[Electroacupuncture at Baliao points for erectile dysfunction after stroke: a randomized controlled trial].

OBJECTIVE: To observe the clinical effect of electroacupuncture at Baliao points in patients with erectile dysfunction after stroke. METHODS: A total of 58 patients with erectile dysfunction after stroke were randomly divided into an observation group (29 cases, 1 case dropped off, 1 case discontinued) and a control group (29 cases, 1 case dropped off). Both groups were given basic treatment, including routine medical treatment, routine acupuncture treatment, rehabilitation training and pelvic floor biofeedback electrical stimulation treatment. The observation group was treated with electroacupuncture at Baliao points, and the control group was treated with shallow acupuncture combined with electroacupuncture at the control points (8 points at 20 mm horizontally beside Baliao points), continuous wave, frequency in 50 Hz, current intensity in 1-5 mA, 5 times a week for 4 weeks. The 5-item version of the international index of erectile function (IIEF-5) score, erectile dysfunction effect on quality of life (ED-EQoL) score and pelvic floor muscle contraction amplitude were compared between the two groups before and after treatment. RESULTS: After treatment, the IIEF-5 scores and the contraction amplitude of fast muscle fiber, comprehensive muscle fiber and slow muscle fiber in the two groups were higher than those before treatment (P<0.05), the ED-EQoL scores were lower than those before treatment (P<0.05), and the changes of above indexes in the observation group were larger than the control group (P<0.05). CONCLUSION: Electroacupuncture at Baliao points can improve the erectile function of patients with erectile dysfunction after stroke, increase the contraction amplitude of pelvic floor muscles, and promote the quality of life of patients.

[Effect of abdominal penetrating moxibustion on function of core muscle group in stroke patients based on surface electromyography].

OBJECTIVE: To observe the effect of abdominal penetrating moxibustion on strength and endurance of core muscle group in patients with stroke. METHODS: Sixty-two patients with stroke were randomly divided into an observation group (31 cases, 2 cases dropped off) and a control group (31 cases, 2 cases dropped off). The patients in the control group were treated with routine basic treatment, acupuncture treatment and rehabilitation training; based on the treatment of the control group, the patients in the observation group were treated with abdominal penetrating moxibustion, approximately 50 min each time, once a day. The treatments in the two groups were given 5 times a week for 4 weeks. The root mean square (RMS) and median frequency (MF) of bilateral transverse abdominis and multifidus of performing sitting-standing and making steps were measured by surface electromyography before and after treatment. The postural assessment scale for stroke (PASS), Berg balance scale (BBS) and lower-limb Fugl-Meyer motor assessment (FMA) scores were observed before treatment, 2 weeks into treatment and 4 weeks into treatment. RESULTS: Compared before treatment, when performing different postures, the RMS and MF of bilateral transversus abdominis and multifidus in the two groups were increased after treatment (P<0.01, P<0.05). The RMS of affected-side transversus abdominis and multifidus and the MF value of bilateral transverse abdominis and multifidus in the observation group were higher than those in the control group (P<0.05). Compared before treatment, the PASS, BBS and FMA scores were increased 4 weeks into treatment in the two groups (P<0.01), and those in the observation group were higher than the control group (P<0.01). CONCLUSION: The abdominal penetrating moxibustion could effectively improve the strength and endurance of core muscle group, improve the posture control, balance ability and lower-limb motor function in patients with stroke.

[Impact of abdominal moxibustion in a period of day from 7 am to 9 am on improvement in post-stroke lower limb spasticity and muscle architecture parameter].

OBJECTIVE: To compare the therapeutic effect on post-stroke lower limb spasticity between the combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training and the simple rehabilitation training. METHODS: A total of 100 patients with post-stroke lower limb spasticity were randomized into an observation group (50 cases, 3 cases dropped off) and a control group (50 cases, 4 cases dropped off ). In the control group, the basic treatment of internal medicine and rehabilitation training of the limbs were adopted. In the observation group, on the basis of the treatment in the control group, at the time zone from 7 am to 9 am, moxibustion on the abdomen with "eight-trigram" moxa box [the central moxa box accurately facing Shenque (CV 8)] was given, lasting for 2 h, once every two days. Both groups were treated for 6 weeks. Separately, before and after treatment, the score of Fugl-Meyer assessment of the lower extremity (FMA-LE) and the grade of modified Ashworth scale (MAS) of ankle joint were evaluated on the affected side in patients of the two groups. Muscle skeleton ultrasound (MSUS) was adopted to determine the first layer muscle thickness (MT) anterior to the tibia, the number of pennation angle (PA) and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side. Besides, after treatment, the therapeutic effect was evaluated in the two groups. RESULTS: After treatment, the score of FMA-LE and the grade of MAS of ankle joint on the affected side were both improved as compared with those before treatment in patients of the two groups (P<0.01, P<0.05). The improvements in the observation group were better than those in the control group (P<0.01, P<0.05). After treatment, MT anterior to the tibia, the number of PA and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side were all increased as compared with before treatment in patients of the two groups (P<0.01). The increase degree in the observation group was larger than that in the control group (P<0.01). The total effective rate was 93.6% (44/47) in the observation group, better than 80.4% (37/46) in the control group (P<0.05). CONCLUSION: The combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training effectively relieves post-stroke lower limb spasticity and improves the limb functions and muscle structure. The total effective rate of this combined treatment is better than that of simple rehabilitation training.

[Effect of jiaotong qiaomai needling technique of acupuncture on the morphology of lower limb muscle based on muscle-skeleton ultrasound measurement in patients with post-stroke strephenopodia].

OBJECTIVE: To evaluate the therapeutic effect on post-stroke strephenopodia treated with jiaotong qiaomai (harmonizing the heel vessel) needling technique of acupuncture. METHODS: A total of 64 patients were randomized into an observation group (30 cases included, 2 cases dropped off) and a control group (30 cases included, 2 cases dropped off). In the control group, the routine needling technique of acupuncture and rehabilitation exercise were provided. In the observation group, on the base of the therapeutic regimen as the control group, the jiaotong qiaomai needling technique of acupuncture was added. Fengchi (GB 20), Rangu (KI 2), Zhaohai (KI 6) on the affected side and Fengfu (GV 16) were selected. The treatment was given once daily, 5 times a week, for 4 weeks totally in either group. Separately, before treatment, in 2 weeks and 4 weeks of treatment, the strephenopodia angle was measured and Holden functional ambulation classification (FAC) was evaluated in the patients. Additionally, before treatment and in 4 weeks of treatment, the muscle-skeleton ultrasound was adopted to measure the thickness of anterior tibia muscle and posterior tibia muscle in the resting state of the patients. RESULTS: The strephenopodia angle and Holden FAC were all improved after 4-week treatment in the two groups as compared with those before treatment (P<0.01, P<0.05), and the results in the observation group were better than those in the control group (P<0.01, P<0.05). Before treatment, the thickness of anterior tibia muscle and posterior tibia muscle on the healthy side was higher than that on the affected side in the patients of the two groups (P<0.05). After treatment, the thickness of anterior tibia muscle and posterior tibia muscle on the affected side was increased as compared with that before treatment in the two groups (P<0.01, P<0.05). The thickness on the healthy side was similar before and after treatment in the observation group (P>0.05), and it was increased on the healthy side after treatment as compared with that before treatment in the control group (P<0.05). After treatment, the thickness of anterior tibia muscle and posterior tibia muscle on the affected side was similar to that on the healthy side in the two groups (P>0.05), and the thickness on the affected side in the observation group was higher than that in the control group after treatment (P<0.05). CONCLUSION: The jiaotong qiaomai needling technique of acupuncture effectively improves the strephenopodia angle and ambulation function, as well as the morphology of anterior tibia muscle and posterior tibia muscle in the patients with post-stroke strephenopodia.

[Effect of electronic moxibustion on activity of parapharyngeal wall in patients with achalasia of cricopharyngeus muscle after stroke based on musculoskeletal ultrasound].

OBJECTIVE: To observe the clinical effect of electronic moxibustion on dysphagia in patients with achalasia of cricopharyngeus muscle after stroke. METHODS: Sixty patients with dysphagia of achalasia of cricopharyngeus muscle were randomly divided into an observation group and a control group, 30 cases in each group. One patient in the observation group and 2 cases in the control group dropped off. The patients in the control group were treated with routine medical treatment, acupuncture treatment and swallowing rehabilitation training; the patients in the observation group were additionally treated with electronic moxibustion at Lianquan (CV 23), Tiantu (CV 22), Tianding (LI 17) and Futu (LI 18), 30 min each treatment. Both groups were treated 5 times a week for 4 weeks. The musculoskeletal ultrasound (MSUS) was applied to test the activity of parapharyngeal wall and the dysphagia score of Ichiro Fujishima was compared before and after 4-week treatment. RESULTS: After treatment, the activity of the parapharyngeal wall and the dysphagia score of Ichiro Fujishima were increased in both groups (P<0.01, P<0.05). The changes of activity of parapharyngeal wall and dysphagia score of Ichiro Fujishima in the observation group were greater than the control group (P<0.05, P<0.01). CONCLUSION: Electronic moxibustion can improve the impaired swallowing function and reconstruct the normal swallowing process.

[Effect of SU Jia-fu's Wenjing Tongdu external treatment combined with long-snake moxibustion at governor vessel on urodynamic for neurogenic bladder after spinal cord injury].

OBJECTIVE: To observe the clinical efficacy of SU Jia-fu's Wenjing Tongdu external treatment combined with long-snake moxibustion at the governor vessel for neurogenic bladder after spinal cord injury. METHODS: A total of 64 patients with neurogenic bladder after spinal cord injury were randomly divided into an observation group and a control group, 32 cases in each group. The patients in the control group were treated with routine acupuncture and rehabilitation of bladder function; based on the treatment in the control group, the patients in the observation group were treated with SU Jia-fu's Wenjing Tongdu external treatment combined with long-snake moxibustion at the governor vessel, twice a week for 8 weeks. Urodynamic test, including residual urine volume (RUV), maximum flow rate of urination (Qmax), bladder pressure at filling phase (Pves), maximum detrusor pressure (Pdet-max) and maximum urinary bladder volume (VMCC), was performed before and after 8-week treatment. RESULTS: The urodynamic indexes in the two groups were improved compared with before treatment (P<0.01, P<0.05); after treatment, VMCC in the observation group was significantly higher than the control group (P<0.01), while RUV and Pves in the observation group were significantly lower than the control group (P<0.05). After treatment, there was no significant difference in Qmax and Pdet-max between the two groups (P>0.05). CONCLUSION: Based on routine acupuncture and rehabilitation of bladder function, SU Jia-fu's Wenjing Tongdu external treatment combined with long-snake moxibustion at the governor vessel could effectively improve urodynamic indexes, reduce residual urine, reduce bladder pressure and increase the maximum capacity of bladder, thereby improving bladder compliance and bladder function.

[Comparative study on function and surface electromyograpgy in patients of lumbar disc herniation treated with acupunctrue and moxibustion].

OBJECTIVE: To compare the differences in the clinical function and lumbar and abdominal myodynamia in patiants of lumbar disc herniation treated with moxibustion at Dazhui (GV 14) and Guanyuan (CV 4) and acupuncture. METHODS: Forty cases were randomized into a moxibustion group and an acupuncture group, 20 cases in each group. In the moxibustion group, the warm moxibustion was applied alternatively at Dazhui (GV 14) and Guanyuan (CV 4) once every other day, 1 h each time, once every day. In the acupuncture group, acupuncture was applied to the corresponding acupoints based on the affected lumbar vertebras, such as Jiaji (EX-B 2), Shens-hu (BL 23), Dachangshu (BL 25) and Huantiao (GB 30), etc. , once evey day 30 min each time. The treatment for 3 weeks was taken as one session in each group. Totally, one session treatment was required. Surface electromyography (SEMG) of bilateral paraspinal muscle and rectus muscle, and JOA score of low back pain were observed in the two groups. RESULTS: (1) JOA score: the score of subjective symptoms, score of activity of daily living (ADL) and total score were improved obviously as compared with those before treatment in the two groups (P<0.01, P<0.05). The results of subjective symptoms score, score of ADL and total score in the acupuncture group were superior to those in the moxibustion group after treatment (6.95+/-0.94 vs 5.50 +/-0.89,10. 90+/-1.86 vs 8.90+/- 1. 92,22.50 +/- 2.82 vs 19.35 +/- 2. 70, all P<0. 05). (2) SEMG comparison: root-mean-square value (RMS) was all reduced in SEMG of the anteflexion, rear protraction, orthostatism, bilateral bending and neck and leg rear flexion for strengthening lumbar muscle as compared with those before treatment in the two groups (P< 0.05, P<0. 01). RMS of the anteflexion and bilateral bending in the acupunture group were reduced much obviously as compared with the moxibustion group. In terms of sitting position anteflexion, rear protraction, orthostatism, bilateral bending and neck and leg rear flexion for strengthening lumbar muscle, median frequency (MF) after treatment was all improved as compared with that before treatment in the two groups (P<0. 05, P<0. 01). In terms of anteflexion, the electrode MF after treatment was improved much obviously in the acupuncture group(P<0. 05). CONCLUSION: Moxibustion at Dazhui (GV 14) and Guanyuan (CV 4) and conventional acupuncture all improve muscle function, relieve muscle fatigue, increase the ability of anti-muscle fatigue, strengthen lumbar vertebral stability, release subjective symptoms and improve ADL. But, the effects of moxibustion are slightly lower than those of acupuncture.

[Chief physician SU Jia-Fu's academic experiences].

Chief physician SU Jia-fu is engaged in clinical work for more than 40 years, forming his own unique acupuncture therapeutic method. He emphasizes the syndrome differentiation in terms of meridians and collaterals and taking unblocked transmission as normal functional state of six Fu-organs, and thinks that the affection characteristic and rule about the circulation parts of meridians and the pertaining organ should be known so as to guide acupuncture treatment; in manipulation of acupuncture, he emphasizes that the key is to grasp lifting and thrusting, twirling and rotating, and keeping vitality; in theatment, he attaches importance to blood-letting puncture from its methods, patients' reaction, blood volume and dynamic state of bleeding and emphasizes that this treatment has special efficacy in pain syndrome.