The Clinical Curative Effect Research Of Different Stimulus Amount On The Acupuncture Treatment Of Upper Limb Muscle Tension After Apoplexy

Purpose:Observing the research of clinical effects of different acupuncture stimulus quantity treating increased upper limb muscle tone after stroke.Material and method:Sixty patients who are eligible for diagnostic criteria of Chinese and Western medicine as well as inclusion criteria are randomly divided into 4 groups.Patients in 4 groups are treated with the same fundamental treatments and rehabilitation therapies;group A is strong stimulation in scalp acupuncture as well as upper limb;group B is strong stimulation in scalp acupuncture and weak stimulation in upper limb;group C is weak stimulation in scalp acupuncture and strong stimulation in upper limb;group D is weak stimulation in scalp acupuncture as well as upper limb.The doctor uses the same brand as well as the same type of the electric acupuncture apparatus to control the acupuncture stimulus quantity by the length of stimulation time,the intensity of stimulus and different frequencies.Modified Ashworth Scale(MAS)should be used to evaluate the spasm scale of patients' affected upper limb;Fugl-Meyer Assessment(FMA)-only upper limb part,motor function of patients' affected upper limb;Modified Barthel Index(MBI)-only upper limb part,levels of activities of daily living of patients' upper limbs respectively before the first acupuncture treatment,after the first acupuncture treatment and after the whole course of acupuncture treatment.Observing whether patients in 4 groups have immediate effect or not after the first acupuncture treatment and the improvement condition of the muscle tone in upper limbs after the whole course of acupuncture treatment.SPSS should be used to analyze the data and compare the differences between the data in order to contrast the curative effect in 4 groups which have different acupuncture stimulus quantity.Results:1.Patients in 4 groups don't fall off.Contrast the basic information which includes gender,age,the course of stroke,location of brain lesion,nature of the disease,and MAS,FMA,MBI before treatment.These data are comparable during the analyzation of the statistical software and the difference is not statistically significant(P>0.05).2.The muscle tone scale in patients in 4 groups has no significant difference based on MAS after the first acupuncture treatment,P>0.05.That's to say,the improvement of muscle tone in affected upper limb in 4 groups has no immediate effect.Only group B has immediate effect on the improvement of upper limb motor function based on FMA after the first acupuncture treatment.Only group B and D have immediate effect on ADL of upper limb based on MBI after the first acupuncture treatment.Contrast the different value of MBI after the first acupuncture treatment and before the treatment between group B and D,the difference is not statistically significant(P>0.05).3.The condition of muscle tone in upper limb in 4 groups has improved based on MAS after the whole course of acupuncture treatment(P<0.05).Compare total effective rate in improving upper limb MAS in 4 groups : Group B> Group D(73.33%)> Group A(46.67%)> Group C(26.67%),the difference is statistically significant(P<0.05).The condition of upper limb motor function in 4 groups had improved based on FMA(P<0.01),pairwise comparison manifests that FMA scores in group B are obviously higher than other 3 groups',the difference is statistically significant(P<0.01 or P<0.05);and FMA scores in group D are higher than group A's and group C's,the difference is statistically significant(P<0.01 or P<0.05).Compared group A with group C,the difference is not statistically significant(P=0.225>0.05),which is : group B > group C >group A= group C,MBI(upper limb)demonstrates that ADL of upper limb has improved based on four methods(P<0.01),pairwise comparison between the groups after the whole course of acupuncture treatment shows that ADL scores in group B is remarkably higher than other3 groups',the difference is statistically significant(P<0.01);ADL scores in group D is notably higher than group A's and C's,the difference is statistically significant(P<0.01);compared group A with group C,the difference is statistically significant(P=0.037<0.05);,which is group B > group D > group A > group C.Conclusion:1.The four different acupuncture stimulus quantities which include strong stimulation in scalp acupuncture as well as upper limb,strong stimulation in scalp acupuncture and weak stimulation in upper limb,weak stimulation in scalp acupuncture and strong stimulation in upper limb,weak stimulation in scalp acupuncture as well as upper limb can improve the upper limb muscle tone,motor function and ADL after stroke,the important is that the effect of strong stimulation in scalp acupuncture and weak stimulation in upper limb is the best.2.The four different acupuncture stimulus quantities have no immediate effect on the improvement of the muscle tone in upper limb;Only strong stimulation in scalp acupuncture and weak stimulation in upper limb has immediate effect on the improvement of the motor function in upper limb;Strong stimulation in scalp acupuncture and weak stimulation in upper limb,weak stimulation in scalp acupuncture as well as upper limb have immediate effect on the improvement of ADL in upper limb but there is no difference between these two methods.3.Contrast the improvement of the muscle tone in upper limb: strong stimulation in scalp acupuncture and weak stimulation in upper limb > weak stimulation in scalp acupuncture as well as upper limb > strong stimulation in scalp acupuncture as well as upper limb > weak stimulation in scalp acupuncture and strong stimulation in upper limb;Contrast the improvement of the motor function in upper limb: strong stimulation in scalp acupuncture and weak stimulation in upper limb > weak stimulation in scalp acupuncture as well as upper limb > strong stimulation in scalp acupuncture as well as upper limb = weak stimulation in scalp acupuncture and strong stimulation in upper limb;Contrast the improvement of the ADL in upper limb: strong stimulation in scalp acupuncture and weak stimulation in upper limb > weak stimulation in scalp acupuncture as well as upper limb > strong stimulation in scalp acupuncture as well as upper limb > weak stimulation in scalp acupuncture and strong stimulation in upper limb.