Zheng's massage combined with electroacupuncture in the treatment of reflex sympathetic dystrophy syndrome of the wrist / 中国骨伤

OBJECTIVE@#To observe the clinical effects of zheng's massage combined with electroacupuncture in the treatment ofreflex sensory dystrophy syndrome of the wrist.@*METHODS@#From October 2016 to September 2018, 48 cases of reflex sensory dystrophy syndrome of the wrist were divided into the observation group and the control group. In the observation group, there were 24 cases, including 10 males and 14 females, ranging in age from 54 to 76 years old, with an average age of (61.41 ±7.90) years old. The patients in the observation group were treated with massage combined with electroacupuncture. The control group consisted of 24 patients, including 9 males and 15 females, ranging in age from 52 to 75 years old, with an averageage of (58.71±8.11 ) years old. The patients in the control group were treated with electroacupuncture alone. All the patients in both groups were treated for 6 weeks. The clinical symptoms and signs, visual anglogue scale (VAS), Cooney wrist score and clinical efficacy evaluation were compared between the two groups before and after treatment, and statistical analysis was conducted.@*RESULTS@#After 6 weeks of treatment, VAS in the control group was 4.9±1.8, and Cooney wrist score was 74.63±1.72; VAS in the observation group was 2.2±1.4, and Cooney wrist score was 86.31±2.53. The comprehensive scores of VAS and Cooney wrist joint between two groups were improved after treatment, and the observation group was better than control group(<0.05). The curative effect of the observation group was better than that of the control group.@*CONCLUSION@#Zheng's massage combined with electroacupuncture has the following advantages in the treatment of reflex sympathetic dystrophy syndrome of the wrist, such as small trauma, patients' willingness promoting functional rehabilitation, which is worthy of clinical promotion.

Therapeutic Observation of Electroacupuncture plus Rehabilitation for Post-stroke Shoulder-hand Syndrome / 上海针灸杂志

Objective To explore the effect of electroacupuncture plus rehabilitation on shoulder-hand syndrome (SHS). Method Eighty SHS patients were randomized into an experimental group and a control group, 40 cases in each group. The experimental group was intervened by electroacupuncture plus rehabilitation training and basic Western medicine treatment, while the control group was by rehabilitation training and Western medicine treatment, 3 sessions a week, 4 weeks in total. The pain intensity of the affected shoulder and upper-limb motor function were observed before and after the treatment. The therapeutic efficacy was also evaluated. Result The Visual Analogue Scale (VAS) score of the shoulder pain and Fugl-Meyer Assessment (FMA) score of the upper-limb motor function were significantly improved after the intervention in the two groups (P<0.01), and the improvements of VAS and FMA in the experimental group were more significant than that in the control group (P<0.01). Conclusion Based on the basic treatment of Western medicine, electroacupuncture plus rehabilitation training can markedly improve the pain intensity of the affected shoulder and upper-limb motor function in post-stroke shoulder-hand syndrome.

Clinical Observation of Yang-supplementing Thread-embedding for Shoulder-hand Syndrome After Cerebral Stroke / 上海针灸杂志

Objective To observe the clinical efficacy of yang-supplementing thread-embedding (acupoint embedded with catgut soaked in Shenfu injection) in treating shoulder-hand syndrome after cerebral stroke. Method Totally 120 patients were randomized into a treatment group and a control group, 60 cases in each group. The treatment group was intervened by acupoint thread-embedding, while the control group was by conventional acupuncture. The changes of symptoms, joint range of motion (ROM), pain, and Fugl-Meyer Assessment (FMA), and general therapeutic efficacy were observed after 30 d treatment. Result The total effective rate was 95.0% in the treatment group versus 85.0% in the control group, and the difference was statistically significant (P<0.05). Conclusion Yang-supplementing thread-embedding and conventional acupuncture both can mitigate pain induced by shoulder-hand syndrome, increase the range of motion, and significantly improve the upper-limb motor function, while the effect of yang-supplementing thread-embedding is superior to that of conventional acupuncture.

Clinical Observation of Acupuncture plus Medicine and Function Training for Post-stroke Shoulder-hand Syndrome / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture plus medicine and function training in treating post-stroke shoulder-hand syndrome. Method Sixty patients with post-stroke shoulder-hand syndrome were randomized into a treatment group of 30 cases and a control group of 30 cases. The treatment group was intervened by acupuncture plus medicine and functional training, while the control group was only by functional training. Before and after intervention, the hand swelling degree, Visual Analogue Scale (VAS), shoulder joint motion scale, Fugl-Meyer Assessment (FMA) scale were used to measure the swelling and pain of hand, motion of shoulder, and motor function of upper limb. Result After intervention, the swelling and pain of hand, motion range of shoulder and motor function of upper limb were significantly improved in both groups (P<0.01), and the improvements in the treatment group were more significant than that in the control group (P<0.05). Conclusion Acupuncture plus medicine and function training can enhance the efficacy in treating post-stroke shoulder-hand syndrome, superior to pure function training.

Therapeutic Observation of Micro-invasive Point-toward-point Thread-embedding for Post-stroke Shoulder-hand Syndrome / 上海针灸杂志

Objective To observe the clinical efficacy of micro-invasive point-through-point thread-embedding in treating acute stage of post-stroke shoulder-hand syndrome. Method Sixty patients were randomized into a treatment group and a control group, 30 in each group. Patients in the treatment group were intervened by micro-invasive point-through-point thread-embedding in addition to rehabilitation training, while patients in the control group were by rehabilitation training alone. Before treatment and after 4-week treatments, Visual Analogue Scale (VAS) was used to estimate shoulder pain, modified Barthel Index (MBI) to detect the activities of daily life, and Fugl-Meyer Assessment Scale to measure the motor function of upper limb. Result Before treatment, there were no significant differences in comparing the involved indexes between the two groups (P>0.05), and the indexes were significantly improved after intervention in both groups (P<0.05). Conclusion Micro-invasive point-through-point thread-embedding can reduce pain intensity, improve the activities of daily life and motor function of upper limb of patients in acute stage of post-stroke shoulder-hand syndrome.

Usefulness of Three-phasic Bone Scan in Young Male Patients Suspected of Post-traumatic Reflex Sympathetic Dystrophy Syndrome / 대한핵의학회잡지

PURPOSE: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. MATERIALS AND METHODS: Patients with narrow range of age (21-25. mean 22.8+/-1.3, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed 21.2+/-7.3wks after trauma. RESULTS: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight bearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). CONCLUSION: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.

A Case of Reflex Sympathetic Dystrophy Syndrome

Reflex sympathetic dystrophy syndrome (RSDS) is a well-recognized disorder in adult group. But it is rarely diagnosed in the pediatric age group. RSDS is often a response to a physical or an emotional distress. Diagnosis of RSDS is made on a clinical basis whenever a patient with a painful limb presenting two or more of the following signs and symptoms : Persistent pain and swelling, vasomotor instability, trophic skin changes in the same extremity and autonomic imbalance. We report a case of RSDS in a 14- year-old girl. Her left arm was cold, edematous and blue with a limited active range of movement. Bone scan and thermography showed abnormal findings in affected arm. Prednisolone therapy, 60mg/day, was started. She also received sympathetic blocks and conservative treatment with physical therapy, transcutaneous electrical nerve stimulation, psychological therapy and anti-depressants. She showed gradual improvement in symptoms and signs.

Quantitative Analysis of Skin Temprature of Reflex Sympathetic Dystrophy Syndrome in Stroke Patients

OBJECTIVE: The purpose of this study is to assess the changes of skin temperature quantitatively in the stroke patients with reflex sympathetic dystrophy syndrome (RSDS) using thermography according to their clinical phases as well as changes after treatment. METHOD: Patient group was consisted of 17 stroke patients with RSDS. Mean onset time of RSDS after stroke was 10.6 weeks. All patients were assessed by triphasic bone scan and clinically classified by phase I, II, and III. Control group was consisted of 9 stroke patients without RSDS. Temperature difference between affected side and unaffected side in wrist and hand regions were assessed in all subjects using Thermovision 570 (Agema Infrared Systems, USA) when initial clinical diagnosis was made. Seven patients were reassessed after high dose steroid and physical therapy. RESULTS: In patients with phase I RSDS, affected wrist and hand showed higher temperature distribution than the unaffected side. On the other hand, patients with phase II and III showed lower temperature in the affected side. The mean temperature difference in patients with phase I RSDS was significantly greater than control group. After treatment, skin temperature of affected side was decreased in phase I patients, but increased in phase II patients. Skin temperature difference tended to be normalized after successful treatment. CONCLUSION: Using thermography, temperature change of affected hand can be assessed quantitatively in stroke patients with RSDS. The thermography is considered to be a useful tool for evaluation of clinical phases and treatment effect in these patients.

A Case of Reflex Sympathetic Dystrophy Syndrome developed after Protein Losing Enteropathy / 대한내과학회지

A 16-year old girl was admitted for chronic diarrhea, generalized edema, severe pain of lower extremities, and general weakness. She could not walk because of burning pain of knee and ankle. 99mTc-MDP bone scan demonstrated increased periarticular uptake in both lower extremity with focal increased activity in proximal portion of both tibias.. Abnormal abdominal activity in ascending, transverse, and descending colon is also seen. Bone densitometry showed severe osteoporosis in lower extremity. 99mTc-HSA scan showed abnormal radioactivity in small bowel, and descending colon indicating protein losing enteropathy. Endoscopic biopsy of terminal ileum showed a few dilated lymphatics in the submucosa. After steroid and supplemental therapy, the symptoms and signs of both protein losing enteropathy and RSDS much improved simultaneously. Reflex sympathetic dystrophy syndrome is a complex of symptoms characterized by severe pain, swelling, autonomic vasomotor dysfunction, and impaired mobility of affected extremities. The important causes are trauma, fracture, and inflammation. We assumed that the reflex sympathetic dystrophy syndrome of this girl was due to protein losing enteropathy. And as far as we know there has not been reported case that protein losing enteropathy assumed as a cause of reflex sympathetic dystrophy syndrome.