OBJECTIVETo observe the effects between acupuncture combined with rehabilitation and simple rehabilitation for shoulder pain after stroke, and to select the best plan of acupuncture manipulations at different stages by orthogonal design.

METHODSNinety patients were treated with comprehensive rehabilitation, and nine cases without acupuncture were arranged into a control group. Eighty-one patients of orthogonal design were applied by acupuncture with the same acupoints and course. The VAS score and its weighted value were regarded as the observation indices,and the effects between the acupuncture group and the control group were compared. The optimal plans of acupuncture manipulations of the early stage and the later stage were chosen after the first course treatment and the third course treatment separately. The acupuncture depth (factor A:A: shallow depth less than 25 mm, A(II): modest depth 25-40 mm, A(III): deep depth 40-50 mm), the acupuncture angle (factor B:B(I): perpendicular insertion, B(II): horizontal insertion, B(III): oblique insertion), needle manipulated frequency (factor C: C(I): zero time, C(II): one time, C(III): three times) and needle retained time(factor D:D(I):20 min, D(II): 30 min, D(III): 60 min) were studied. The differences among all factors and the diversity among major factors at different stages were analyzed.

RESULTS(1) Acupuncture combined with rehabilitation at the early and the later stage acquired better improvement than simple rehabilitation (all P < 0.01). (2) The optimal acupuncture manipulation plan at the early stage was A(III) B(III) C(I) D(I), which was deep acupuncture and oblique insertion for 20 min with zero-time manipulation; the optimal acupuncture manipulation plan at the later stage was A(III) B(III) C(III) D(I), which was deep acupuncture and oblique insertion for 20 min with three-time manipulation. (3) There was significance for acupuncture depth and angle at the early stage (both P < 0.01) and there was significance for insertion depth, acupuncture angle and manipulating frequency at the later stage (all P < 0.05). (4) At the early stage, the insertion depth was statistically significant between A(I) and A(II), A(I) and A(III), A(II) and A(III) (P < 0.05, P < 0.01), and the statistical significance was existed between B(I) and B(III) (P < 0.01). At the later stage, the insertion depth was statistically significant between A(I) and A(III), A(III) and A(II), A(I) and A(II) (P < 0.05, P < 0.01), and the statistical significance was existed between C(I) and C(III), C(II) and C(III) (P < 0.05).

CONCLUSIONAcupuncture combined with rehabilitation acquire apparent effect for shoulder pain after stroke. At the early stage,the optimal plan is deep and oblique insertion for 20 min with zero-time manipulation. At the later stage, the best plan is deep and oblique insertion for 20 min with 3-time manipulation.

Acupuncture Therapy ; Aged ; Aged, 80 and over ; Combined Modality Therapy ; Female ; Humans ; Male ; Middle Aged ; Shoulder Pain ; etiology ; rehabilitation ; therapy ; Stroke ; complications ; Treatment Outcome

Objective: to select the optimal acupuncture therapeutic projects on cerebral infarction-related motor dysfunction of lower limbs. Methods: to optimize the combination projects on 4 factors and 3 levels affecting the acupuncture effect on cerebral infarction by using orthogonal design targeting on patients with cerebral infarction-related motor dysfunction of lower limbs, and Fugl-Meyer score of limb motor function was taken as indexes. Results: The relatively optimal Fugl-Meyer score of lower limb function can be obtained within 3-day duration of cerebral infarction. Conclusions: As far as the considered factors and levels are concerned, the previously mentioned project is the optimal acupuncture therapeutic project for cerebral infarction-related motor dysfunction of lower limbs.

Motion style acupuncture is generally used in combination with the movement therapy of affected parts in the process of needle acupuncture. In the process of acupuncture, the "movement" of the affected part can play a targeted guiding role in "spirit" and "Qi", It can lead the mind (spirit) and Qi to the place of disease, so as to achieve the realm of "treating spirit", "guiding Qi" and "keeping Qi", and eliminate diseases by activating the self-healing force of the human body. It is not only an important operation method of this acupuncture, but also the core idea and the key to take effect. In this acupuncture method, local acupoints or acupoints on the distal unaffected side are selected for acupuncture. The exercise methods include active and passive exercise. In the treatment of depression syndrome, hiccup, angina pectoris and other medical diseases, they often cooperate with respiratory exercise, as well as massage and self feeling. This acupuncture method is mostly used in the treatment of orthopedic and traumatological diseases, and can also treat facial paralysis, depression, anxiety, stroke and stroke sequelae, hiccup, angina pectoris and other medical diseases. It is less used in gynecology, or facial features. The treatment effect is better than simple acupuncture. It can also be combined with electroacupuncture, Traditional Chinese Medicine and Western medicine to improve the curative effect. In the future, it is necessary to further explore the relevant dominant diseases and explore the exercise methods more suitable for the relevant diseases. More attention should also be paid to the thinking of exercise inducing Qi and the concept of treating God contained in this acupuncture method.

The literature and relevant books on the scalp needling schools were retrieved to collect the main scalp needling schools and compare the point location principles and needling techniques so as to optimize the scalp needling scheme. Currently there are ten major schools of scalp acupuncture, representing for example by,and, etc. The principles of stimulating localization are different among the schools, in which,'s skull line localization is mainly for the treatment of cerebrovascular diseases,prefers the penetrating technique for the treatment of pain and mental disorders according to traditional meridian theory, and the other schools take the cortical functions into account for the stimulating localization. Regarding needling techniques,stresses on the deep puncture to the periosteum, and the rest school masters puncture beneath the bonnet aponeurosis. The quick rotation of needle is required in's scalp needling,'s skull needle,and the needling technique for opening brain and promotion collateral. The long-term needle retaining is required in's scalp needling and's scalp needling. It is believed that the stimulating localization principles are not standardized, the theoretic evidences are not clear and the needling depth is different among the schools. There are no standard criteria on needling angle, depth, direction, rotating speed and needle retaining time. The evidence-based medicine is recommended. Through strict scientific design, based on the clinical and experimental evidences, it is required to determine the theoretic scientific evidence of scalp acupuncture, the specificity of stimulating areas, the effective stimulating areas and quantify the needling manipulations and clarify the optimal scheme of scalp needling.

The acupuncture direction is closely related with the efficacy of acupuncture analgesia. In this article, the relationship between efficacy of acupuncture analgesia and factors, such as whether the needle towards disease location, whether the needle towards meridian direction, whether the needle following spinal cord direction and whether the needle following muscle direction, were analyzed. The previous clinical and literature research indicated that the needle towards disease location was superior to reverse direction, however, the efficacy of analgesia between needle following and reversing meridian, needle towards and at disease location, needles following and reversing spinal cord direction, needles following and reversing muscle direction was controversial. Therefore, the solutions to these problems will benefit the optimized acupuncture treatment plan for pain disorders.

The progress of acupoint research on acupuncture treatment for acute migraine was reviewed in terms of acupoint selection of traditional medicine, acupoint selection of modern medicine and comprehensive method. Seven factors of the acupoint selection were analyzed, such as meridian tropism, acupoint property and disorders. The key issues on the optimal acupoint selection scheme were explored. It was believed that the relevant specificity was displayed in the acupoint selection for acute migraine treated with acupuncture. The specificity of it was reflected not only on the meridians and acupoints in TCM, but also on the relevant specificity of acupoints in modern medicine theory. The shortages and the gaps in the current research situation of acupoint selection were analyzed. The optimized approaches to acupoint selection are proposed in the aspects of TCM, modern medicine and the integrated medicine so that a higher stage of the research on acupoint selection is anticipated.
Acupuncture Points ; Humans ; Meridians ; Migraine Disorders ; therapy