Clinical observation on acupuncture treatment for post-stroke spastic hemiplegia

Objective： To observe the clinical effect of contralateral needling plus rehabilitation for post-stroke spastic hemiplegia. Methods： Thirty-six patients with post-stroke spastic hemiplegia were randomly divided into a treatment group and a control group, 18 cases in each group. The two groups were all given rehabilitation training. The contralateral needling was adopted in the treatment group on the acupoints group of brain-refreshing and orifice-opening needling method. The routine acupuncture was applied in the control group on the same acupoints. Respectively before and after the treatment, the modified Ashworth scale （MAS） and clinical spasticity index （CSi） were used to assess the therapeutic effects. Results： The total effective rate was 94.4% in the treatment group and 67.7% in the control group, with a statistical difference in comparison of the two groups （P〈0.05）. In comparison of MAS and CSI scores after the treatment between the treatment group and control group, the differences were statistically significant （P〈0.05）. Conclusion： The contralateral needling plus rehabilitation training is an effective method for the treatment of post-stroke spastic hemiplegia.     

Treatment of post-stroke spastic hemiplegia by acupuncture plus rehabilitation training

Objective： To observe the clinical effects of acupuncture plus rehabilitation training for post-stroke spastic hemiplegia. Methods： Eighty patients with post-stroke spastic hemiplegia in conformity with the inclusion criteria were randomly divided into two groups, a treatment group and a control group, 40 cases in each group. Both two groups were given treatments of routine Western medicine and rehabilitation training. Those in the treatment group were treated by puncturing antagonistic muscles, and those in the control group were given routine acupuncture treatment, to observe the changes in the scores of modified Ashworth scale （MAS）, Fugl-Meyer assessment （FMA） and Barthel index （BI） after treatments in the two groups. Results： After treatment, the scores of MAS, FMA and BI in the two groups were statistically different from those of the same group before the treatment （all P〈0.02）. After treatment, the differences in the scores of MAS, FMA and BI were all statistically significant （P〈0.01 or P〈0.05）. Conclusion： Acupuncture of antagonistic muscles plus rehabilitation training is better than routine acupuncture plus rehabilitation in the treatment of post-stroke spastic hemiplegia.     

ACUPOINT TO ACUPOINT PENETRATIVE NEEDLING AND ITS CLINICAL APPLICATION

Acupoint to acupoint penetrative needling method has a long history in traditional Chinese medicine. Chinese physicians in various dynasties hold that this type of needling method can strengthen the needling sensations and raise the therapeutic effect in clinical practice. This needling method can be divided into straight penetration, oblique penetration and transverse penetration. In clinical application, it can also be divided into external-medial meridian penetration, a single meridian penetration, neighboring meridians penetration, and neighboring aoupoints penetration, etc. in accordance with the involved acupoints and meridians. Clinical practice demonstrates that penetrative needling possesses advantages of stronger needling sensations, better therapeutic effect and fewer aoupoints selection. For this reason, it is extensively applied in clinic.     

Effect of individualized needling on gross motor function in cerebral palsy infants

Objective: To observe the effect of individualized needling protocol (on the basis of functional brain mapping and standardized syndrome differentiation in Chinese medicine) on gross motor functions of infants with cerebral palsy (CP) and thus study the innovative means of combining acupuncture with rehabilitation management technique. Methods: A total of 74 CP infants were randomized into a treatment group and a control group, 37 in each group. Combined individualized needling and rehabilitation training were used in the treatment group, versus combined Jin’s needling (16 brain-benefiting points) and rehabilitation training in the control group. For both groups, acupuncture treatment was conducted once every other day and rehabilitation training every day. The dynamic changes of gross motor functions before treatment and after every 1-month treatment were measured and assessed using the Gross Motor Function Measure (GMFM)-66. Results: After treatment, the GMFM scores were significantly increased in both groups (P<0.01); there were no between-group statistical differences in increase range of the GMFM scores (P>0.05); the treatment protocol was not interacted with the treatment time; and the GMFM scores for spastic CP infants were better in the treatment group than that in the control group (P<0.05). Conclusion: Combined scalp acupuncture and rehabilitation training can produce positive effects on gross motor functions of CP infants. Individualized needling can obtain better effects than 16 brain-benefiting points in improving the gross motor functions of spastic CP infants.     

Clinical observation on scalp acupuncture combined with rehabilitation training for hemiplegia after stroke

Objective： To observe the clinical efficacy of the scalp acupuncture combined with rehabilitation training for hemiplegia. Methods： One hundred and thirty-six cases with hemiplegia after stroke who met the inclusion criteria were randomly divided into three groups according to visiting sequence. Forty-eight cases in the observation group were treated by scalp acupuncture combined with rehabilitation training, 35 cases in the medicine group were treated by Chinese and Western medicines, and 53 cases in the medicine plus rehabilitation group were treated by Western medicine and rehabilitation training. Patients＇ consciousness, speech and limb functions were scored before and after treatment, and the results were compared. Results： After treatment, the scores of consciousness, speech and limb functions after treatment were lower than those before treatment. And their decrease in the observation group were more statically significant than that in the medicine group and the medicine plus rehabilitation group （P〈0.01 or P〈0.05）. The total effective rates of the three groups were significantly different （P〈0.01 or P〈0.05）. The total effective rate of the observation group was better than that of the other two groups （both P〈0.01）. Conclusion： Scalp acupuncture combined with rehabilitation therapy has better effect for stroke hemiplegia.     

不同针灸疗法治疗中风后痉挛性偏瘫的网状Meta分析

Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.     

COMMENTS ON ACUPUNCTURE TREATMENT OF DISEASES ACCORDING TO SEASONAL CONDITIONS IN 《THE INTERNAL CLASSIC》

In the present paper, the author gives some comments on acupuncture treatment of diseases from 1 ) selecting acupoints based on seasonal conditions; 2) performing reinforcing or reducing needling manipulations in accordance with the waxing and wanning of the moon; 3 ) conducting acupuncture treatment in accordance with the time and the state of disease; and 4) performing acupuncture treatment based on the prosperity or decline of the meridian-qi, which are described in medical book The Yellow Emperor‘ s Internal Classic.     

CLINICAL OBSERVATION ON TREATMENT OF 120CASES OF PERIPHERY FACIAL PARALYSIS WITH PENETRATION NEEDLING

In the present study,the therapeutic effect of penetration needling was observed in 120cases facial paralysis patients and compared with that of the routine needling in another105cases.Re-sults showed that though no significant difference was found between these two groups in the therapeu-tic effect,the acupoints used were fewer in penetration needling group and its effect on tear and poste-rior-auricular pain was superior to that of routine needling.     

DEVELOPMENT OF CLINICAL STUDIES ON ACUPUNCTURE TREATMENT OF SHOULDER PAIN IN PATIENTS WITH WIND STROKE

In the present paper, the authors review some new results of acupuncture treatment of shoulder pain in stroke patients from ① application of filiform needle with different needling manipulations, ② selection and combination of acupoints, and ③ some special needling methods including point-injection. Generally, if acupuncture therapy is used in combination with other rehabilitation methods, the therapeutic effect of shoulder-pain-relief will be much better. Regarding the acupoint selection, both local acupoints and those of the yang meridians are primarily used in clinical practice. Further studies on treating shoulder pain of hemiplegia based upon the basic theory of TOM are necessary.     

TREATMENT OF 18 CASES OF TRIGEMINAL NEURALGIA WITH ELONGATED NEEDLE

In this paper, a total of 18 cases of primary trigerninal neuralgia were treated with elongated needle.Of the 18 cases, 5 were male and 15 female, ranging in age from 27 to 58 years and in disease duration from 3 days to 8 years. Main acupoints used were Taiyang (EX-HN 5) to Xiaguan (ST 7, for penetration needling), Xiajiache, Fengchi (GB 20), Yanglingquan (GB 34) and Taichong (LR 3). The treatment was given once daily, with 12 sessions being a therapeutic course. After 2 courses of treatment, of the 18 cases, 10 cases were cured, 7 experienced improvemerit in pain and one failed in the treatment, with an effective rate of 94.4%. The key point for treating trigerninal neuralgia is applying penetrative needling from EX-HN 5 to ST 7 to achieve ideal needling sensations.     

Warm needling at Back-Shu acupoints for melasma in women

Objective： To observe the clinical effect of warm needling at the Back- Shu acupoints for melasma in women. Methods： A total of 100 cases who met the inclusion criteria were randomly allocated into a treatment group of 52 cases and a control group of 48 cases. Cases in the treatment group were treated with warm needling at the Back-Shu acupoints, whereas cases in the control group were treated with conventional acupuncture therapy. The therapeutic efficacies were then evaluated after three courses of treatment. Results： The total effective rate in the treatment group was 96.2%, versus 85.4% in the control group, showing a statistical difference （P〈0.05）. Conclusion： Warm needling at the Back-Shu acupoints works well for melasma in women.     

Fifty-three cases of the sequela of peripheral facial paralysis treated with the penetrating-sticking-pulling technique of acupuncture

Objectives:To observe the clinical effect on the sequela of peripheral facial paralysis treated with the penetrating-sticking-pulling technique of acupuncture.Methods:A total of 53 patients with the sequela of peripheral facial paralysis were diagnosed and divided into an observation group(26 cases)and a control group(27 cases)according to the visiting sequence.In the observation group,the penetrating-sticking-pulling technique of acupuncture was adopted.The Sibai(四白 ST 2),Quanliao(颧髎 SI 18)and Jiache(颊车 ST 6)et al.were needling toward Dicang(地仓 ST 4)separately.The combined acupoints were selected according to clinical symptoms of individual patient.In the control group,the routine acupuncture was used,in which,ST 2,EX-HN 5,ST 7,ST 6,and ST 4 as well as Hegu(合谷 LI 4)on the healthy side were selected.The treatment was given once every two days and a 7-treatment made one course.There were 3 days at interval between the courses.After 2 courses of treatment,the facial nerve function,e.g.,Hourse-Brackmann(H-B)grading,Sunnybrook score and clinical effect were observed.Results:①After treatment,H-B grading and Sunnybrook score were better than those before treatment in either of the observation group or the control group(P0.05,P0.01).H-B grading and Sunnybrook score were(2.23± 0.64)and(96.62 ± 2.59),respectively,in the observation group after treatment and they were(3.21± 0.43)and(80.33± 3.16)respectively in the control group.H-B grading and Sunnybrook score in the observation group were better than the control group,indicating the significant differences(P0.05,P0.01).② The curative rate and the total effective rate were 69.23% and 96.15%,respectively,in the observation group and they were 37.04% and 81.48%,respectively,in the control group,presenting the significant differences(both P0.05).Conclusion:The penetrating-sticking-pulling technique of acupuncture achieves the definite effect on the sequela of peripheral facial paralysis and this therapy deserves to be promoted in clinical practice.     

Introduction to the application of sacroiliac acupuncture

Sacroiliac acupuncture was developed by the research faculty from Shanghai Research Institute of Acupuncture and Meridian on the basis of modem and traditional Chinese medical theories combined with clinical practice. Decades of clinical observations have proved its efficacy for treating lumbosacral neuralgia, systremma, epithelial gluteal neuritis, periformis injury, strain of lumbosacral spine muscles and muscular atrophy of the lower limbs. The author is thus going to introduce this needling therapy as follows.     

Survey on Treatment of Cerebral Palsy by Scalp Acupuncture

Infantile cerebral palsy （cerebral palsy） refers to the syndrome of the motor and posture developing disturbance, caused by non-progressive injury in the developing fetus or infant. Acupuncture therapy can be used to improve various clinical manifestations of the infants with cerebral palsy, and in the treatment of the functional disturbance and accompanying symptoms of cerebral palsy; the satisfactory therapeutic results have been achieved. In this article, the literature on the treatment of cerebral palsy by scalp acupuncture in the recent years has been surveyed and assessed.     

Professor Jiping ZHAO's experiences in the differentiation and treatment of peripheral facial paralysis with acupuncture

Professor Jiping ZHAO has unique thoughts on the diagnosis and treatment of peripheral facial paralysis.She pays the great attention to clinical differentiation in treatment with acupuncture, especially meridian differentiation. She believes that the differentiation of lesion is core and the early judgment is critical for the better therapeutic effects on intractable facial paralysis. The local acupoints are selected in the guide of the theory of meridian sinew and stimulated on the base of three-needling theory. The distal acupoints are decided in light of the syndrome differentiation, of which, Hégǔ(合谷 LI 4), Zúsānlǐ(足三里ST 36) and Taichōng(太冲 LR 3) are the basic acupoints. Additionally, Professor ZHAO lays the emphasis on the 5 th branch of facial nerve(cervical branch) in diagnosis and treatment.     

CLINICAL SIGNIFICANCE OF“TREATING VITALITY” AND “RESERVING VITALITY”

"Treating vitality"and"reserving vitality"are very important manipulations during acupuncture treatment of diseases. "Treating vitality" comprises adjusting and treating both the acupuncture doctor's and the patient's vitality; while "reserving vitality" demands the acupuncture doctor carefully to experience the sensations of 'excess' or 'deficiency' under the needle, wait for the arrival of qi, observe the patient's responses, and then perform reducing or reinforcing needling manipulations in accordance with the state of excess- or deficiency- syndrome. "Treating vitality" and "reserving vitality" impenetrate the whole process of acupuncture treatment all along. Through years' clinical practice, the author of the present paper discusses the functions of the two aspects in every stage of acupuncture treatment, including before acupuncture, during needle insertion, during retention and withdrawal of the needle. The purpose of this paper is to explain the clinical significance of treating and reserving vitality and arouse many acupuncture doctors' attention.     

Acupuncture and moxibustion combined with western medication for ninety cases of Bell's palsy at different stages: A randomized controlled trial

Objective: To observe the differences in the clinical effect on Bell's palsy at the acute stage and the recover stage, as well as the differences in the clinical effect between the simple acupuncture-moxibustion therapy and the combined therapy of acupuncture-moxibustion and western medication, explore the optimal intervention time point and therapeutic regimen.Methods: All of the patients were collected from the outpatients and the inpatients in the Specific Department of Acupuncture for Facial Paralysis in Hubei Chinese Medicine Hospital. A total of 128 patients with Bell's palsy were collected from February 2017 through to February 2018 and 90 patients of them were in compliance with the inclusion criteria. 90 cases were randomized into three groups, named group A(acupuncture and moxibustion at the acute stage), group B(acupuncture and moxibustion combined with western medication at the acute stage) and group C(acupuncture and moxibustion combined with western medication at the recovery stage), 30 cases in each one. In the group A, acupuncture and moxibustion were adopted at the acute stage of Bell's palsy. In the group B, at the acute stage, acupuncture and moxibustion were adopted in combination with the oral medication of hormone and vitamin. In the group C, at the recovery stage, acupuncture and moxibustion were adopted in combination with the oral medication of hormone and vitamin. The clinical healing time and the total effective rate were observed in the patients of the three groups and the occurrence of sequelae in facial paralysis was followed-up.Result: ①The clinical healing time in the Group B was slightly shorter than the Group A, but without statistical significance in comparison(P 0.05). The clinical healing time in either the Group A or the Group B was shorter than Group C, indicating the statistical significance in comparison(both P 0.05).②The results of 3-month follow-up observation showed that there were 3 cases of sequelae in the group A, 2 cases in the Group B and 7 cases in the Group C. ③After treatment, the total effective rate in either the Group A or the Group B was higher than the Group C, indicating the statistical significance in comparison(both P 0.05).Conclusion: The simple use of acupuncture and moxibustion at the acute stage achieves the similar clinical effect on Bell's palsy as the treatment of acupuncture-moxibustion combined with western medication. The simple application of acupuncture and moxibustion prevents from the potential side effects of hormone to the largest extent and displays its dominate advantages in safety. Besides, the early intervention of acupuncture-moxibustion shortens the healing time and effectively improves the prognosis of Bell's palsy.     

Clinical curative effect of electric acupuncture on acute cerebral in- farction： a randomized controlled multicenter trial

OBJECTIVE： To examine whether electric acupuncture can improve the daily life of patients with ischemic cerebral apoplexy at acute stage.METHODS： A stratified-block randomized controlled multicenter trial was designed for this study.Totally 340 patients with acute ischemic cerebral apoplexy were randomly divided into an electric acupuncture group and a control group. In the electric acupuncture group, 170 patients were treated with electric acupuncture and routine therapy, and170 patients in the control group with routine therapy alone. Major indexes for judging curative effect were Barthel index at 3- and 6- months follow-up visits and number of re-hospitalized patients. Mi-nor indexes for judging curative effect were change in the score for nervous dysfunction at 4and 12 weeks follow-up visits and number of patients persisting in rehabilitation treatment with acupuncture during follow-up visit.RESULTS： Baseline data at the time of case selection between the two groups were similar. The odds ratio（OR） was 0.92, and the 95% confidence interval（CI） was 0.49-1.73 in disabled rate and 0.73 and 0.51-1.05 in the number of re-hospitalized patients in the electric acupuncture group at 6-month follow up visit compared with the control group.There was no difference in the score for nervous dysfunction at the end of 12-week follow-up visit between the two groups. The score for nervous dysfunction at the end of 4-week treatment in the electric acupuncture group was significantly higher than that in the control group（P〈0.05）. The number of patients discharged from hospital who persisted in rehabilitation treatment with acupuncture in the acupuncture group was significantly higher than that in the control group.CONCLUSION： Using electric acupuncture to treat patients with acute ischemic cerebral apoplexy can effectively improve the nervous dysfunction scores after 4-week treatment and their ability to deal with daily life after 6-month follow-up visit. Systematic treatment with acupuncture may also reduc     

CLINICAL RESEARCH ON IMPROVING BRAIN MICROCIRCULATION OF CHILDREN WITH CEREBRAL PALSY BY ACUPUNCTURE

Objective: To investigate the therapeutic action and value of acupuncture in cerebral palsy rehabilitation.Methods: A total of 150 patients from 1.5 to 7 years old with spastic cerebral palsy were randomly divided into three groups.Acupuncture group(group A): 50 patients were treated with head acupuncture and body acupuncture; rehabilitation training group(group B): 50 patients were treated with physical therapy of Bobath and Vojta methods.Acupuncture plus rehabilitation training group(group C): 50 patients were investigated.Results: The total effective rates of group A and group C were obviously higher than that of group B.After treatment the DQ values of group A and group C were higher than that of group B( P0.01).The improvement rates of brain dysphasia and atrophy in computed tomography of groups A and C were significantly higher than that of group B(P0.05-0.01).The recovery-to-normal rates of ECT brain blood stream in groups A and C were obviously higher than that of group B(P0.01).The results of TCD in group A(PI: 1.19±0.19 and 1.10±0.16; VP:(132.92±17.14) cm/s and(139.63±14.64) cm/s) and group C(PI: 1.18±0.24 and 0.91±0.19; VP:(131.84±15.93) cm/s and(139.68±15.66) cm/s) after treatment were better than those before treatment(P0.01).Conclusion: Acupuncture can obviously increase cerebral circulation, improve cerebral cell metabolism, promote partial or complete compensation of cerebral function and restore the function of plasticity of cerebral tissue in children with cerebral palsy.     

Clinical analysis of acupuncture combined with tuina in treating cervical vertigo

Objective： To investigate the clinical efficacy of acupuncture combined with tuina in treating patients with cervical vertigo. Methods： According to the principle of randomization, 258 cases with cervical vertigo who met the inclusion criteria for the study were randomly divided into an observation group and a control group, with 129 cases in each. The patients in the observation group received acupuncture combined with tuina therapy, while those in the control group were just treated by the same acupuncture therapy as in the observation group. After 10-day continuous treatments, the clinical efficacies of the two groups were analyzed and compared. Results： The total effective rate of the observation group was 100%, versus 86.0% of the control group, and the difference was significant（P〈0.05）. After treatment, cervical range of motion（ROM） scores in both groups were statistically significantly different from those before treatment（all P〈0.05）; in addition, there was a statistically significant difference in inter-group comparison of ROM score（P〈0.05）. Conclusion： Compared with simple acupuncture treatment, acupuncture combined with tuina therapy has a better effect in improving the ROM of cervical vertigo patients, with higher clinical efficacy.