days measured again individually after treatment, to compare the therapeuticeffect and analyze the data using statistical software.4. Therapeutic effect evaluationTo date, the recognized effect evaluating criteria is absent, by referring the relatedreferences, we selected the elbow, waist, knee and angle joints for researching. Significantresponder: the total score of Ashworth scale of all joints muscle tension decreased more than4 grades; responder: the total score decreased more than 2 grades; improvement: the totalscore decreased more than 1 grade; no responder: the muscle tension having no change;deterioration: the muscle tension increased. Extremity kinesis function and ADL werecompared between groups and in different periods.ResultAfter 14-day and 28-day treatment, Ashworth score of both groups decreased(P＜0.01),the score of Fugl-Meyer scale and Barthel index scale increased (P＜0.01), all demonstratedstatistical significance.Compared with controlled group, Ashworth score of treatment group decreasedsignificantly(P＜0.05), score of Fugl-Meyer scale and Barthel index scale increased obviouslyafter 28-day treatment(P＜0.05), all demonstrated statistical significance.Discussion1,Compare with controlled therapy, the acupuncture therapy using purging Yin andtonifying Yang method can decrease patient's muscle tension, improve the extremity kinesisfunction and promote the ADL.2,The acupuncture therapy using purging Yin and tonifying Yang method can decrease patient's muscle tension, improve the extremity kinesis function and promote the ADL, and itis better than the acupuncture therapy using hand-foot 12 needling method for apoplexyspastic paralysis patient in decreasing the muscle tension. |
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