| ObjectiveThis clinical study was to investigate the clinical efficacy of Jin (well)-points moxibustion combined with the electro-acupuncture treatment for ischemic stroke hemiplegia. Compared with the electro-acupuncture treatment group as Jin (well)-points moxibustion, the control group was purely the electro-acupuncture. Observations for the two kinds of the treatments for the paralysis efficacy in patients with the clinical symptom scores, the motor functions, the neurological deficits, the activities of daily living, and the quality of life, etc. are in order to reveal the Jin (well)-points moxibustion combined with the mechanism of the acupuncture treatment for ischemic stroke as well as paralysis and the disease-oriented clinical treatments for more effective therapies.MethodsThis is a case study of64stroke patients with hemiplegia from Taiwan CMCs collected ischemic, randomized controlled trial method, ischemic stroke patients with hemiplegia were randomly assigned in a1:1ratio to well points Moxibustion combined electro-acupuncture group, EA group, the number of cases to32cases in each group. Of which31males and33females, the youngest43years old, maximum78years, the shortest duration of21days, the longest149days. Western diagnostic criteria referring to the Chinese Medical Association in2009compiled the diagnostic criteria for "Clinical Practice Guidelines· Neurology Volume" in the formulation of the relevant cerebral infarction. TCM diagnostic criteria referring to the State Drug Administration to develop a "stroke diagnosis and evaluation standard." Efficacy of specific projects include:Stroke of TCM symptom score, simplified Fugl-Meyer motor function, neurological function, activities of daily living rating scale (Barthel Index), Life Satisfaction Index A (life satisfaction index A, LSIA), quality of Life Index (quality of life index, QLI)."Stroke patients with clinical neurologic impairment score standard" overall efficacy criteria refer to "Chinese medicine treatment of stroke clinical research guidelines," the evaluation standard syndromes and the Fourth National Conference on Cerebrovascular Disease pass.Results①TCM symptom scorea. TCM symptomsWell Points Moxibustion combined electro-acupuncture group before and after treatment showed clinical symptoms of the integration, language disadvantage, an improvement over the pre-treatment of the symptoms of irritability after treatment. Hemiplegia, numbness, significant relief compared with pre-treatment Violet dark lip symptoms (P<0.01).EA group the integration of TCM symptoms before and after treatment showed that after treatment, patients with ischemic stroke hemiplegia, numbness, tongue Jian strong language, lip Violet dark compared with before treatment have a remission (P<0.05) the remaining aspects of TCM symptom score, although reduced, but no significant difference (P>0.05) compared with before treatment.b. The total score of TCM symptomsWell Points Moxibustion combined electro-acupuncture group before and after treatment of TCM total symptom score compared to scores decreased, and the difference was statistically significant (P<0.01). TCM symptoms are also compared with the total score before treatment after treatment EA group was statistically significant (P<0.05). Comparison between the two groups, P <0.05, total score difference between the two groups after treatment was statistically significant clinical symptoms.②Simple Fugl-Meyer motor scoresAfter the well points Moxibustion combined electro-acupuncture group therapy simplified Fugl-Meyer motor scores compared with before treatment, scores have improved statistically significant (P<0.01). EA group after treatment simplified Fugl-Meyer motor scores compared with the pre-treatment also significantly improved (P<0.01). Comparison between the two groups, simplified Fugl-Meyer motor function score P<0.05, significant difference between the two groups was statistically significant. The difference between the two sets of motor function score comparisons, P<0.01.Conclusions show that well points Moxibustion combined EA group, EA group to alleviate physical dysfunction in patients with hemiplegia, promote physical reflex activity, collaborative movement better regulation, and combine well points Moxibustion comprehensive EA the degree of improvement was significantly better than therapy EA group (P<0.01), and the difference between the two groups before and after treatment with statistically significant compared.③neurological functionWell Points Moxibustion combined electro-acupuncture group before and after treatment of the neurological deficit score showed that the lower limb and hand muscle strength, walking ability significantly compared to the previous treatment (P<0.01). Conscious patients with hemiplegia, verbal ability, compared with pre-treatment also has to some extent alleviated (P <0.05). For horizontal gaze function, facial paralysis treatment was improved (P>0.05). EA group before and after treatment of the neurological deficit score showed that after treatment, patients with ischemic stroke upper limb muscle strength, improve walking ability was significantly (P<0.01), awareness, hand strength, lower extremity muscle strength before treatment there were significant differences (P compared to<0.05), no significant difference remainder (P>0.05).Defect score compared with before treatment, significantly reduced scores well points Moxibustion combined electro-acupuncture group after treatment of neurological function (P<0.01). EA group after treatment of neurological deficit scores compared with pre-treatment difference was statistically significant (P<0.01). Two pairwise comparison, well points Moxibustion combined total score of nerve function compared with electro-acupuncture group, the difference was statistically significant after acupuncture treatment group (P<0.05). Well Points Moxibustion combined electro-acupuncture group and electro-acupuncture therapy alone in reducing ischemic stroke patients with hemiplegia neurological deficit total credit side effect is significant, the difference in scores before and after treatment, combined with well points Moxibustion EA the most significant reduction in the magnitude of the group. ④activities of daily living (Barthel Index)Well Points Moxibustion combined electro-acupuncture group before and after treatment of the Barthel Index score showed, stool, modification, transfer (bed-chair), the situation is dressing up and down stairs score some height than before treatment, the difference was statistically significant (P<0.05). Activities walking can improve more significantly than before treatment (P<0.01). EA group showed that after treatment of ischemic stroke patients with hemiplegia stool, modified, transferred-were statistically significant compared (P<0.05before (bed chair), dressing, and walking up and down stairs and treatment capacity).Barthel Index score before treatment comparison with well points Moxibustion combined electro-acupuncture group after treatment, scores improved significantly (P<0.01). EA group situation combined with well points Moxibustion similar EA group, the difference was statistically significant (P<0.01). Comparison between the two groups and the difference between the two groups score comparison, no statistically significant P>0.05. From the results, well points Moxibustion combined electro-acupuncture, electro-acupuncture can better improve the ability of patients with activities of daily living, their scores were significantly improved, but the difference was not significant.⑤quality of life assessmenta. Life Satisfaction Index A (LSIA)Well Points Moxibustion therapy combined with electro-acupuncture group life satisfaction index A (LSIA) score improved compared with before treatment, the difference was statistically significant (P<0.05). Compared to some increase (P<0.05) before the EA group Life Satisfaction Index A (LSIA) score and treatment. Comparison between the two groups and the difference between the two groups score comparison, no statistically significant P>0.05.Life Satisfaction Index A (LSIA) scale reflects the subjective evaluation of the patient satisfaction in daily life, from the statistical results, combined with well points Moxibustion EA group, EA group had a better life satisfaction after treatment, considerable degree of improvement groups.b. Quality of Life Index (QLI)Well Points Moxibustion combined electro-acupuncture group, the difference was not statistically significant (P>0.05) before and after acupuncture treatment group Life Satisfaction Index A (LSIA) score and treatment. Comparison between the two groups and the difference between the two groups score comparison, no statistically significant P>0.05.Statistics from the above results, combined with well points Moxibustion EA group, EA group after treatment life satisfaction index A (LSIA) score compared with pre-treatment, although improved, but the degree of improvement is not obvious.⑥assessed the efficacy of traditional Chinese medicine syndromeWell Points Moxibustion combined electro-acupuncture group recovered four cases, effective in10cases, effective in13cases,5cases ineffective, the total effective rate was84.38%; cured EA group2patients were cured, there are six cases, effective there are13cases,9cases ineffective, the total effective rate was71.88%. TCM symptoms after two therapeutic effect by x2test, x2=7.83, P=0.014, P<0.05, the difference was statistically significant. Conclusions show that the improvement in patients with ischemic stroke symptom efficacy of TCM, Moxibustion well points better than the simple combination of electro-acupuncture acupuncture treatment.⑦neurological clinical efficacyThe proportion of the number of clinical neurological effects, combined with well points Moxibustion EA group has basically recovered five cases,9cases markedly effective in12cases,6cases ineffective, the total effective rate was81.25%; electro-acupuncture group had almost recovered four cases were cured, there are seven cases, effective in11cases,10cases, total effective rate was68.75%. TCM symptoms after two therapeutic effect by x2test, x2=11.54, P=0.026, P<0.05, the difference was statistically significant. Conclusions show that well points Moxibustion combined electro-acupuncture in relieving nerve function is superior to the pure electro-acupuncture treatment. ConclusionThe results of this study showed that combining well points Moxibustion EA group, EA group for improving the clinical symptoms (hemiplegia, numbness, Violet dark lips, etc.) in patients with ischemic stroke have a certain effect, and improve patient Fugl-Meyer motor function, activities of daily living (Barthel Index) score, reduce neurological deficits, to a certain extent, can improve patients’ life satisfaction index a (LSIA). Which improve motor function in patients with hemiplegia, neurological deficits, the well points Moxibustion combined EA and the EA group as compared to more significant effect. And in activities of daily living (Barthel Index) score, quality of life assessment (Life Satisfaction Index A (LSIA), Quality of Life Index (QLI)), the obvious differences between the two groups may be related with a shorter duration of treatment, improve the ability to improve the lives and activities of the quality of life needs to be long-term training and psychological control of activities of daily living. In addition, there is a certain quality of life assessment subjectivity inevitably have some impact on the efficacy results of the evaluation, which needs to be further improved in future studies. |
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