RESUMO
Objective:To explore the clinical application value of sound touch elastography (STE) in the evaluation of the curative effect of acupuncture and moxibustion in the treatment of stroke patients with upper limb spasm.Methods:Fifty-five patients with upper limb spasm after stroke were selected as stroke group, and thirty healthy volunteers matched with age, gender and body mass index (BMI) were selected as control group between September 2020 and March 2021. The shear wave velocity (SWV) of biceps brachii and triceps brachii were measured in both groups. In stroke group, the SWVs of biceps brachii and triceps brachii on spastic side and non-spastic side were measured before and after acupuncture treatment, and the correlations between SWV and spastic grade (X), muscle response angle (R1), passive range of motion (R2), spastic angle (R2-R1) of modified Tardieu scale (MTS) were analyzed.Results:At 0 degree, the SWV of spastic biceps brachii (3.85±0.62)m/s was significantly higher than those of the non-spastic side [(3.34±0.35)m/s] and control group [(3.15±2.66)m/s] (all P<0.001), and decreased [ (3.45±0.47)m/s] after acupuncture treatment ( P<0.001). At 90 degree, the SWV of non-spastic biceps brachii was larger than those of spastic side and control group [1.98(1.92, 2.14)m/s vs 1.98(1.92, 2.11) m/s, 1.95(1.86, 2.05)m/s, all P<0.05], and there was no significant difference between the SWV of spastic side and control group ( P>0.05). There were no significant differences in SWV of triceps brachii between the spastic side and control group at both 0 degree or 90 degree ( P>0.05). At 0 degree, SWV positively correlated with MTS (x) ( rs=0.639, P<0.001) and negatively with R1 ( rs=-0.527, P<0.001) and R2 ( rs=-0.825, P<0.001) on the spastic biceps brachii. Conclusions:STE can provide quantitative index for the objective evaluation of the curative effect of acupuncture in upper limb spasm after stroke, and it is proposed to be an effective means of clinical diagnosis and efficacy evaluation in patients with upper limb spasm after stroke.
RESUMO
Objective To investigate the effects of the decoction of Huoxue Jiangtang Yin (HJY) combined with metformin on glucose and lipid metabolism and fat factors in type 2 diabetes patients with insulin resistance ( IR). Methods A total of 84 type 2 diabetes patients with IR were randomly assigned to experiment group and control group, 42 cases in each group. Both groups were given the basic treatment of controlling diet, exercise therapy, banning from smoking and alcohol, and psychological therapy. Additionally, the control group was given metformin orally, and the experiment group was given oral use of metformin and the decoction of HJY ( mainly composed of Radix Astragalie, Rhizoma Rehmanniae, Radix Salviae Miltiorrhizae, Radix Pseudostellariae, Fructus Schisandrae, Radix Ophiopogonis, Radix Dioscoreae, Rhizoma Polygonati, Cortex Moutan, Radix et Rhizoma Rhei, Flos Carthami, and Semen Persicae). The treatment for both groups covered 20 weeks for a course of treatment. Before and after the treatment, we observed the indexes of fasting plasma glucose (FPG), 2-h postprandial plasma glucose (2hPG), glycosylated hemoglobin (HbA1c), fasting insulin ( FINS) , homeostasis model assessment of insulin resistance ( HOMA-IR) , body mass index ( BMI) , blood lipid of total cholesterol ( TC) , triglyceride ( TG) and low density lipoprotein cholesterol ( LDL-C) , interleukin 6 ( IL -6) , tumor necrosis factor alpha ( TNF-α) , and secreted frizzled related protein 5 ( SFRP5). Results After treatment, FPG, 2hPG, HbA1c, BMI, FINS, TC, TG, LDL-C, HOMA-IR, TNF-α and IL -6 levels were all decreased (P<0.05 or P<0.01), and SFRP5 level was increased (P<0.05) in both groups compared with those before treatment. The improvement of the indexes in the experiment group was superior to that in the control group ( P<0.05 or P<0.01) Conclusion HJY combined with metformin has an effect on controlling body weight, regulating the glucose and lipid metabolism, and improving IR through regulating fat factors of IL-6, TNF-α and SFRP5 in type 2 diabetes patients with IR.
