1.Retrospective analysis on acupuncture in treatment of cerebral infarction evaluated with propensity score.
Junming FAN ; Shan QIAO ; Peng LIU ; Yongshu DONG ; Wei feng CUI
Chinese Acupuncture & Moxibustion 2015;35(1):72-76
The actual efficacy of acupuncture on cerebral infarction was explored in clinical practice. The retro spective cohort study was adopted to investigate 344 cases via inpatient's medical cases. According to whether acupuncture was received or not, an acupuncture group (207 cases) and a non-acupuncture group (137 cases) were divided. The matching method, regression method and weighting method of propensity score (PS) were adopted, and the efficacy on muscle strength was taken as effect index so that the specific impacts of acupuncture were ex plored on the muscle strength in the patients of cerebral infarction. Before matching, COX regression model and Logistic regression model were used. And PS hierarchical regression, PS inverse probability weighting method (IPTW) and PS standardized mortality weighting method (SMRW) were applied to the analysis on the relationship between the muscle strengthen changes and the total effective rate in the two groups. It was found that the efficacy in the acupuncture group was better than that in the non-acupuncture group, indicating the significant difference (P<0.05). Meanwhile, the rehabilitation therapy also brought the obvious impacts on the efficacy evaluation (OR=2.737, P=0.0055). After PS matching, the Logistic regression model was used to analyze whether acupuncture or rehabilitation therapy impacted the total effective rate of muscle strength. The results showed that the efficacy was impacted apparently with the rehabilitation therapy involved (OR=2.930, P=0.0247). Without the rehabilitation effect considered, the efficacy in the acupuncture group was better potentially than that in the non-acupuncture group, but without significant difference (OR=2. 235, P=0,058 7). All of these indicate that on the basis of routine treatment, without the effect of rehabilitation therapy considered, acupuncture improves in tenden cy of the muscle strength of the patients with cerebral infarction. However, it is expected to increase the study medical cases for further verification.
Acupuncture Points
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Acupuncture Therapy
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Adult
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Aged
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Aged, 80 and over
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Cerebral Infarction
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physiopathology
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therapy
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Female
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Humans
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Male
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Middle Aged
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Muscle Strength
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Propensity Score
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Retrospective Studies
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Treatment Outcome
2.Characteristics of TCM syndrome elements and syndromes of hypertension with insomnia in the real world
Chunqiu ZHU ; Xiaoya LI ; Hui LI ; Junming FAN ; Hui QING ; Yongshu DONG ; Weifeng CUI
International Journal of Traditional Chinese Medicine 2023;45(12):1482-1489
Objective:To analyze the distribution of TCM syndrome elements and syndromes in patients with hypertension with insomnia (HWI) in the real world.Methods:A cross-sectional study and retrospectively enrolled. The positive symptoms and TCM syndrome type entries of 359 patients with HWI who were collected from Henan Integrated Medicine Hospital,Henan Provincial People's Hospital,the First Affiliated Hospital of Henan University of Chinese Medicine from December 2020 to August 2022 were retrospectively studied. Based on factor analysis dimension reduction and systematic cluster analysis, the TCM syndrome elements and potential syndrome types of patients were summarized. The Latern 5.0 software was used to establish a latent structure model and comprehensive clustering based on the mountain climbing method (LTM-EAST) algorithm, and analyze and judge the common syndrome types, providing a basis for proposing the clinical common syndrome types of this disease.Results:Factor analysis extracted 14 common factors, and the cumulative contribution rate was 63.254%. Among the 36 symptom variables with frequency ≥ 70, more than half of the patients with hypertension and insomnia were upset, irritable, less sleepy, dreamy, dizzy, palpitations, stuffy chest, dry mouth, easy to wake up, and tired. The tongue color was mainly light red tongue and red tongue. The tongue is mainly thin and greasy. The first three pulse conditions are string pulse, number pulse and slippery pulse. The disease location and syndrome elements of hypertension with insomnia were mainly liver (52.09%), heart (33.43%), spleen (26.46%) and kidney (23.68%); The disease syndrome elements are mainly phlegm dampness (34.54%), yin deficiency (29.25%), heat (fire) (25.35%), and qi stagnation (25.07%). Ten syndrome types are obtained by frequency statistics, nine syndrome types are obtained by factor clustering, and seven syndrome types are inferred by implicit structure clustering. Among the syndrome types inferred by the above three methods, there are seven syndrome types that recur at least twice, which can be identified as the common syndrome type of hypertension with insomnia.Conclusions:The common clinical symptoms of HWI are upset and irritable, less sleep, more dreams, dizziness, palpitations, stuffy chest, dry mouth, easy to wake up, mental fatigue and body tiredness. The disease location and syndrome elements are mainly in liver, heart, spleen and kidney. The disease mainly involves phlegm dampness, yin deficiency, heat and qi stagnation. The common clinical syndrome types are liver depression transforming fire type, yin deficiency and yang hyperactivity type, phlegm dampness intrinsic type, yin deficiency and internal heat type, heart and gallbladder qi deficiency type, heart and spleen deficiency type, and heart kidney disjunction type.