| ObjectiveTo observe the clinical efficacy of Taichi Tuina in the treatment of muscular atrophy in patients with Motor neuron disease（MND）.To explore the theory and mechanism of taiji tuina in the treatment of muscular atrophy in patients with motor neuron disease in order to explore the effective treatment plan in traditional chinese medicine,provide the basis for the clinical treatment of motor neuron disease with taiji tuina,and guide the clinical treatment.MethodsA total of 96 patients diagnosed with MND were included in the trial.The cases were mainly from the patients who were hospitalized in Department of Tuina/Rehabilitation Medicine,Wudong Hospital District,Hubei Provincial Hospital of Traditional Chinese Medicine from March 2021 to December 2021 and who discontinued treatment due to various reasons（epidemic or other force majeure）.The diagnosis of MND met the diagnostic criteria in the flaccidity section（2008）of the Guidelines for Diagnosis and Treatment of Common Diseases in Internal Medicine of Traditional Chinese Medicine（TCM Syndrome Section）and the Guidelines for Diagnosis and Treatment of Amyotrophic Lateral Sclerosis in China（2012）.Eligible patients were selected according to the TCM diagnostic criteria,western diagnostic criteria,inclusion criteria,and exclusion criteria.The control trial was adopted in the trial.The patients who could complete the trial were set as the treatment group,and the patients who discontinued the treatment for some reason were set as the blank control group.Taichi Tuina was performed in the treatment group,while no special treatment was given to the blank control group.The changes in limb circumference and muscle content,the modified amyotrophic lateral sclerosis function scale（ALSFRS-R）score and the ALS patient self-evaluation questionnaire（ALSAQ-40）score of the patient were used as the evaluation criteria for the effect of Tai Chi Tuina treatment.Due to the limited conditions,no muscle content index was set in the blank control group.The treatment group was treated with Tai Chi Tuina once a day,1.5 hours per time,with six consecutive treatments and one day’s rest.Thirty treatments（on the 35 th day）constituted one course of treatment,and two courses of treatment were required in total（on the 70 th day）.No treatment was given to the blank control group.Comprehensive evaluation was performed before the test（T0）,on the 35 th day of the test（T1）,and on the70 th day of the test（T2）,and the relevant scores and indicators were compared before and after.SPSS26.0 software was used for statistical analysis of the obtained data to evaluate whether the score difference was statistically significant before and after treatment.In the treatment group,pulmonary function,routine blood test,coagulation function,liver and kidney function,myocardial infarction and biochemical test were checked at T0,T1 and T2,respectively,as safety indicators.The blank group was not tested for safety indicators.Results1.Basic information analysis: A total of 96 subjects were recruited in this experiment,and after the experiment,2 subjects dropped out,with a drop-out rate of 2.1%.Finally,the total sample size was 94 cases,66 cases in the treatment group and 28 cases in the blank control group.According to statistics,in terms of gender distribution,the number of male patients with MND is obviously more than that of female patients.In terms of age distribution,the majority of patients aged 40 and above,accounting for 89.36% of the total number,and the least patients aged 20-30,accounting for4.26%;In terms of course distribution,most patients with this disease have a course of more than 24 months,accounting for 59.58%of the total number,and the least patients have a course of less than 12 months,accounting for 14.89%.In terms of the distribution of the onset site,MND patients have the most onset of upper limbs,accounting for 59.57% of the total number,and the least onset of medulla oblongata is 7.45%.The above information is comparable by statistical comparison（P > 0.05）.2.Comparison of limb girth in different stages: Compared with T0,the girth of limbs in the treatment group increased,and it was statistically significant（P < 0.05）.There was no significant change in the circumference of limbs in the blank group,and the difference was statistically significant（P<0.05）.Compared with T0,the circumference of limbs in the treatment group increased significantly（P < 0.05）.The circumference of limbs in the blank group was lower than that at T0,and the difference was statistically significant（P<0.05）.Compared with T1,the circumference of limbs in the treatment group had no significant change,and the difference was not statistically significant（P >0.05）.In the blank group,the circumference of limbs was lower than that at T1,and the difference was statistically significant（P<0.05）.It shows that Taichi Tuina can increase the circumference of limbs of MND patients and improve the degree of muscle atrophy to some extent when the treatment reaches 30 times.3.Comparison of muscle content before and after treatment: in the treatment group,compared with T0,the muscle content of limbs in T1 patients was increased,and it was statistically significant（P < 0.05）;On T2,the muscle content of limbs was increased as compared with that of T0,with statistical significance（P < 0.05）.There was no significant change in limb muscle content between T2 and T1（P > 0.05）.It indicated that Tai Chi Tuina could increase the muscle content in patients with MND in a certain treatment stage and help to improve the degree of muscle atrophy in patients to a certain extent.4.ALSFRS-R scale score for different stages: At T0,there was no significant difference between the two groups of data（P > 0.05）,suggesting comparability.There was no significant change in ALSFRS-R scores between the two groups when the treatment group was compared with the blank control group at T1,and the difference was not statistically significant（P > 0.05）.On T2,compared with the blank control group,the ALSFRS-R score of patients in the treatment group was higher than that of the blank control group,and the difference was statistically significant（P < 0.05）.ALSFRS-R scale can reflect the degree of decrease in body area function of MND patients and the progression of diseases in different individuals to a certain extent.By comparing the scores of the two groups at different stages,it shows that Tai Chi Tuina helps to delay the degree of decrease in body area function and disease progression in MND patients to a certain extent.5.ALSAQ-40 questionnaire score in different stages: at T0,there was no significant difference between the two groups of data（P > 0.05）,suggesting comparability.At T1,compared with the blank control group,the ALSAQ-40 score of patients in the treatment group was higher than that of the blank control group,and the difference was statistically significant（P < 0.05）.At T2,compared with the blank control group,the ALSAQ-40 score of patients in the treatment group was higher than that of the blank control group,and the difference was statistically significant（P < 0.05）.ALSAQ-40 questionnaire could reflect the daily living ability and psychological status of MND patients.By comparing the scores of the two groups in different stages,it could be shown that Tai Chi Tuina intervention helped to improve the daily living ability and relieve psychological burden of MND patients to a certain extent.In addition,in a certain period of time,the daily living ability and mental health level of patients were improved with the increase of the number of treatments.6.Detection results of safety indicators: In the treatment group,the 66 MND patients who finally completed the trial were indicated by the safety indicators tests（lung function,routine blood test,coagulation function,liver and kidney function,myocardial infarction three items,and biochemical complete set）at T0,T1 and T2.Compared with T0,T1 and T2 showed no obvious abnormality.Conclusion1.When Tai Chi Tuina intervention reaches 30 times,it helps to increase the circumference of limbs and muscle content of MND patients,and to some extent,it can alleviate or even improve the degree of muscle atrophy of patients.2.When Tai Chi Tuina intervention reaches 30 times,it can delay the decline of body function and disease progression of MND patients to some extent.3.Tai Chi Tuina helps to improve the daily living ability of patients with MND and relieve the psychological burden of patients to a certain extent.Plays a role of treating body and mind in the same way on the human body. |
PDF Full Text Request