A Clinical Observation Of Treating Acute Ischemic Stroke With Primarily Penetrating Acupuncture

Stroke is one of critical illness that most of people outbreak. The feature of stroke are as these:high probability of out breaking; high probability of disability and high probability of recrudescence. The most common type of stroke is acute ischemic stroke. Generally, the acute phase is within two weeks. It is a significant clinical study that how to use Chinese traditional therapy to intervene the stroke at early phase, to seek a safe and effective treatment model, and improve the patients’quality of life.Purpose of studyTo explore the clinical effect of acute ischemic stroke treatment of three kind of methods:penetrating acupuncture method, XingNao KaiQiao acupuncture method and non-acupuncture method. To assess the penetrating acupuncture impact to neurological deficits and daily life ability, provide the scientific basis to clinical acupuncture treatment of acute ischemic stroke.Methodology of studyCase selection:The all157patients observed are all being hospitalized between December2011to March2013in the Department of Neurology, Nanfang Hospital. Patients are divided into three groups in accordance with the order of coming to hospital randomly,53cases in penetrating acupuncture method group,52cases in XingNao KaiQiao group and52cases in non-acupuncture group. General information are comparable (P>0.05) when three groups are being selected.The basic treatment:three groups are receiving conventional medical treatment, mainly to control blood pressure, regulate blood sugar, blood lipids, and symptomatic treatment, prevention of complications.Method of treatmentPenetrating acupuncture Method GroupAcupoints:Head penetrating acupuncture:Through Baihui to Qubin (bilateral), Through Qianshencong to Xuanni (brain lesion side). Body penetrating acupuncture: through Jianyu to Jiquan, through Quchi to Shaohai, through Hegu to Laogong, through Huantiao to Fengshi, through Yanglingquan to Yinlingquan, through Qiuxu to Shenmai, through Yefeng to Jiafeng, through Waiguan to Neiguan, through Yangchi to Daling, through Xiyangguan to Ququan, through Juegu to Sanyinjiao, through Taichong to Yongquan(Affected limb)XingNao KaiQiao Method GroupAcupoints:Neiguan(double), Shuigou, Sanyinjiao of affected limb, Chize, Jiquan and Weizhong. Select acupoints per conditions:Liver-yang hyperactivity to add Taichong and Taixi; Wind phlegm blocking add Fenglong and Hegu; Hot phlegm solid organs add Neiting and Fenglong; Qi weak and blood stasis add Xuehai and Qihai; Yin weak and wind moving add Taixi and Fengchi.Non-acupuncture group:No acupuncture treatment, only use drugs.Course of treatment:acupuncture treatment once a day,7days is one course. Totally perform continuous two treatment courses.The efficacy assessment:use clinical neurological deficit Rating Scale (NDS) and Functional Independence Measurement Scale (FIM) to evaluate all patients before and after treatment.Statistical analysis:SPSS19.0statistical software are used for data processing, measurement data using mean±standard deviation (); The independent sample t-test be used for2sample comparison; The variance analysis be used for multiple sample comparison; Paired Samples Test be used for self before-after comparison; Rank sum test be used for ordinal response data.ResultGeneral data.53cases in penetrating acupuncture method group:38male patients and15female patients, age from36-76, average(55.60±10.46) years old;52cases in XingNao KaiQiao group:37male patients and15female patients, age from21±75, average(57.29±11.73) years old;52cases in non-acupuncture group:37male patients and15female patients, age from21-73, average(57.62±12.25) years old. After comparison, there were no statistical differences in the sex, age between three groups(age comparison F=0.464, P>0.05; sex comparison X2=0.005, P>0.05). The data are comparable.The difference of neurological deficit (NDS) score among three groups before treatment is not statistically significant (F=1.310, P=0.273). After treatment:the neurological deficit scores of three groups are decreased differently (penetrating acupuncture method group t=15.365, P<0.01; XingNao KaiQiao group t=12.830, P<0.01; non-acupuncture group, t=9.339, P<0.01); The treatment efficacy of the penetrating acupuncture Method and XingNao KaiQiao Acupuncture Method group are significantly better than the control group, the decline is significantly greater than non-acupuncture group, have more effect statistically significant (F=8.799, P<0.05; difference comparison between penetrating acupuncture method group and non-acupuncture group, XingNao KaiQiao group and non-acupuncture group, both is P<0.05). But the difference between the penetrating acupuncture method group and XingNao KaiQiao groups is not statistically significant (P=0.312).The efficacy of neurological deficit treatment by three groups shows:0case recovered,28cases markedly effective,18cases effective,7cases ineffective in penetrating acupuncture method group;0case recovered,25cases markedly effective,19cases effective,8cases ineffective in XingNao KaiQiao group;0case recovered,11cases markedly effective,22cases effective,19cases ineffective in non-Acupuncture group. The differences among the three groups after treatment is statistically significant effect (X2=15.491, P<0.01). Pairwise comparisons between groups, the test level after calibration is taken as P’=0.05/3=0.0167. The result shows that the treatment efficacy of penetrating acupuncture method and brain-activating acupuncture method group are better than non-acupuncture group(The efficacy comparison between penetrating acupuncture method group and non-acupuncture group P’=0.001; The efficacy comparison between Brain-activating group and non-acupuncture group P’=0.008; The difference between penetrating acupuncture method group and brain-activating groups is not statistically significant efficacy P’=0.859)The difference among three groups of FIM score before treatment is not statistically significant (F=0.637, P=0.53). After treatment, the FIM scores of three groups are increased differently ((penetrating acupuncture Method group1t=-16.114,P <0.01; XingNao KaiQiao group t=-22.705,P<0.01; non-acupuncture group, t=-10.374,P<0.01). The treatment efficacy of the penetrating acupuncture method and XingNao KaiQiao acupuncture method group are significantly better than the non-acupuncture group, and the comparison of efficacy is statistically significant (F=49.112, P<0.01; the comparison of difference between through Aacupuncture method group and non-acupuncture group, as well as XingNao KaiQiao acupuncture group and non-group comparisons, both P<0.01). But the difference between the penetrating acupuncture method group and brain-activating group is not statistically significant (P=0.061).The comparison of FIM level changes. Before treatment:5cases mild dependency,30cases moderate dependency and18cases severe dependency in penetrating acupuncture method group;4cases mild dependency,29cases moderate dependency and19cases severe dependency inXingNao KaiQiao group;5cases mild dependency,29cases moderate dependency and18cases severe dependency in non-acupuncture group. That is to say there is no significant difference(X2=0.142, P>0.05) among the three groups on FIM level before treatment. After treatment:13cases conditional independence,31cases mild dependency,6cases moderate dependency and3cases severe dependency in penetrating acupuncture method group; 13cases conditional independence,30cases mild dependency,7cases moderate dependency and2cases severe dependency in XingNao KaiQiao group;2cases conditional independence,16cases mild dependency,28cases moderate dependency and6cases severe dependency in non-acupuncture group. The differences among the three groups after treatment is statistically significant effect (X2=33.287, P<0.01). The treatment efficacy of penetrating acupuncture Method and XingNao KaiQiao acupuncture method group are better than non-acupuncture group. Pairwise comparisons between groups, the efficacy comparison between penetrating acupuncture method group and non-acupuncture group is statistically significant(P<0.01). The efficacy comparison between XingNao KaiQiao group and non-acupuncture group is statistically significant(P<0.01). But the difference between the penetrating acupuncture method group and brain-activating group is not statistically significant (P>0.05)ConclusionThe penetrating acupuncture method has a good clinical effect in early intervention for acute ischemic stroke, for it can significantly reduce the neurological deficit score of acute ischemic stroke patients, and improve index of FIM functional independence scale.The penetrating acupuncture method can pick two acupoints with one acupuncture. Acupoints seletion are simple and sense of acupuncture is strong. Compared to XingNao KaiQiao group, it relives the harm to acupoints and decrease the patients’ pain during treatment, and then it is able to let patients keep being treated by the penetrating acupuncture method.The cases collected in this study is limited. It is only limited to the observation of efficacy of ischemic stroke at early phase. The conclusions is only explanation for this clinical observation data. The efficacy of ischemic stroke recovery stage and aftermath stage have not been studied yet.