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7Clinical Observation on Treatment of Spastic Hemiplegia Jiaji Point
Acupuncture Clip
Wang Linjing,Jin Ze
The Second Affiliated Hospital of Heilongjiang University Of Chinese Medicine five ward of acupuncture and moxibustion,Harbin 150001,China
Abstract:Objective Clinical observations on the curative effect of needling neck, waist JiaJi points on apoplexy spasm.Method 60 patients were separated in two parts randomly. 30 patients in therapy group while another 30 in control group. We took the therapy group with needling neck, waist JiaJi points and routine treatment. Mine while, control group was treated by routine treatment only.10 days is a period of treatment. Totally last for 4 weeks. Result The improvement of spasm symptom on therapy group are better than control group (p<0.05). Both group has obvious improvement on motor function and self-care ability, no statistical significant (p>0.05).Conclusion There are unique advantages in improving body spasm symptom by needling neck, waist JiaJi points.
key words:jiaji point;acupuncture;apoplexy;spasm
Introduction
After a stroke caused by dysfunction directly affects the quality of life of patients, the effects of spastic hemiplegia of daily life is more serious. Limb spasm is a major obstacle to the functional recovery of hemiplegia, long muscle spasm may make the ipsilateral limb contracture deformity, even lifelong paralysis, a problem at the same time it is a long plagued the medical profession, there is no specific treatment, therefore, to take more effective treatment to reduce muscle tension, release or key inhibition of spasticity as stroke recovery treatment. Based on the evaluation method of modern rehabilitation medicine, to study systematically the muscle spasticity ridge points acupuncture neck, waist clip with the treatment of post stroke, report as follows now:
Materials and methods
The following methods of investigation were used a total of 60 patients met the inclusion criteria, were randomly divided into treatment group and control group, 30 cases in treatment group, 30 cases in the control group. According to Brunnstrom classification of stroke, 30 cases in treatment group.Two sets of data by statistical treatment, there was no significant difference in gender, age, on the other side, lesions, distribution and severity of disease distribution difference (P > 0.05) paralysis. Comparison of two groups of upper and lower limb, curative effect after treatment, there were significant differences (P < 0.05).
1, clinical data
1.1 data: 2007 September -2009 October, Second Hospital Affiliated to Heilongjiang University Of Chinese Medicine geriatric inpatients, aged between 45-75 years . A total of 60 patients met the inclusion criteria, were randomly divided into treatment group and control group, 30 cases in treatment group, 30 cases in the control group. According to Brunnstrom classification of stroke, 30 cases in treatment group, 18 cases of upper grade II, 7 cases in grade in, ^ 5 cases; 9 cases of grade II, 18 cases in grade IH, ^ 3 cases; 30 cases in the control group, 18 cases of grade II, 6 cases in grade in, 6 cases of grade IV; lower extremity 13 cases of grade II, 9 cases in grade IH, 8 cases of grade IV. Two sets of data by statistical treatment, there was no significant difference in gender, age, on the other side, lesions, distribution and severity of disease distribution difference (P > 0.05) paralysis. Comparison of two groups of upper and lower limb, curative effect after treatment, there were significant differences (P < 0.05).
1.2 diagnostic criteria:
diagnosed as stroke through the 1995 fourth national cerebrovascular disease academic conference, the clinical and CT or MRI were; (2) the Brunnstrom stroke in recovery stage H - IV, Ashworth assessment of spasticity of paralysis limb muscle tension, level 0, and < 3. 1.3 exclusion criteria
The history of motor dysfunction including severe bone and joint diseases, joint contractures and / or tonic; those with severe hypertension, coronary heart disease, pulmonary infection, liver and kidney dysfunction, severe diabetes and a history of mental illness; © with agnosia, aphasia, apraxia, visual field defects and mental retardation; epilepsy combined with Parkinson syndrome syndrome, or water and electrolyte disturbance; the refusal of treatment; the field cannot follow-up. 1.4 evaluation methods:
the evaluation form, according to the unified format; each evaluation item were evaluated before and after treatment in each appraisal; at the same time 1 days out on; Before and after treatment were evaluated in each assessment; at the same time 1 days; all kinds of interference factors excluded assessment; Determination of need to do 3 times, and then calculate the average value.
2, treatment and observation method 2.1 acupuncture therapy:
2.1.1cervical, lumbar Jiaji acupuncture: hemiplegia spasm side C5-T1 spinous opening 0.5 inch and L2-S1 spinous opening 0.5 inch; technique with reinforcing-reducing. Acupuncture Deqi electroacupuncture after use, select the dilatational wave treatment. 2 times a day, each time the needle for 40 minutes. Consecutive acupuncture for 6 days, 1 days of rest, a total of 4 weeks of treatment.
2.1.2 routine acupuncture method: Scalp acupuncture and bilateral motor areas, Baihui, Sishencong (left, right). Upper cave as Jianyu, hand three years, Quchi, Hegu, Waiguan, Zhongzhu; lower extremity from central jump, Liangqiu, Zusanli, yinlingquan, Sanyinjiao, Yanglingquan, JieXi, taichong. 2 times a day, continuous acupuncture 6D, rest 1D, were treated for 4 weeks. The 2.2 control group
Only with routine acupuncture. 2 times a day, continuous acupuncture 6D, rest 1D, were treated for 4 weeks.
3, treatment effect Standard of 3.1 curative effect
Ashworth grade(1) 0 ~ IV for the evaluation of spasticity. Upper limb to limb elbow, to the knee as the observation object, markedly reduced 2 muscle tension; effective to reduce 1 muscle tension; better to reduce half grade muscle tension; invalid for no improvement. Evaluation of the simplified Fug1-Meyer motor function (FMA), in before and after treatment respectively, and then determine the effect of nimodipine, > 67% was markedly, < 67%, > 33% effective, 33% ineffective. ". Evaluation of daily life ability by using Barthel's ADL index, below 40 for all or most dependent on others; 41 ~ 60 partial dependent on others; > 61 points for the living.
Results and discussion 1.Results
1.1two groups of spasticity curative effect comparison Comparison of two groups of upper and lower limb, curative effect after the treatment, the
difference was statistically significant (P<0.05), explain the treatment group improved on spasticity is better than that of control group.
Chart 1. Spasticity Comparison and Curative Effect
n Upper Limb Lower Limb
GrouP Effective improvement No EffectEffective Effective ImprovementNo Effect Effective
Rate Rate
Treatment
Group 2 9 19 36.7 1 7 22 26.7
Comparison
Group 6 10 14 53.3 6 8 16 46.7
1.2.Fulg-Meyer Assessment and Curative Effect
Data collected through the comparison between the upper and lower limb indicates the treatment has significantly improved patients'mobility. The statistical difference is unremarkable (P>0.05). Chart 2.Fulg-Meyer Assessment and Curative Effect_
Upper Limb Lower Limb
Group Effective improvement No EffectEffective Effective ImprovementNo Effect Effective
_Rate_Rate_
Treatment
Group 13 14 3 90 18 10 2 93.4
Comparison
Group9 17 4_867_14_13_3 90_
1.3Barthel Comparison
Barthel level improved significantly (P<0.01) after the treatment. . The statistical difference is
unremarkable (P>0.05). Result shows the method has improved patients' mobility.
Chart 3. Barthel Index Comparison and Curative Effect_
Pre treatment Post Treatment
Group <40point 41~60point >61point <40 point 41~60 point >61 point
Treatment
Group 522 6 2 8 17 5
Comparison
Group_24 5_1_9_16_5_
Discussion
After a stroke hemiplegic muscle tension secondary to upper motor neuron injury, spinal and brainstem reflex overactivity performance(2) , is a senior central loss of the ability to control voluntary movement performance. Through our research, based on conventional acupoints and acupuncture stroke hemiplegia side of the neck, lumbar Jiaji points, and has obvious effect on relieving muscle spasm. Acupuncture hemiplegia side neck, lumbar Jiaji points can be excited in the muscle of Ib fiber, inhibition of the anterior horn cells(3) , can make the spasms eased. We found through a large number of clinical research, post stroke hemiplegic limbs muscle tension is the upper limb flexor posterior leg muscles spasm. Cervical Jiaji points selected C5-T1 spinous opening 0.5 inch; lumbar Jiaji points selected L2-S1 spinous opening 0.5 inch; C5-T1 brachial plexus, including radial nerve, median nerve, ulnar nerve, axillary nerves, the dominant forearm extensor extensor, hand, finger extensor; L2-S1 lumbar plexus, including femoral nerve innervation, obturator nerve, posterior leg muscles, including the flexor digitorum longus, flexor hallux length, according to the acupuncture has good two-way regulation theory, acupuncture hemiplegia side neck, lumbar Jiaji points, can inhibit the exciting muscle spasm, make its soothing, excited the corresponding antagonistic muscle (4,5), the contraction, the muscle tension convulsion side hyperthyroidism reduces muscle tension convulsion, antagonistic muscle, inhibit spasm, tension to balance.
Through the analysis of the curative effect, treatment group in improving the spasm extent effect of contrast group.
n
Description of acupuncture at Cervical Jiaji points, the waist with Shujin setting function, can effectively reduce spasticity due to upper motor neuron injury, spasticity have definite therapeutic effect.
Reference
[1]Nazzal M, Sa'adah MA, Al-Ansari D, et al.Stroke rehabilitation: application and analysis of the modified Barthel index in an Arab community.Disabil Rehabil. 2001, 23 (1): 36-42.
[2] George Adeerman. Encyclopedia of neuroscience. Shanghai: Burke Howie Sal out Press and Shanghai science and Technology Press, 1992:302.
[3] Li Peng Hong. Assessment and treatment of spastic hemiplegia. Chinese Journal of rehabilitation medicine, 1993,8 (2):91-92.
[4]Li Peifang [4] antagonist muscles. Acupuncture treatment of post-stroke hypermyotonia [J]. Chinese Journal of rehabilitation, 2001,16 (1): 42 - 43
[5].Chen Jiajun. Lily, promoting [D]. clinical research of treatment of Limb Dyskinesia due to apoplexy preservation: JilinUniversity, 2001
Clinical Observation on 51 Patients with Parkinson's Disease Treated by
Yangjinhua Powder Capsule
WANG Yulin1,SUN Shentian1, WANG Mansu2,HAN Yuedong3,KUANG Haixue4
(1.The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin 150001 China; 2.The First People's Hospital of Yuexiu District of Guangzhou; 3.Harbin Institute of Modern Chinese Medicine; 4.College of Pharmacy, Heilongjiang University of Chinese Medicine)
[Abstract] Objective: Observe the clinical effect of Yangjinhua Powder Capsule (Flos Daturae Powder Capsule) in the treatment of Parkinson's disease (PD). Methods: Of the 51 PD patients,15 who came for the first visit were administered Yangjinhua Powder Capsule only, and 36 who had been taking western medicine were given Yangjinhua Powder Capsule without stopping using the original medicine. The Unified Parkinson Disease Rating Scale (UPDRS) was used to score the patients before treatment, 7 days, 3 months, and 6 months after treatment respectively, and as well to evaluate the total effect and untoward reactions. Results: After treatment, 29 (56.86%) patients were remarkably improved; 11 (21.57%) patients were improved; and 2 (3.92%) patients were slightly improved. Totally 42 patients were improved. The total effective rate was 82.35%. After 7 days' treatment, the improvement of tremor was significant (P<0.05).After one month's treatment, the total score of UPDRS, UPDRS H and UPDRS IH scores, and tremor and myotonia scores were all significantly improved (P<0.05 or P<0.01). Conclusion: Yangjinhua Powder Capsule is effective in improving the clinical symptoms of PD patients.
[Key Words] Yangjinhua Powder Capsule (Flos Daturae Powder Capsule) ; Parkinson's Disease (PD); Unified Parkinson Disease Rating Scale (UPDRS); tremor; myotonia
Introduction
Parkinson's disease (also known as paralysis agitans) is a degenerative disorder of the central nervous system which is more common in the elderly. The main clinical symptoms of it are resting tremor, myotonia, slowness of movement and difficulty with keeping balance in walking and gait. Since early 1960s, PD is treated mainly through the use of levodopa which is always the first choice to control the disease. However, using levodopa drugs for long time will become ineffective at treating the symptoms, and some harmful reactions such as dyskinesia will appear[1]. In recent years, the scholars of the world praise highly the treatments with the use of dopamine receptor agonists and levodopa, but the curative effect is unsatisfactory, either. In consideration of that, we
