RESUMO
ObjectiveTo investigate the efficacy of along-meridian distal point selection in treating post-cerebral infarction shoulder-hand syndrome.MethodSixty patients with post-cerebral infarction shoulder-hand syndrome were randomly allocated to treatment and control groups, 30 cases each. The control group was treated by routine neurological medical treatment, conventional acupuncture for stroke-attack on meridians and rehabilitation training and the treatment group, by along-meridian distal point selection in addition. The therapeutic effects were evaluated in both groups after four courses of treatment. The VAS scores, affected-side hand swelling scores and upper limb FMA scores were compared between the two groups before and after treatment. ResultThe VAS score, affected-side hand swelling score and upper limb FMA score were significantly better in both groups after treatment than before (P<0.01). Post-treatment VAS score, affected-side hand swelling score and upper limb FMA score were significantly better in the treatment group than in the control group; there were statistically significant differences (P<0.01,P<0.05). ConclusionAlong-meridian distal point selection has clinically a better improving effect on the pain, affected-side hand swelling and upper limb function in patients with post-cerebral infarction shoulder-hand syndrome.
RESUMO
This symposium was held as the second in a three part series at Kagawa Conference (June 6-8, 2003). During the Tsukuba conference (2002), distal area treatment was the topic of focus. The criteria and evidence for the effectiveness of distal area treatments were presented. Three symposists and one minor speaker reported on the effectiveness of distal area treatments from clinical and basic viewpoints. However, another symposist showed the superiority of local area treatments and denied the effectiveness of distal area treatments. There fore, we decided that a succinct and definitive discussion on distal area treatments (etc) should be presented during the second symposium. To this end, long time members of JSAM were given a questionnaire survey prior to the conference. Respondents were asked to define their own use of local and distal treatment, to hypothesize on the curing mechanism involved and to state which practice methods they use most.<BR>Mr. Ogawa reported that, as a result of analyzing the questionnaire survey no distinct differences were found in the definitions stated by respondents from several different schools. The standard images of “the local area” were the area where pains were felt when pressure is applied, the areas which transmit special sensitivity or the area where a disorder is found. Also, the images of “the distal area” were the areas which have some relationship to the local area, such as meridians and collaterals, nerves, reflex points, tender points, or related points which induce a clearly recognizable physical reaction.<BR>Mr.Shinohara showed the superiority of distal area treatments according to the muscle meridian theory by utilizing the 3 arm crossover examination. Furthermore, he established the delayed myalgia as a model of the illness on a specific muscle meridian region. He investigated the effect of intradermal needling. He observed that after a weight bearing exercise on the biceps brachii, the threshold of tenderness on the Lung meridian decreases. He proposed the possibility of using the points in extremities which had selectively responded by manifesting of the delayed myalgia.<BR>Mr. Moriyama, one of the minor speakes, explained, using the theory of biomechanics, the possibility of in-fluences of distal area disharmony on the local area. He introduced the Meridian Test as one clinically useful method for finding disharmony which is typically difficult to discern and may contribute to the disorder. He proposed that a microscopic “eye” to be used to see the local area and the macroscopic “eye” b used to see the whole body in medical examination and treatment. Using the “eyes” in synthesis and not separately, he concluded, must be the basic state for treatment.<BR>Another minor speaker, Mr.Shiraishi reported on analyzed results of the experiments on lumbago patients. Applying Yuandaoci (distant needling) reduced a response on points of the trunk (BL 23, Shenshu, Jinyu) in stimulating points, i.e, BL 40 (Weizhong, Ichu), BL 57 (Chengshan, Shozan) BL 58 (Feiyang, Hiyo) BL 60 (Kunlun, Konron) GB 34 (Yanglingquan, Yoryosen) varying in many ways and confirming the peculiarity of each point, meridian and collateral. Based on these findings he supports the effectiveness of distal meridian area treatments.<BR>Mr. Ozaki, also, another minor speaker proposed, from the outcome of animal experiments. Stimulation by acupuncture at either adjacent or distal areas can affect motor reflex. So from this point of view, insertion at adjacent and distal area has some recordable effect. He added that stimulation given either at adjacent or distal areas would converge to the same neuron and the same modification would occur. From this point of view, the difference in processing information at the neuron level would control the manifestation of the effect and thus investigations on these treatments should be discussed as a synthesis, including, not