Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study.
Immediate effects of scalp acupuncture with twirling reinforcing manipulation on hemiplegia following acute ischemic stroke: a hidden association study.
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DOI：
10.4103/1673-5374.182702
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发表时间：
2016-05
影响因子：
6.1
通讯作者：
Yang XM
中科院分区：
文献类型：
--
作者：
Du XZ;Bao CL;Dong GR;Yang XM
数据挖掘通过揭示数据集中针灸操作和治疗效果之间的隐藏规则，有可能为改进临床针灸策略提供信息。本研究对30例急性缺血性中风偏瘫患者进行针刺治疗。所有参与者都经过了预先筛选，以确保他们对针灸立即有反应。在双侧百会(GV20)和太阳穴(EX-HN5)之间的特定经络处采用捻转加强针刺手法。记录治疗前及治疗后即刻的神经功能缺失评分、简化Fugl-Meyer评分、偏瘫肢体近端和远端的肌力、最大H反射与最大M波的比值(Hmax/Mmax)、治疗前及治疗后即刻的肌张力、基线时的中医证候。然后使用关联算法和人工神经网络反向传播算法进行数据挖掘。研究发现，捻补手法对虚实两虚的中医证候疗效无明显差异。上肢远端和下肢近端肌力的变化是影响Fugl-Meyer评分即刻变化的主要因素之一。上肢肌张力变化与Hmax/Mmax即刻变化呈正相关，下肢肌张力变化与Hmax/Mmax即刻变化呈正相关和负相关。另外，当上肢和下肢肌张力差值为>；0或<；0时，Hmax/Mmax差值分别为正或负，说明头针对偏瘫肢体肌张力有双向作用。因此，针刺加捻补手法对不同症状、不同病期的急性缺血性中风患者有不同的疗效。Hmax/Mmax比值的变化反映了上肢和下肢肌肉张力的改善，这对偏瘫患者运动功能的恢复至关重要。
Data mining has the potential to provide information for improving clinical acupuncture strategies by uncovering hidden rules between acupuncture manipulation and therapeutic effects in a data set. In this study, we performed acupuncture on 30 patients with hemiplegia due to acute ischemic stroke. All participants were pre-screened to ensure that they exhibited immediate responses to acupuncture. We used a twirling reinforcing acupuncture manipulation at the specific lines between the bilateral Baihui (GV20) and Taiyang (EX-HN5). We collected neurologic deficit score, simplified Fugl-Meyer assessment score, muscle strength of the proximal and distal hemiplegic limbs, ratio of the maximal H-reflex to the maximal M-wave (Hmax/Mmax), muscle tension at baseline and immediately after treatment, and the syndromes of traditional Chinese medicine at baseline. We then conducted data mining using an association algorithm and an artificial neural network backpropagation algorithm. We found that the twirling reinforcing manipulation had no obvious therapeutic difference in traditional Chinese medicine syndromes of “Deficiency and Excess”. The change in the muscle strength of the upper distal and lower proximal limbs was one of the main factors affecting the immediate change in Fugl-Meyer scores. Additionally, we found a positive correlation between the muscle tension change of the upper limb and Hmax/Mmax immediate change, and both positive and negative correlations existed between the muscle tension change of the lower limb and immediate Hmax/Mmax change. Additionally, when the difference value of muscle tension for the upper and lower limbs was > 0 or < 0, the difference value of Hmax/Mmax was correspondingly positive or negative, indicating the scalp acupuncture has a bidirectional effect on muscle tension in hemiplegic limbs. Therefore, acupuncture with twirling reinforcing manipulation has distinct effects on acute ischemic stroke patients with different symptoms or stages of disease. Improved muscle tension in the upper and lower limbs, reflected by the variation in the Hmax/Mmax ratio, is crucial for recovery of motor function from hemiplegia.