Muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in the treatment of shoulder-hand syndrome after stroke

Abstract

To observe the effect of muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting in improving nail fold microcirculation in the patients with shoulder-hand syndrome (SHS) after stroke, and the effects on hemorrheology, calcitonin gene-related peptide (CGRP) and serum substance P (SP). A total of 72 patients were randomized into an observation group and a control group by the random number table method, with 36 cases in each group. The control group was treated with physical rehabilitation training, and the observation group was treated with additional muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting treatment. The treatment course lasted for 4 weeks. After treatment, the clinical efficacy of the two groups was compared. The changes in shoulder-hand syndrome scale (SHSS), simplified Fugl-Meyer assessment-upper extremity (FMA-UE), visual analog scale (VAS), activities of daily living (ADL), traditional Chinese medicine (TCM) syndrome score, nail fold microcirculation hemorheology indictors [whole blood viscosity (high-shear, low-shear), hematocrit, erythrocyte sedimentation rate (ESR)], CGRP and SP levels were observed. The total effective rate in the observation group was 86.1%, higher than 63.9% in the control group (P<0.05). The overall curative effect in the observation group was better than that in the control group (P<0.05). After treatment, the scores of pain sensation, edema, external turn and rotation of the arm in SHSS, and the total score were significantly decreased in both groups (all P<0.05), and each score in the observation group was lower than that in the control group (all P<0.05). After treatment, the scores of VAS and TCM syndrome in both groups decreased significantly (all P<0.05), and the scores of FMA-UE and ADL increased significantly (all P<0.05). The scores of VAS and TCM syndrome in the observation group were lower than those in the control group (both P<0.05), and the scores of FMA-UE and ADL were higher than those in the control group (both P<0.05). After treatment, the whole blood viscosity (high-shear and low-shear) and hematocrit in both groups decreased obviously (all P<0.05), and ESR increased obviously (both P<0.05), and the whole blood viscosity (high-shear and low-shear) and hematocrit in the observation group were lower than those in the control group (all P<0.05), and ESR was higher than that in the control group (P<0.05). After treatment, the peritubular state, loop shape, blood flow and total score of nail fold microcirculation in both groups decreased significantly (all P<0.05), and each score in the observation group was lower than that in the control group (all P<0.05). After treatment, SP in both groups decreased obviously (both P<0.05), CGRP increased obviously (both P<0.05), and SP in the observation group was lower than that in the control group (P<0.05), CGRP was higher than that in the control group (P<0.05). Compared with conventional physical rehabilitation training, muscle regions of meridians warm needling method plus pricking Jing-Well points for blood-letting treatment can significantly reduce the clinical symptoms of SHS, promote the recovery of physical functions, improve the nail fold microcirculation and hemorrheology indictors, and regulate the serum cytokine levels such as CGRP and SP.