Clinical Study On Surface Eletromyography And Syndrome Elements Of Traditional Chinese Medicine In Patients With Cervical Dystonia

Objective To analyze the common TCM syndrome types,disease location,TCM syndrome elements of Cervical Dystonia(CD)patients and the correlation with sex,age,Toronto western spasmodic torticollis rating scale(TWSTRS).Surface electromyography(sEMG)was used to collect the surface EMG data of neck muscles of patients with CD,and quantitatively evaluate the sEMG of patients with CD.At the same time,the correlation between sEMG related parameters of CD patients and TWSTRS was analyzed,and the data before and after botulinum injection treatment were analyzed and compared,so as to provide objective basis for the diagnosis and treatment of cervical abnormal muscles in patients with CD.Methods1.From October 2018 to January 2021,patients with CD were selected from outpatients or inpatients in the affiliated Hospital of Institute of Neurology of Anhui University of traditional Chinese Medicine as experimental group(CD group).All subjects met the clinical diagnostic criteria of CD,and healthy people of the same age were selected as control group(NC group).2.Statistical analysis of the common TCM syndrome types,disease location and disease syndrome elements of CD patients,and the correlation between disease location,disease syndrome elements and sex,age,TWSTRS.3.Use surface electromyography to analyze the surface electromyography of CD patients and NC groups,and calculate the relevant parameter values ??through the system,including the frequency domain index average power frequency value(MPF)and median frequency value(MF),Time domain index root mean square value(RMS)and integral myoelectric value(IEMG),use the TWSTRS scale to assess the severity of the patient’s condition.4.The differences of sEMG indexes IEMG,RMS,MPF and MF between CD group and NC group were analyzed,and the correlation with the total score of TWSTRS scale was also analyzed.The diagnostic efficacy of CD patients was evaluated by ROC curve analysis,and the efficacy of botulinum toxin A(BTX-A)injection was evaluated by sEMG index.5.To analyze the differences of surface EMG values of CD patients with different TCM syndrome types.Results1.The common syndrome types of CD patients are Gan Yu Qi Zhi、Gan Sheng Yin Xu.the syndrome elements of the disease are liver,spleen and kidney,and the syndrome elements of the disease are Qi Zhi,Ying Xu and Tan Shi.There was no correlation between disease location,syndrome factors of etiology and disease and total score of TWSTRS,TWSTRS-Ⅱ score,TWSTRS-Ⅲ score and age in CD patients,but there was correlation between disease location,syndrome factors of etiology and disease and TWSTRS-Ⅰ score(r = 0.820,r = 0.785,P < 0.05),and correlation between sex and sex(P > 0.05).2.Compared with the NC group,the IEMG values ??of SCM,SPC and UT in CD patients were significantly higher(Z =-2.139,-2.002,-2.760,P<0.05),and there was no significant difference in the IEMG values ??of LS(Z=-0.725,P>0.05);The RMS value was significantly higher than that of the NC group(Z=-2.243,-3.105,-3.105,P<0.05),and there was no significant difference in the RMS value of LS(Z=-0.449,P>0.05);The MPF value was significantly lower than that of the NC group(Z=-2.898,-2.105,-2.277,P<0.05),and there was no significant difference in the MPF value of LS(Z=-1.725,P>0.05);the MF value was similar to that of the NC group The ratio was significantly higher(Z=-3.105,-2.553,-2.967,-2.277,P<0.05).3.The IEMG values ??of SCM,SPC and UT in patients with rotating CD were significantly reduced compared with those before treatment(Z=-2.090,-2.090,-2.090,P < 0.05),and there was no significant difference in IEMG values ??of LS(Z=-0.153),P>0.05);the RMS value was significantly lower than before treatment(Z=-2.090,-1.98,-2.23,-2.23,P < 0.05);MPF was significantly higher than before treatment(Z=-2.803,-2.191,-2.293,-2.497,P<0.05);MF was significantly higher than before treatment(Z=-2.191,-2.191,-2.497,-2.23,P<0.05).4.Evaluation of the IEMG values ??of SCM,SPC and UT in CD patients.The AUC of CD patients are 0.715,0.701,and 0.778,respectively.The IEMG value of the three groups of muscle groups is used to evaluate the AUC of CD patients.The AUC of CD patients is 0.806;the AUC of CD patients evaluated by the RMS value are respectively0.726,0.812,0.813,the RMS value of the three groups of muscle groups evaluated the AUC of CD patients as 0.851;the MPF value evaluated the AUC of CD patients were0.792,0.712,0.729,and the MPF value of the three groups of muscle groups evaluated the AUC of CD patients The AUC of CD patients assessed by MF was 0.813,0.757,0.799,respectively.The AUC of CD patients assessed by MF of the three groups of muscle groups was 0.837,which was higher than that of its single use(P<0.05).5.There is a positive correlation between the IEMG and RMS values ??of patients with CD and the total score of the TWSTRS scale,while the MPF,MF and the total score of the TWSTRS scale have a negative correlation.6.There were significant differences in SCM-RMS among different TCM syndrome types(Z=-2.064,P =0.042),there was no significant difference in IEMG,MPF and MF(P>0.05).Conclusions1.The common syndrome elements of CD patients are liver,spleen and kidney,and the syndrome elements of disease are Qi Zhi,Ying Xu and Tan Shi.Among them,Among them,the location of the disease and the syndrome factors of etiology and disease were correlated with sex and TWSTRS-Ⅰ score.2.CD patients have objective EMG abnormal signals,sEMG indicators can be used for the objective evaluation of SCM,SPC,UT,LS muscles.3.sEMG can be used to evaluate the efficacy of botulinum injection,which can accurately reflect the recovery of related muscles.4.sEMG parameters can be used to evaluate the diagnostic efficiency of patients with CD,and the combined use can improve the diagnostic efficiency.5.There is a certain correlation between the sEMG parameter index and the total score of the TWSTRS scale.6.There was no significant difference in sEMG among CD patients with different TCM syndrome types.