The Clinical Research On The Treatment Of Hemiplegia After Ischemic Stroke By Early Intervention With Tuina And Rehabilitation Training

ObjectiveThrough the observation of the clinical curative effect of the treatment of Tuina combined with rehabilitation training in early stage of hemiplegia after ischemic stroke,compare the differences in efficacy,and explore the timing of interventions in the treatment of ischemic stroke,so as to provide more effective reference for clinical selection.MethodSixty-six inpatients with ischemic stroke were selected and randomly divided into the trial group(34 cases)and the control group(32 cases).Both groups were studied on the basic treatment of traditional Chinese and western medicine combined with stroke unit mode,they were combined with massage and modern rehabilitation training after the disease was stable.The trial group started treatment within 14 days after onset,while the control group began treatment within 14 days to 30 days.Before and after treatment,the overall efficacy of the patients was evaluated by the scores of TCM symptom scores in the “ Diagnostic and therapeutic criteria for stroke”.The degree of severity of the patients was assessed using the neurological function deficit scale(NFDS)for Stroke patients drawn up in the Fourth National Conference on Cerebrovascular Disease in 1995.The simple Fugl-Meyer assessment(FMA)was used to assess motor function of the affected limbs.The modified Barthel index(MBI)was used to assess the patient’s activities of daily living(ADL).And by comparing the difference between the two groups before and after treatment,we evaluated the clinical efficacy of different timing intervention combined with Tuina and rehabilitation training in the treatment of hemiplegia after ischemic stroke.Result1.The overall curative effect comparison: The total effective rate in the trial group was 85.29%,and the total effective rate in the control group was 68.75%,and the difference was statistically significant(P<0.05).2.Comparison of TCM symptom scores before and after treatment: Before treatment,the scores of TCM symptoms in the two groups were comparable(P>0.05).After treatment,the scores of TCM symptoms in both groups improved compared with before treatment,and the difference was statistically significant(P<0.05),and the trial group was superior to the control group(P<0.05).3.Comparison of clinical neurological deficit scores before and after treatment: Before treatment,the scores of clinical neurological deficit in the two groups were comparable(P>0.05).After treatment,the scores of clinical neurological deficit in both groups improved compared with before treatment,and the difference was statistically significant(P<0.05),and the trial group was superior to the control group(P<0.05).4.Comparison of level of Fugl-Meyer motor function before and after treatment: Before treatment,the Fugl-Meyer scores of the upper limb,the Fugl-Meyer scores of the lower limb and the total Fugl-Meyer scores in both groups were comparable(P>0.05).After treatment,the Fugl-Meyer scores of the upper limb,the Fugl-Meyer scores of the lower limb and the total Fugl-Meyer scores in both groups improved compared with before treatment,and the difference was statistically significant(P<0.05),and the trial group was superior to the control group(P<0.05).5.Comparison of ADL scores before and after treatment: Before treatment,the scores of ADL in the two groups were comparable(P>0.05).After treatment,the scores of ADL in both groups improved compared with before treatment,and the difference was statistically significant(P<0.05),and the trial group was superior to the control group(P<0.05).Conclusion1.Tuina combined with rehabilitation training can effectively improve the neurological deficit in patients with hemiplegia after ischemic stroke,promote the recovery of limb motor function,and significantly increase their daily living activities.2.After the stable vital signs of patients with hemiplegia after ischemic stroke,no matter in the improvement of the overall efficacy or local function,Tuina combined with rehabilitation training is intervened within 14 days of onset,which is better than 14 days to 30 days intervention.