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OBJECTIVES: To observe the efficacy of napex acupoint thread-embedding combined with metoprolol tartrate tablet for prophylactic treatment of migraine without aura, and to compare its efficacy with simple napex acupoint thread-embedding and simple metoprolol tartrate tablet. METHODS: A total of 105 patients with migraine without aura were randomized into a combination group (35 cases, 5 cases dropped out), a thread-embedding group (35 cases, 4 cases dropped out) and a western medication group (35 cases, 2 cases dropped out). In the thread-embedding group, napex acupoint thread-embedding was applied at bilateral Fengchi (GB 20) and points of 1.5 cun nearby to the lower edge of spinous process of cervical 2. In the western medication group, metoprolol tartrate tablet was given orally, 12.5 mg a time, twice a day. In the combination group, napex acupoint thread-embedding combined with oral metoprolol tartrate tablet was delivered. The treatment of 8 weeks was required in the 3 groups. The days of headache attacks, frequency of headache attacks, headache severity (visual analogue scale [VAS] score) and the migraine specific quality of life questionnaire version 2.1 (MSQ) score were observed during baseline period (4 weeks before treatment to before treatment), observation period (1-4 weeks and 5-8 weeks in treatment) and follow-up period (1-4 weeks after treatment completion) respectively, the proportions of the days of headache attacks/frequency of headache attacks relieved by 50% were calculated, and the safety was evaluated in the 3 groups. RESULTS: During the observation period and the follow-up period, the days of headache attacks, frequency of headache attacks and headache VAS scores in the 3 groups were reduced compared with those of the baseline period (P<0.05). During the observation period and the follow-up period, the days of headache attacks and the frequency of headache attacks in the combination group were lower than those in the thread-embedding group and the western medication group (P<0.05); during the observation period (1-4 weeks in treatment), the headache VAS scores in the combination group and the thread-embedding group were lower than that in the western medication group (P<0.05); during the observation period (5-8 weeks in treatment) and the follow-up period, the headache VAS scores in the combination group were lower than those in the thread-embedding group and the western medication group (P<0.05). During the observation period and the follow-up period, the scores of role restriction, role prevention and emotion function of MSQ in the combination group were increased compared with those of the baseline period (P<0.05); during the observation period (5-8 weeks in treatment) and the follow-up period, the role prevention scores of MSQ in the thread-embedding group and the western medication group were increased compared with those of the baseline period (P<0.05); during the follow-up period, the emotion function scores of MSQ in the thread-embedding group and the western medication group were increased compared with those of the baseline period (P<0.05). During the observation period and the follow-up period, the scores of role restriction, role prevention and emotion function of MSQ in the combination group were higher than those in the thread-embedding group and the western medication group (P<0.05). There was no statistical difference in the proportions of the days of headache attacks/frequency of headache attacks relieved by 50% among the 3 groups (P>0.05), and there were no serious adverse reactions in the 3 groups. CONCLUSIONS: Napex acupoint thread-embedding combined with metoprolol tartrate tablet, simple napex acupoint thread-embedding and simple metoprolol tartrate tablet all can reduce the days of headache attacks and the frequency of headache attacks, relieve headache severity and improve the quality of life in patients with migraine without aura. Napex acupoint thread-embedding combined with metoprolol tartrate tablet has a better effect.
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Pontos de Acupuntura , Enxaqueca sem Aura , Humanos , Metoprolol/uso terapêutico , Qualidade de Vida , Cefaleia , Resultado do TratamentoRESUMO
Focusing on the phenomenon of "de-acupoints" of the needle insertion sites in Fu's subcutaneous needling (FSN), the authors allocated the evolution and characteristics of the needle insertion sites of FSN. From six aspects, named morphology and structure, location, nomenclature, numbers and meridian tropism, indications and acupuncture manipulations, the comparison was made between the insertion sites of FSN and traditional acupoints. It is believed: â The needle insertion sites of FSN has the basic attributes of acupoint, which not only refers to the operation site, but also indicates the reaction of disease; moreover, it is the treatment site with significant therapeutic effect. â¡The optimized sites of insertion in FSN should be named differently and their locations and numbers should be specified relatively. â¢The insertion sites of FSN should be further intersected and integrated with traditional acupoints, and a part of traditional acupoints should become the insertion sites of FSN. â£Accepting and integrating the insertion sites of FSN, and expanding the scope of traditional acupoints may be the new project in the research of traditional acupoints.
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Terapia por Acupuntura , Acupuntura , Meridianos , Moxibustão , Pontos de AcupunturaRESUMO
OBJECTIVE: To observe the effect of horizontal penetration needling at vertigo auditory area and balance area on residual dizziness after successful repositioning maneuver in patients with benign paroxysmal positional vertigo (BPPV). METHODS: Sixty-six patients with residual dizziness after successful repositioning maneuver for BPPV were randomly divided into an observation group (34 cases, 1 case dropped off) and a control group (32 cases, 2 cases dropped off). The patients in the observation group were treated with horizontal penetration needling at vertigo auditory area and balance area, once every other day; three times were taken as a course of treatment, and two courses of treatment were given. The patients in the control group received no acupuncture and medication. The dizziness handicap inventory (DHI) and visual analogue scale (VAS) scores were observed before treatment and after 1 and 2 courses of treatment. RESULTS: Except for the emotional score of DHI in the control group after 1 course of treatment, the sub item scores and total scores of DHI and VAS scores in the two groups after treatment were lower than those before treatment (P<0.01, P<0.05). After 1 and 2 courses of treatment, the function scores, emotion scores, total scores of DHI and VAS scores in the observation group were lower than those in the control group (P<0.01). CONCLUSION: Whether acupuncture or not, residual dizziness after repositioning maneuver for BPPV can be relieved within 2 weeks; horizontal penetration needling at vertigo auditory area and balance area could improve dizziness symptoms and shorten the course of disease.
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Vertigem Posicional Paroxística Benigna , Tontura , Vertigem Posicional Paroxística Benigna/terapia , Tontura/terapia , Humanos , Posicionamento do Paciente , Procedimentos Cirúrgicos VascularesRESUMO
OBJECTIVE: To observe the therapeutic effect of horizontal penetration needling combined with rizatriptan monobenzoate tablets, simple horizontal penetration needling and simple rizatriptan monobenzoate tablets for migraine without aura in acute stage. METHODS: A total of 99 patients with migraine without aura in acute stage were randomized into an acupuncture plus medication group, an acupuncture group and a western medication group, 33 cases in each one. In the acupuncture group, horizontal penetration needling was applied once at Hanyan (GB 4) to Xuanli(GB 6), Shenting (GV 24) to Yintang (GV 29), Baihui (GV 20) to Qianding (GV 21), etc. for 2 h. In the western medication group, oral rizatriptan monobenzoate tablets for 10 mg were given once. In the acupuncture plus medication group, treatment of acupuncture combined with rizatriptan monobenzoate tablets were given, the application was the same as the acupuncture group and the western medication group. Before treatment and 0.5, 2, 24 h after treatment, the visual analogue scale (VAS) score was observed, the remission rate and the disappearance rate of migraine of 2, 24 h after treatment were compared in the 3 groups. RESULTS: Compared before treatment, the VAS scores of each time point after treatment were decreased in the 3 groups (P<0.05), and the changes in the acupuncture plus medication group were greater than those in the acupuncture group and the western medication group (P<0.05). The remission rates of 24 h after treatment and the disappearance rates of migraine of 2, 24 h after treatment in the acupuncture plus medication group were higher than those in the acupuncture group and the western medication group (P<0.05). CONCLUSION: Horizontal penetration needling combined with rizatriptan monobenzoate tablets have significant therapeutic effect on rapid analgesia and continuous analgesia for migraine without aura in acute stage, its effect is superior to simple horizontal penetration needling and simple rizatriptan monobenzoate tablets.
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Terapia por Acupuntura , Enxaqueca sem Aura , Pontos de Acupuntura , Humanos , Comprimidos , Resultado do Tratamento , Triazóis , TriptaminasRESUMO
By analyzing Fu 's subcutaneous needling phenomenon, the attribute of Fu 's subcutaneous needling therapy in traditional acupuncture, the innovation and the role in the development of traditional acupuncture were demonstrated. The authors believe that the de-meridian in Fu 's subcutaneous needling therapy is similar to the connotation of meridian before the Han dynasty, the de-acupoint phenomenon in Fu 's subcutaneous needling therapy reproduces the acupoint evolution, and the sites of needle insertion of this therapy are partially overlapped with the location of traditional acupoints. In manipulation, the technique of Fu 's subcutaneous needling therapy is derived from the traditional acupuncture technique and it is also in reference to the theory and the method of modern medicine, such as muscle energy technology and fasciology. The needle device and the sweeping technique are the most essential innovation of Fu 's subcutaneous needling therapy. Fu 's subcutaneous needling therapy has the distinct attribute of traditional acupuncture.
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Terapia por Acupuntura/métodos , Acupuntura , Meridianos , Moxibustão , Pontos de Acupuntura , Humanos , Medicina Tradicional ChinesaRESUMO
The problems of the syndrome differentiation of migraine in acupuncture treatment were collected, e.g. inconsistency of syndrome differentiation, unclear staging of syndrome differentiation, lack of standardization in comparison between syndrome differentiation and non-differentiation, insufficient research on the factors of syndrome differentiation. In view of the exiting problems, focusing on two aspects of migraine, namely syndrome differentiation and acupuncture effect, the clinical treatment and research are conducted in migraine treated with acupuncture based on syndrome differentiation. It is believed that the comprehensive observation of the relationship between syndrome differentiation and acupuncture effect, as well as the analysis of the relevant factors of syndrome differentiation of migraine should be the focus in future research.
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Terapia por Acupuntura , Transtornos de Enxaqueca , Humanos , Transtornos de Enxaqueca/terapia , Resultado do TratamentoRESUMO
The manipulation and key points of professor FAN Gang-qi 's horizontal penetration needling method for headache were introduced. This acupuncture method selects local acupoints of head, including occipital acupoint group, temporal acupoint group, frontal acupoint group and vertex acupoint group. The needles are shallowly and horizontally inserted at acupoints, with needle end towards the focus or headache site. The needle retaining time is long (6 h). This method is commonly used in the treatment of migraine, cervicogenic headache and tension-type headache. The manipulation is standard with better repeatability.
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Terapia por Acupuntura , Acupuntura , Cefaleia Pós-Traumática , Pontos de Acupuntura , Cefaleia/terapia , Humanos , AgulhasRESUMO
To summarize the status quo of acupoint optimization for prophylactic treatment of migraine from acupoint selection based on traditional Chinese medicine theory, acupoints selection based on modern medical theory, and the relative specificity of acupoints. It is found that at present, there are many gaps in the research of preventive treatment of migraine, while the initial optimization scheme of acupoints is formed, and there is controversy in the relative specificity of acupoints. It is believed that through the systematic analysis of the disease characteristics of acupuncture, manipulation, acupuncture tools and other factors that affect the selection of acupoints, the relative specificity of acupoints can be further clarified, and the advantages of acupoint selection based on traditional Chinese medicine theory and modern medical theory can be further optimized for the preventive treatment of migraine and improve the curative effect.
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Terapia por Acupuntura , Transtornos de Enxaqueca , Pontos de Acupuntura , Humanos , Medicina Tradicional ChinesaRESUMO
OBJECTIVE: To investigate the efficacy and safety of Tui Na for treating spasticity of the upper limbs of stroke patients. DESIGN: A prospective, multicenter, blinded, randomized controlled intervention study. SUBJECTS: Stroke patients with upper limb spasticity who were treated between December 2013 and February 2017 in 16 participating institutions in China were randomly assigned to receive either Tui Na plus conventional rehabilitation (Tui Na group, n = 222,) or conventional rehabilitation only (control group, n = 222). METHODS: Eligible adult patients (aged 18-75 years) were enrolled 1-12 months after stroke and randomly allocated in a 1:1 ratio to the two groups. Outcome assessors were blinded to treatment allocation. Muscle tone in the spastic muscles was evaluated using the Modified Ashworth Scale (MAS), and the primary endpoint was the change in MAS score over 4 weeks of treatment. RESULTS: Among patients who had experienced stroke 1-3 months before treatment, the Tui Na group experienced significantly greater reductions in MAS scores for three muscle groups than did the control group after 4 weeks of treatment. These improvements were sustained at the 3- and 6-month follow-ups. However, among patients who suffered from stroke 4-6 months and 7-12 months before treatment, the change in MAS with treatment did not differ significantly between those who did and those who did not receive Tui Na. No Tui Na-related adverse events during treatment were reported the groups. CONCLUSION: Tui Na was effective and safe for alleviating poststroke spasticity within 1-3 months after stroke onset.
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Espasticidade Muscular/terapia , Reabilitação do Acidente Vascular Cerebral , Acidente Vascular Cerebral/terapia , Extremidade Superior/fisiopatologia , Adolescente , Adulto , Idoso , Toxinas Botulínicas Tipo A/efeitos adversos , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Espasticidade Muscular/induzido quimicamente , Fármacos Neuromusculares/efeitos adversos , Fármacos Neuromusculares/uso terapêutico , Avaliação de Resultados em Cuidados de Saúde , Estudos Prospectivos , Acidente Vascular Cerebral/fisiopatologia , Reabilitação do Acidente Vascular Cerebral/métodos , Resultado do Tratamento , Adulto JovemRESUMO
The progress of acupoint research on acupuncture treatment for acute migraine was reviewed in terms of acupoint selection of traditional medicine, acupoint selection of modern medicine and comprehensive method. Seven factors of the acupoint selection were analyzed, such as meridian tropism, acupoint property and disorders. The key issues on the optimal acupoint selection scheme were explored. It was believed that the relevant specificity was displayed in the acupoint selection for acute migraine treated with acupuncture. The specificity of it was reflected not only on the meridians and acupoints in TCM, but also on the relevant specificity of acupoints in modern medicine theory. The shortages and the gaps in the current research situation of acupoint selection were analyzed. The optimized approaches to acupoint selection are proposed in the aspects of TCM, modern medicine and the integrated medicine so that a higher stage of the research on acupoint selection is anticipated.
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Transtornos de Enxaqueca/terapia , Pontos de Acupuntura , Humanos , MeridianosRESUMO
The acupuncture direction is closely related with the efficacy of acupuncture analgesia. In this article, the relationship between efficacy of acupuncture analgesia and factors, such as whether the needle towards disease location, whether the needle towards meridian direction, whether the needle following spinal cord direction and whether the needle following muscle direction, were analyzed. The previous clinical and literature research indicated that the needle towards disease location was superior to reverse direction, however, the efficacy of analgesia between needle following and reversing meridian, needle towards and at disease location, needles following and reversing spinal cord direction, needles following and reversing muscle direction was controversial. Therefore, the solutions to these problems will benefit the optimized acupuncture treatment plan for pain disorders.
Assuntos
Analgesia por Acupuntura/métodos , Terapia por Acupuntura/métodos , Agulhas , Humanos , Meridianos , Medula Espinal/anatomia & histologiaRESUMO
The literature and relevant books on the scalp needling schools were retrieved to collect the main scalp needling schools and compare the point location principles and needling techniques so as to optimize the scalp needling scheme. Currently there are ten major schools of scalp acupuncture, representing for example by JIAO Shunfa, FANG Yunpeng and YU Zhishun, etc. The principles of stimulating localization are different among the schools, in which, YU Changde's skull line localization is mainly for the treatment of cerebrovascular diseases, ZHANG Mingjiu prefers the penetrating technique for the treatment of pain and mental disorders according to traditional meridian theory, and the other schools take the cortical functions into account for the stimulating localization. Regarding needling techniques, FANG Yunpeng stresses on the deep puncture to the periosteum, and the rest school masters puncture beneath the bonnet aponeurosis. The quick rotation of needle is required in JIAO Shunfa's scalp needling, YU Changde's skull needle, International Scalp Points Standardization and the needling technique for opening brain and promotion collateral. The long-term needle retaining is required in YU Zhishun's scalp needling and ZHU Mingqing's scalp needling. It is believed that the stimulating localization principles are not standardized, the theoretic evidences are not clear and the needling depth is different among the schools. There are no standard criteria on needling angle, depth, direction, rotating speed and needle retaining time. The evidence-based medicine is recommended. Through strict scientific design, based on the clinical and experimental evidences, it is required to determine the theoretic scientific evidence of scalp acupuncture, the specificity of stimulating areas, the effective stimulating areas and quantify the needling manipulations and clarify the optimal scheme of scalp needling.
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OBJECTIVE: To observe the effects between acupuncture combined with rehabilitation and simple rehabilitation for shoulder pain after stroke, and to select the best plan of acupuncture manipulations at different stages by orthogonal design. METHODS: Ninety patients were treated with comprehensive rehabilitation, and nine cases without acupuncture were arranged into a control group. Eighty-one patients of orthogonal design were applied by acupuncture with the same acupoints and course. The VAS score and its weighted value were regarded as the observation indices,and the effects between the acupuncture group and the control group were compared. The optimal plans of acupuncture manipulations of the early stage and the later stage were chosen after the first course treatment and the third course treatment separately. The acupuncture depth (factor A:A: shallow depth less than 25 mm, A(II): modest depth 25-40 mm, A(III): deep depth 40-50 mm), the acupuncture angle (factor B:B(I): perpendicular insertion, B(II): horizontal insertion, B(III): oblique insertion), needle manipulated frequency (factor C: C(I): zero time, C(II): one time, C(III): three times) and needle retained time(factor D:D(I):20 min, D(II): 30 min, D(III): 60 min) were studied. The differences among all factors and the diversity among major factors at different stages were analyzed. RESULTS: (1) Acupuncture combined with rehabilitation at the early and the later stage acquired better improvement than simple rehabilitation (all P < 0.01). (2) The optimal acupuncture manipulation plan at the early stage was A(III) B(III) C(I) D(I), which was deep acupuncture and oblique insertion for 20 min with zero-time manipulation; the optimal acupuncture manipulation plan at the later stage was A(III) B(III) C(III) D(I), which was deep acupuncture and oblique insertion for 20 min with three-time manipulation. (3) There was significance for acupuncture depth and angle at the early stage (both P < 0.01) and there was significance for insertion depth, acupuncture angle and manipulating frequency at the later stage (all P < 0.05). (4) At the early stage, the insertion depth was statistically significant between A(I) and A(II), A(I) and A(III), A(II) and A(III) (P < 0.05, P < 0.01), and the statistical significance was existed between B(I) and B(III) (P < 0.01). At the later stage, the insertion depth was statistically significant between A(I) and A(III), A(III) and A(II), A(I) and A(II) (P < 0.05, P < 0.01), and the statistical significance was existed between C(I) and C(III), C(II) and C(III) (P < 0.05). CONCLUSION: Acupuncture combined with rehabilitation acquire apparent effect for shoulder pain after stroke. At the early stage,the optimal plan is deep and oblique insertion for 20 min with zero-time manipulation. At the later stage, the best plan is deep and oblique insertion for 20 min with 3-time manipulation.
Assuntos
Terapia por Acupuntura , Dor de Ombro/reabilitação , Dor de Ombro/terapia , Acidente Vascular Cerebral/complicações , Idoso , Idoso de 80 Anos ou mais , Terapia Combinada , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor de Ombro/etiologia , Resultado do TratamentoRESUMO
In order to optimize acupuncture protocol for stephenipodia after stroke, related papers of the recent 20 years are retrieved. Interrelated factors which may influence the therapeutic effect of acupuncture are analyzed through the aspects such as acupoints, needling methods and opportunities of acupuncture. It is held that importance should be attached on relation between acupoints and anatomy during acupoint selection. Different acupuncture protocol can be adopted in different phases of stephenipodia according to its time of occurrence. And it is found that the combination of acupuncture and rehabilitation can reinforce the therapeutic effect. Relationship between effect of acupuncture and patient's condition, acupoint selection and prescription, acupuncture manipulations (including directions, angles, reinforcing and reducing, quantity of stimulus) are worth to be further studied. On the base of the above all mentioned studies, optimization can be carried out on selection of acupoints and acupuncture manipulations. And therapeutic effect can be enhanced when the optimized acupuncture protocol is combined with rehabilitation therapies.
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Terapia por Acupuntura , Doenças do Pé/terapia , Acidente Vascular Cerebral/complicações , Pontos de Acupuntura , Doenças do Pé/etiologia , HumanosRESUMO
The literature on acupuncture-moxibustion and acupuncture-moxibustion combined with other therapies for all kinds of pain as well as organized medicine of pain in recent ten years are analyzed. It is found out that application of single acupuncture-moxibustion has positive effect on most of pain, while acupuncture-moxibustion combined with other therapies could improve the efficacy in a certain extent. The organized medical model of pain, by integration of clinical paths and optimization of medical methods, could achieve best effect on pain. With acupuncture-moxibustion joining in the organized medical model of pain, the analgesia effect could be enhanced, medical cost decreased and patient's life quality improved. The suitable disease, clinical path, action function and mechanism need further evidence-based research.
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Terapia por Acupuntura , Moxibustão , Manejo da Dor , HumanosRESUMO
OBJECTIVE: To evaluate effects of Tongnao Huoluo acupuncture therapy (THAT) on Bcl-2 and Caspase-3 rats with acute cerebral infarction (ACI). METHODS: Totally 264 SD rats were randomly divided into 5 groups, i.e. the THAT group (n =72), the thrombolysis group (n =72), the body acupuncture group (n =72), the ischemia control group (n =24), and the sham-operation group (n =24). Successfully modeled rats were recruited in all groups except the sham-operation group. Rats in the THAT group, the thrombolysis group, and the body acupuncture group were divided into 3 subgroups according to the disease occurrence time, i.e., < or = 1.5 h THAT group, 1.5+ -2 h THAT group, and 2+ -3 h THAT group. The neuroethological scores were assessed at 6, 24, and 72 h after treatment. The expressions of Bcl-2 and Caspase-3 were detected using immunohistochemical staining at 24 and 72 h respectively. RESULTS: In aspect of improving scores of neurological functions: At 6 h after treatment within 2 h after the disease occurrence, the neuroethological scores were lowered more obviously in the thrombolysis group than in the THAT group (P <0.05). There was statistical difference at 24 and 72 h within 2 - 3 h after the,disease occurrence between the THAT group and the thrombolysis group (P <0.05). Compared with before treatment, there was statistical difference at 24 and 72 h within 3 h after the disease occurrence (P <0. 05, P <0.01). In aspect of lowering the expression of Caspase-3 and elevating the expression of Bcl-2: There was statistical difference in lowering the expression of Caspase-3 and elevating the expression of Bcl-2 between the THAT group and the thrombolysis group at 72 h within 2 -3 after the disease occurrence (P <0.05, P < 0.01). CONCLUSION: THAT showed favorable effects in lowering neuroethological scores, lowering expression of Caspase-3, and elevating the expression of Bcl-2 of ACI rats.
Assuntos
Terapia por Acupuntura , Caspase 3/metabolismo , Infarto Cerebral/metabolismo , Infarto Cerebral/terapia , Proteínas Proto-Oncogênicas c-bcl-2/metabolismo , Animais , Masculino , Ratos , Ratos Sprague-DawleyRESUMO
Through the collection of the literatures published in recent years on the opportunity of acupuncture therapy for post-stroke dysphagia, the therapy of acupuncture-moxibustion combined with the rehabilitation training is regardes as the optimal program in the paper. In this program, the timing of acupuncture intervention is a key factor to impact the efficacy on post-stroke dysphagia. It is vitally significant to grasp the intervention timing of acupuncture-moxibustion in the recovery of swallowing function as well as articulation function with dysphagia involved.
Assuntos
Terapia por Acupuntura , Transtornos de Deglutição/terapia , Moxibustão , Acidente Vascular Cerebral/complicações , Animais , Transtornos de Deglutição/etiologia , HumanosRESUMO
OBJECTIVE: To optimize primarily acupuncture program for dysphagia after cerebral infarction. METHODS: Sixty-three patients with pseudobulbar palsy dysphasia after cerebral infarction were selected as the subjects. Water swallow test was adopted for observation index. Orthogonal design was used to study the different combinations of treatment programs among four factors and three levels, named acupuncture opportunity (factor A: A1: 1-10 d, A2: 11-20 d, A3: 21-40 d), point combination (factor B: B1: points in the neck, B2: points in the neck + points in the glossopharyngeal part, B3: points in the neck + points in the glossopharyngeal part + differentiating point), needling depth (factor C: C1: shallow puncture, C2: moderate puncture, C3: deep puncture), and treatment session (factor D: D1: 2 sessions, D2: 4 sessions, D3: 6 sessions); as well as the influences on pseudobulbar palsy dysphagia after cerebral infarction so as to determine primarily the optimized acupuncture program for dysphagia after cerebral infarction. RESULTS: The direct analysis of orthogonal design indicated that the best level and the combination of four factors and three levels were A1 (or A2), B3, C3 and D3. It meant that for the patients less than 20 days for sickness, the points in the neck, points in the glossopharyngeal part and points selected according to syndrome differentiation were selected for deep puncture and the treatment lasted for 6 sessions. This program achieved the best improvement in water swallow test. The comparison between the primary effect and secondary effect among four factors (variance analysis) showed that factor A and C were the significant factors (P < 0.05), factor B and D were not significant (P > 0.05). It was suggested that acupuncture opportunity and needling depth played the significant roles in clinical efficacy. The comparison among different levels in terms of the significant factors A and C (multiple comparison) presented that A1 and A2 were superiorly significant than A3 (P < 0.001), A1 was not different in significance from A2 (P > 0.05). C3 was superiorly significant than C2 and C1 (P < 0.001, P < 0.01) and C2 was superiorly significant than C1 (P < 0.05). CONCLUSION: By the comprehensive summarization of direct analysis, variance analysis and multiple comparison combined with actual clinical situation, the optimal program of acupuncture treatment for pseudobulbar palsy dysphasia after cerebral infarction is that in terms of the four factors and three levels, for the patients within 1 to 20 days for sickness, acupuncture is applied to the points in the neck or combined with points in the glossopbaryngeal part or the points se-i lected according to syndrome differentiation, with deep puncture, for 4 to 6 sessions of treatment.
Assuntos
Terapia por Acupuntura , Infarto Cerebral/complicações , Transtornos de Deglutição/terapia , Idoso , Idoso de 80 Anos ou mais , Deglutição , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/fisiopatologia , Feminino , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
Literatures on acupuncture analgesia of the recent 30 years are analyzed through the target pain syndromes, points and tools selected for needling as well as the chosen direction, angle and depth of insertion. The relationship between effect of acupuncture analgesia and needling direction, angle as well as depth is initially optimized to enhance the analgesic effect. The result shows that the 3 factors are the key influences. However, studies on the above mentioned relation are still far from enough. Aiming at enhancing the effect of acupuncture analgesia and exploring the relative mechanism, it is held that multivariate analysis should be adopted to do systematic analysis on relationship between effect and mechanism of acupuncture analgesia and direction, angle and depth of the needle insertion.
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Analgesia por Acupuntura/instrumentação , Analgesia por Acupuntura/métodos , Terapia por Acupuntura/instrumentação , Terapia por Acupuntura/métodos , Animais , Humanos , AgulhasRESUMO
[In the present paper, the authors make a systemic analysis on the combined treatment of cerebrovascular diseases with acu-moxibustion and herbal medicines from 1) background, 2) objective, 3) methods and contents, and 4) the underlying mechanism. It is thought of that optimizing the therapeutic program of acu-moxibustion and herbal medicines, and then optimizing their combined ways, time, quantity, etc. may improve clinical curative effect further. Concerning the study on the combined treatment of cerebrovascular diseases with acu-moxibustion and Chinese herbal medicines, the emphasis should be laid on the research on their pathways to pass through or pass by the blood-brain barrier and their protection action on the brain neurons which is the combining point for revealing the underlying mechanisms of the joint application of acu-moxibustion and herbal medicines.