| ObjectiveBy combing and summarizing the literature on acupuncture treatment of hemiplegia after acute ischemic stroke in the past 10 years,the rules of acupoint selection,meridian selection and prescription of upper limb were analyzed.On this basis,clinical trials were conducted by using the acupuncture prescription rules obtained,and the clinical efficacy of acupuncture stimulating the propagated sensation along channel in the treatment of upper limb motor dysfunction after acute ischemic stroke was observed in a randomized controlled method,so as to provide experimental basis for clinical treatment of this disease.Methods1 Literature researchThrough computer and manual search,collect and screen in Chinese Journal Full-text Database,Wanfang Database,and VIP Chinese Science and Technology Journal Database for acupuncture treatment from January 2010 to December 2019.After ischemic stroke hemiplegia of clinical research literature,establish acupuncture upper limb acupoint prescription database,using frequency statistics,and SPSS Modeler 18.0 software Apriori algorithm modeling for association rule analysis,and obtaining the upper limb acupoint prescription with the highest correlation.2 Clinical TrialsA total of 66 patients who met the inclusion criteria from the Department of Encephalopathy and Acupuncture in the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from May 2020 to December 2020 were randomly divided into the treatment group and the control group in a 1:1 ratio,with 33 patients in each group.Based on the same basic treatment,the patients who were in different groups received different acupuncture manipulation treatment.Using the upper extremity acupuncture point prescription Jianyu,Quchi,Shousanli,Waiguan,Hegu obtained from literature research,the treatment group advanced needle Jianyu,,and acupuncture was performed through small tremor,lifting,twisting,and shooting.When the meridian air is conducted to the elbow,the needle will be inserted into the curved pool,and so on,the needle will be passed through the meridian relay to stimulate the sense of passing through the meridian to the fingertips.The control group used the above-mentioned acupoint prescription,and they were treated with routine acupuncture without manipulation.The lower extremities of both groups were routinely acupuncture.Acupuncture lasted for 30 minutes each time,once a day,6 days a week,for 2consecutive weeks,a total of 12 times.Before the first treatment,1 week of treatment,and 2weeks of treatment,the Fugl-Meyer Assessment Upper Extremity Scale,Wolf motor function test,and Medical Research Council of patients in the treatment group and the control group were recorded.The modified Barthel index was recorded before treatment and during the follow-up 4 weeks after the end of treatment.Using SPSS23.0 software for statistical analysis,to assess the therapeutic effect between the two groups.Results1 Literature research(1)Finally,191 articles that met the requirements were included in this study,and a total of 49 acupoints were involved.The highest frequency of use is Hegu,Quchi,Jianyu,Shou Sanli,Waiguan,Neiguan and so on.(2)A total of 7 meridians were involved,Large Intestine Meridian of Hand-Yangming was the most frequently used,accounting for 57.3% of the total frequency.The other higher frequency were Triple Energizer Meridian of Hand-Shaoyang,Pericardium Meridian of hand-Jueyin,and Heart Meridian of Hand-Shaoyin,etc.(3)The prescriptions for acupuncture points with the strongest clinical relevance for hemiplegia after acute ischemic stroke are Jianyu,Quchi,Shousanli,Waiguan,and Hegu.2 Clinical Trials(1)A total of 66 patients who met the criteria were included in this study,33 patients in each group.During the trial treatment period,a total of 5 patients were dropped from the two groups,so 61 patients were included in the final statistics.Baseline data showed that there were no statistical differences in age,gender,disease course,FMA-UE rating scale,WMFT rating scale,MRC muscle strength grade and MBI index rating scale between the two groups at the time of enrollment(P>0.05),indicating comparability between the two groups at the time of enrollment.(2)Clinical curative effect: After statistical analysis,the total effective rate of clinical treatment in the treatment group was 93.55%,and that in the control group was 83.33%.The overall therapeutic effect of the treatment group than the control group(P<0.05).(3)Comparison of the group: the control group and the treatment group compared to pre-treatment,after 1 week of treatment,after 2 weeks of treatment,FMA-UE scale,the WMFT scale,the MRC Scale scores were improved(P<0.05),and shows a gradual upward trend.Treatment group and the control group compared to pre-treatment,after 4 weeks of follow-up MBI scale scores were significantly increased,there was a significant difference(P<0.001).Tip both of two treatment methods can be effective in improving acute ischemic stroke patients with upper limb motor function,and can effectively improve the patient’s activities of daily living.(4)Comparison between groups: the treatment group compared with the control group,FMA-UE scale,the WMFT scale,the MRC Scale after 1 week of treatment,no significant changes in scores difference(P>0.05);after 2 weeks of treatment a significant overall score Higher than the control group(P<0.05).There was a significant difference in the difference between the MBI scale scores of the two groups and the changes before the treatment at the follow-up 4 weeks after the end of the treatment,and the increase was more obvious in the treatment group(P<0.001).Tip upper limb motor function and activities of daily living improving acute ischemic stroke patients,the treatment group is more superior than the control group.Conclusion1 Clinical acupuncture treatment of hemiplegia after acute ischemic stroke frequently used upper limb acupoints such as Hegu,Quchi,Jianyu,Shousanli,etc.The meridian emphasizes the choice of Large Intestine Meridian of Hand-Yangming.And the prescriptions for upper limb acupoints with the highest clinical relevance are "Jianyu,Quchi,Shousanli,Waiguan,Hegu".2 The use of acupuncture to stimulate the propagated sensation along channel can effectively improve the upper limb motor function of patients with acute ischemic stroke.To a certain extent,it can also improve the patient’s ability of daily living,and the curative effect is better than conventional acupuncture. |
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