Surface Electromyography Characteristics Of Upper Limb Spastic Paralysis After Stroke Of Yin Deficiency And Blood Stasis Type And The Efficacy Of Sangdan Tongluo Decoctio

Objective:According to Root mean square(RMS)of surface electromyography was used to analyze the characteristics of upper limb post-stroke spasticity with Yin deficiency and blood stasis,And to explore the change characteristics of surface electromyography after intervention of Sandan Tongluo Decoction.In order to provide quantitative reference and objective basis for clinical diagnosis and treatment and efficacy evaluation.Methods:1、Sixty patients with upper limb spastic paralysis after stroke with Yin deficiency and blood stasis and 10 healthy controls matched in age and sex were selected.Surface EMG signals of(Biceps Brachii,BB),(Flexor Pollicis Brevis,PB)and(First Dorsal Interosseeous,FDI)of all subjects were collected by the same tester under resting,passive and active contraction states,RMS values of patients with spasm and healthy controls were observed.At the same time,the Modified Ashworth Scale(MAS)was used to grade the patients with spasm,and the correlation between the RMS value and MAS grading was observed.2、60 patients who met the inclusion criteria were divided into TCM group and TCM control group by randomized controlled clinical study.The traditional Chinese medicine control group was treated with standardized Western medicine treatment based on the Guide,and the traditional Chinese medicine group was treated with Sandan Tongluo Decoction on the basis of the traditional Chinese medicine control group.The course of treatment was 2 weeks.MAS score,FMA-UE score and RMS values of BB,FPB and FDI at rest,passive contraction and active contraction were recorded before and after the experiment.The changes of RMS value,MAS score and FMA-UE score were observed,and the clinical efficacy was evaluated combined with MAS rating.Results:1、Surface electromyography features:(1)Comparison of RMS values of BB,FPB and FDI in the left and right side of healthy controls at resting,passive contraction and active contraction,P>0.05,the difference was not statistically significant.The RMS values of BB,FPB and FDI in the healthy and affected side of patients with spasm at resting,passive contraction and active contraction(the affected side > the healthy side > the healthy control),P<0.05,the difference was statistically significant.(2)The RMS values of BB,FPB and FDI in the healthy side of patients with spasm at rest,passive contraction and active contraction were compared with MAS classification,P>0.05,and the difference was not statistically significant.The RMS values of BB,FPB and FDI on the affected side of patients with spasm at resting,passive contraction and active contraction were positively correlated with MAS grade(P<0.05),and the difference was statistically significant.2、Efficacy study results:(1)At rest,RMS values of BB,FPB and FDI on the affected side of the two groups before and after treatment did not change significantly(P>0.05),and the difference was not statistically significant.Under passive contraction and active contraction,the RMS values of BB,FPB and FDI on the affected side of the two groups decreased after treatment compared with before treatment(P<0.05),and the RMS values of BB,FPB and FDI on the affected side of the Chinese medicine group decreased after treatment compared with the control group(P<0.05),and the difference was statistically significant.The results indicated that both groups were effective in improving the RMS value of the upper limbs of patients with spasm,and the Chinese medicine group was superior to the control group.Intra-group comparison of MAS scores before and after treatment showed that P<0.05 in the TCM group was statistically significant,while P>0.05 in the control group was not statistically significant.After treatment,MAS scores of the two groups were compared,P>0.05,and the difference was not statistically significant.t is suggested that Sandan Tongluo decoction can improve MAS score.(3)After treatment,The FMA-UE scores of the two groups before and after treatment were compared in each group,all P<0.01,and the differences were statistically significant.After treatment,FMA-UE was compared between the two groups,P<0.01,and the difference was statistically significant.It is suggested that Sangdan Tongluo Decoction can effectively improve FMA-UE score,and the TCM group is better than the control group.(4)Statistical analysis of clinical effective rate of the two groups showed that the total effective rate of the traditional Chinese medicine group was78.57% and that of the control group was 44.83%.The clinical efficacy of the two groups was tested,P=0.007(P<0.01),indicating that the efficacy of the Chinese medicine group was significantly better than that of the control group,and the difference was statistically significant.Conclusion:1、In patients with upper limb spasmodic paralysis after stroke with Yin deficiency and blood stasis,the BB,FPB and FDI on the affected side were abnormal in both the affected side and the healthy side under resting,passive and active contraction.It provides objective basis for carrying out early bilateral rehabilitation training and enhancing bilateral limb coordination ability.2、In patients with upper limb spasmodic paralysis after stroke with Yin deficiency and blood stasis,BB,FPB and FDI in the affected side were positively correlated with MAS grading in resting,passive and active contraction states.The results showed that there was a high correlation between the surface electromyography signal and the degree of spasm.It has important clinical significance in quantitative evaluation of muscle spasm degree.3、Sangdan Tongluo Decoction can improve the RMS value,MAS score and FMA-UE score of BB,FPB and FDI on the affected side of patients with upper limb spastic paralysis after stroke with Yin deficiency and blood stasis under passive and active contraction,and has good safety,which is worthy of clinical promotion and further study.