| Objective: Patients recovering from ischemic stroke with hemiplegia were used as study subjects.We investigated the effect of the combined therapy of pricking the branch point of the tibial and common peroneal nerve in the affected lower extremity with a bird’s peck on the muscle strength of the lower extremity in patients recovering from ischemic stroke,with the aim of optimizing the acupuncture method for lower extremity hemiplegia in recovery from ischemic stroke and providing a more effective treatment plan for the limb rehabilitation of patients with ischemic stroke.method:1.Grouping: A random number table method was used to divide the 60 patients eligible for this study with lower limb hemiparesis during the recovery period of ischemic stroke into 30 cases in the control group(ordinary acupuncture group)and 30 cases in the observation group(bird’s peck acupuncture tibiofibular nerve branch point group).2.Treatment:2.1 Acupoint selection:Refer to the prescription for treatment of stroke disease in Acupuncture and Moxibustion Therapy(11th Edition):Baihui,Shuigou,affected side Fengshi,Xuehai,Zusanli,Fenglong,Yanglingquan,Yinlingquan,Sanyinjiao,Xuanzhong,Taichong,combined with upper limb incompetence,take the Jianyu,Quchi,Shousanli,Hegu.2.2 Control group:Treatment was performed using the common acupuncture method.The patient is placed in a supine position with full exposure of the above selected acupuncture sites.After disinfecting the body surface with 75% alcohol,a 0.3mm×(25mm-40mm)milli-needle was used to pierce the body routinely,and the needle was left in place until the Qi was obtained through a flat complementary and flat diarrheal technique.The needle was retained for 30 min,during which the needle was performed once every 10 min by the method of flattening and flattening,and the needle was slowly lifted to the subcutaneous level and then quickly withdrawn without pressing on the needle hole.2.3 Observation group:The tibiofibular nerve branch point was treated by adding the method of sparrow pecking on top of the normal acupuncture,firstly,the tibiofibular nerve branch point was sparred with sparrow pecking,and then the normal acupuncture points were spiked conventionally.Positioning of the branch point of the tibio-peroneal nerve: located in the posterior femoral region,3 inches above the midpoint of the transverse popliteal stripe,at the medial edge of the biceps femoris muscle,at the angle of intersection with the semitendinosus muscle,at the depth of which is the bifurcation point of the tibial and common peroneal nerves.Specific manipulation of the branch point of the tibiofibular nerve: The patient was placed in a supine position with the skin of the hemiplegic side lower extremity fully exposed.Have the assistant lift the lower limb of the paralyzed side of the patient,holding the affected limb from the back of the ankle with one hand and gently pressing the patient’s knee joint from above to below with the other hand to keep the patient in a straightened functional position and elevated at 45°.After disinfecting the skin of the tibiofibular nerve branch point with 75% alcohol,the operator selects a 0.3mm×(40mm-50mm)milli-needle according to the obesity of the patient’s body size and applies the sparrow peck stabbing method to the tibiofibular nerve branch point,stays for a moment after stabbing directly into the needle,and then continuously carries out small amplitude and fast frequency of lifting and pounding in each direction up,down,left and right.When the patient feels an electric shock-like sensation radiating to the lower extremity,and at the same time the lower extremity involuntarily lifts,or shakes,or flexes the knee and other reactions suggest that the branch point of the tibiofibular nerve has been pricked,such reactions repeatedly appear 2-3 times can be removed immediately.3.Course of treatment: a course of 6 days,1 treatment per day,1day off after 6 consecutive days of treatment,a total of 4 courses of treatment.4.Observed indicators and statistical methods: The MMT unassisted muscle strength assessment,FMA-LE lower extremity motor function score,FAC functional walking ability rating,and modified Barthel index score were collected and counted before and after treatment in both groups.All data were statistically analyzed using SPSS25.0 software to observe and compare the clinical efficacy and pre and post differences of each index.result:There were no cases of dislodgement,discontinuation or rejection and no malignant progression or other serious adverse events during the conduct of this study.1.The baseline data of the two groups were statistically analyzed at P>0.05,indicating that the distribution of gender,age,disease duration,and laterality was not statistically different between the two groups and was comparable.2.MMT score results:(1)Comparing the MMT scale ratings of the two groups before treatment,P>0.05,there was no statistical difference,and the groups were comparable.(2)Comparing the ratings obtained from the MMT scale within the two groups before and after treatment,the ratings of the tibiofibular nerve branch point group and the normal acupuncture group were significantly higher after treatment than before treatment,P<0.01,indicating that both treatments significantly improved the muscle strength of the lower limbs in hemiplegic patients.(3)Comparing the MMT scale ratings of the two groups after treatment,P<0.01,there was a statistically significant difference between the groups,indicating that there was a difference in the efficacy of the two treatments in improving the muscle strength of the lower limbs in patients with hemiplegia,and the addition of the tibiofibular nerve branch point method with the bird’s peck on top of it was more effective than the ordinary acupuncture method.3.FMA-LE score results:(1)Comparing the FMA-LE scale scores of the two groups before treatment,P>0.05,there was no statistical difference,and the groups were comparable.(2)Comparing the scores obtained from the FMA-LE scale in the two groups before and after treatment,the scores in the group of tibiofibular nerve branch points with the normal acupuncture group were significantly higher after treatment than before treatment,P<0.01,indicating that both treatments could significantly improve the motor function of lower limbs in hemiplegic patients.(3)Comparing the FMA-LE scale scores of the two groups after treatment,P<0.01,there is a statistically significant difference between the groups,indicating that there is a difference in the efficacy of the two treatments in improving the motor function of the lower limbs in hemiplegic patients,and the efficacy of adding the tibiofibular nerve branch point method with the bird’s peck to it is better than that of the ordinary acupuncture method.4.FAC score results:(1)Comparing the FAC scale ratings of the two groups before treatment,P>0.05,there was no statistical difference,and the groups were comparable.(2)Comparing the ratings obtained from the FAC scale in the two groups before and after treatment,the ratings of the tibiofibular nerve branch point group and the normal acupuncture group were significantly higher after treatment than before treatment,P<0.01,indicating that both treatments significantly improved the walking ability of the lower limbs in hemiplegic patients.(3)Comparing the FAC scale ratings of the two groups after treatment,P<0.05,there is a statistical difference between the groups,indicating that there is an efficacy difference between the two treatments in improving the walking ability of the lower limbs in hemiplegic patients,and the efficacy of adding the tibiofibular nerve branch point method with the bird’s peck on top of it is better than that of the ordinary acupuncture method.5.MBI score results:(1)Comparing the MBI scale scores of the two groups before treatment,P>0.05,there was no statistical difference,and the groups were comparable.(2)Comparing the scores obtained from the MBI scale in the two groups before and after the treatment,the scores in the group of tibiofibular nerve branch points with the normal acupuncture group were significantly higher after treatment than before treatment,P<0.05,indicating that both treatments could significantly improve the daily living ability of the hemiplegic patients.(3)Comparing the MBI scale scores of the two groups after treatment,P<0.01,there was a statistically significant difference between the groups,indicating that there was an efficacy difference between the two treatments in improving the daily living ability of hemiplegic patients,and the efficacy of adding the tibiofibular nerve branch point method with the bird’s peck on top of it was better than that of the ordinary acupuncture method.in conclusion:1.The addition of the tibiofibular nerve branch point method with bird’s peck on top of ordinary acupuncture can effectively improve the muscle strength of the lower limb on the hemiplegic side in patients recovering from ischemic stroke,and the efficacy is better than that of the ordinary acupuncture method.2.The addition of the tibiofibular nerve branch point method with a bird’s peck on top of the ordinary acupuncture had better efficacy on the motor function,walking ability and daily living ability of the lower extremity of the hemiplegic side in patients recovering from ischemic stroke,and the efficacy was better than that of the ordinary acupuncture method. |
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