BACKGROUND： Clinical diagnosis of various neurological disorders involving the sensory nerves depends primarily on subjective description, which cannot be quantitatively evaluated, and is also less reproducible and s...BACKGROUND： Clinical diagnosis of various neurological disorders involving the sensory nerves depends primarily on subjective description, which cannot be quantitatively evaluated, and is also less reproducible and specific. Quantitative sensory testing methods can overcome these shortcomings and is currently used to identify the function of the C- and A-fibers. OBJECTIVE： To apply the quantitative sensory testing method for analyzing changes in temperature sensation, cryalgesia, thermalgesia, and vibration sense on the skin surface of hemiplegic patients with post-stroke shoulder-hand syndrome, and to analyze the relationship between these changes and shoulder-hand syndrome. DESIGN, TIME AND SETTING： A non-randomized, concurrent, control study was performed at the Clinic and Inpatient Department of the Third Xiangya Hospital, Central South University, between June 2000 and April 2001. PARTICIPANTS： Thirty post-stroke, hemiplegic patients were divided into shoulder-hand syndrome and control groups, according to whether patients exhibited shoulder-hand syndrome, with 15 patients in each group. METHODS： A TSA2001 quantitative sensory testing device （Medoc, Israel） was used for quantitative sensory testing. All sensory testing employed limits, testing temperature sense on the palm thenar eminence and vibration sense on the thumb metacarpal. Cold threshold was ≤ 28 ℃, warmth threshold was ≥ 36 ℃, cold-evoked pain threshold was ≤ 5 ℃, heat-evoked pain threshold was ≥ 51 ℃, vibration threshold was ≥ 5 μm/s; if a patient met one of these items, he/she was considered to be hypoanesthesia. MAIN OUTCOME MEASURES： Cold, warm, cold-evoked pain, heat-evoked pain and vibration threshold changes on skin from the paralyzed upper extremity was measured in the shoulder-hand syndrome and control groups. RESULTS： Incidence of sensory disability in the shoulder-hand syndrome group increased more significantly than in the control group （P 〈 0.05）, with the primary manifestations being decreased cold threshold （P 〈 0.05） and increased warmth threshold （P 〈 0.05）. The value differences between cold and cold-evoked pain thresholds, as well as between warmth and heat-evoked pain thresholds, decreased significantly in the shoulder-hand syndrome group （P 〈 0.05）. There were no significant differences between the two groups in cold-evoked pain, heat-evoked pain, or vibration thresholds. CONCLUSION： The primary manifestations of sensory impairment in hemiplegic patients with post-stroke shoulder-hand syndrome were displayed as thermohypesthesia and hyperalgesia. Functional impairments of nerve fibers that control pain and temperature sense may play an important role in the pathogenesis of post-stroke shoulder-hand syndrome.展开更多
Objective:To compare the clinical effects of body acupuncture,moxibustion,and body acupuncture plus moxibustion in the treatment of post-stroke shoulder hand syndrome(SHS).Methods:A total of 90 SHS patients after stro...Objective:To compare the clinical effects of body acupuncture,moxibustion,and body acupuncture plus moxibustion in the treatment of post-stroke shoulder hand syndrome(SHS).Methods:A total of 90 SHS patients after stroke were randomly divided into the body acupuncture group,the moxibustion group,and the body acupuncture plus moxibustion group,with 30 cases in each.On the basis of rehabilitation and routine treatment,the patients in different groups were treated with body acupuncture,moxibustion,and body acupuncture plus moxibustion respectively.Treatment was given once a day,5 times a week,and 4 weeks in all.The visual analogue scale(VAS)scores,edema grading scores,and simplified Fugl-Meyer assessment(FMA)scores were evaluated before and after treatment,and the therapeutic effects of patients were evaluated as well.Results:After treatment,the VAS and edema grading scores of the three groups were all lower and the FMA scores were all higher than those before treatment,with statistically significant differences(all P<0.05).The VAS and edema grading scores of the acupuncture plus moxibustion group were lower and the FMA score was higher than those of the body acupuncture group and the moxibustion group,with statistically significant differences(all P<0.05).The total effective rate of the acupuncture plus moxibustion group was 96.7%,higher than 80.0%of the body acupuncture group and 83.3%of the moxibustion group,with statistically significant differences(both P<0.05).Conclusion:Body acupuncture,moxibustion,and body acupuncture plus moxibustion are all effective for post-stroke SHS,while the effect of acupuncture plus moxibustion is the best in relieving the pain and swelling,and improving effectively the joint movement of post-stroke SHS patients,which should be popularized in clinical practice.展开更多
基金This study belongs under the sub-topic of"Treatment and assessment of stroke under biol-ogy-psychology-society pattern" that has received the Third-class Award of Medical Science and Technology of Hu’nan Province, No. 200203-U-08
文摘BACKGROUND： Clinical diagnosis of various neurological disorders involving the sensory nerves depends primarily on subjective description, which cannot be quantitatively evaluated, and is also less reproducible and specific. Quantitative sensory testing methods can overcome these shortcomings and is currently used to identify the function of the C- and A-fibers. OBJECTIVE： To apply the quantitative sensory testing method for analyzing changes in temperature sensation, cryalgesia, thermalgesia, and vibration sense on the skin surface of hemiplegic patients with post-stroke shoulder-hand syndrome, and to analyze the relationship between these changes and shoulder-hand syndrome. DESIGN, TIME AND SETTING： A non-randomized, concurrent, control study was performed at the Clinic and Inpatient Department of the Third Xiangya Hospital, Central South University, between June 2000 and April 2001. PARTICIPANTS： Thirty post-stroke, hemiplegic patients were divided into shoulder-hand syndrome and control groups, according to whether patients exhibited shoulder-hand syndrome, with 15 patients in each group. METHODS： A TSA2001 quantitative sensory testing device （Medoc, Israel） was used for quantitative sensory testing. All sensory testing employed limits, testing temperature sense on the palm thenar eminence and vibration sense on the thumb metacarpal. Cold threshold was ≤ 28 ℃, warmth threshold was ≥ 36 ℃, cold-evoked pain threshold was ≤ 5 ℃, heat-evoked pain threshold was ≥ 51 ℃, vibration threshold was ≥ 5 μm/s; if a patient met one of these items, he/she was considered to be hypoanesthesia. MAIN OUTCOME MEASURES： Cold, warm, cold-evoked pain, heat-evoked pain and vibration threshold changes on skin from the paralyzed upper extremity was measured in the shoulder-hand syndrome and control groups. RESULTS： Incidence of sensory disability in the shoulder-hand syndrome group increased more significantly than in the control group （P 〈 0.05）, with the primary manifestations being decreased cold threshold （P 〈 0.05） and increased warmth threshold （P 〈 0.05）. The value differences between cold and cold-evoked pain thresholds, as well as between warmth and heat-evoked pain thresholds, decreased significantly in the shoulder-hand syndrome group （P 〈 0.05）. There were no significant differences between the two groups in cold-evoked pain, heat-evoked pain, or vibration thresholds. CONCLUSION： The primary manifestations of sensory impairment in hemiplegic patients with post-stroke shoulder-hand syndrome were displayed as thermohypesthesia and hyperalgesia. Functional impairments of nerve fibers that control pain and temperature sense may play an important role in the pathogenesis of post-stroke shoulder-hand syndrome.
基金Supported by Hunan University of Traditional Chinese Medicine First-class Discipline Opening Fund Project:2018 ZYXO8Hunan Science and Technology Innovation Program-Innovation Platform and Talent Program:2017 RS3052Hunan Academician Expert Work Station(Shi Xue-min)Open Fund:2018 YSZJJ02。
文摘Objective:To compare the clinical effects of body acupuncture,moxibustion,and body acupuncture plus moxibustion in the treatment of post-stroke shoulder hand syndrome(SHS).Methods:A total of 90 SHS patients after stroke were randomly divided into the body acupuncture group,the moxibustion group,and the body acupuncture plus moxibustion group,with 30 cases in each.On the basis of rehabilitation and routine treatment,the patients in different groups were treated with body acupuncture,moxibustion,and body acupuncture plus moxibustion respectively.Treatment was given once a day,5 times a week,and 4 weeks in all.The visual analogue scale(VAS)scores,edema grading scores,and simplified Fugl-Meyer assessment(FMA)scores were evaluated before and after treatment,and the therapeutic effects of patients were evaluated as well.Results:After treatment,the VAS and edema grading scores of the three groups were all lower and the FMA scores were all higher than those before treatment,with statistically significant differences(all P<0.05).The VAS and edema grading scores of the acupuncture plus moxibustion group were lower and the FMA score was higher than those of the body acupuncture group and the moxibustion group,with statistically significant differences(all P<0.05).The total effective rate of the acupuncture plus moxibustion group was 96.7%,higher than 80.0%of the body acupuncture group and 83.3%of the moxibustion group,with statistically significant differences(both P<0.05).Conclusion:Body acupuncture,moxibustion,and body acupuncture plus moxibustion are all effective for post-stroke SHS,while the effect of acupuncture plus moxibustion is the best in relieving the pain and swelling,and improving effectively the joint movement of post-stroke SHS patients,which should be popularized in clinical practice.
