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Treatment of 128 Cases of Apoplectic Hemiplegia with Scalp Acupuncture and


Treatment of 128 Cases of Apoplectic Hemiplegia with Scalp Acupuncture and Psychotherapy

Psychotherapy is referred to "mental treatment" in traditional Chinese medicine. In one chapter of History Of Liao Dynasty, it is recorded that "in treatment of accumulated heat in the heart, drugs may not work well, so, mental treatment is indicated". Psychotherapy contains various styles, that the author adopted in the present paper is" thought inducing method". The so-called scalp-acupuncture psychotherapy is that when manipu1ating the needle to evoke needling sensations, the practitioner guides the patient to have a thought of the affected limb-moving as normal situations. Since 1995, the author has adopted this therapy to treat apoplectic hemiplegia and achieved satisfactory results. Here is the summary of 128 cases with complete data.

CLINICAL DATA:
 All the 128 cases of apoplectic hemiplegia were out-patients and in-patients in the department of acup-moxibustion of our hospital. Among them, 75 cases were male and 53 female, ranging in age from 36 to 78 years. They were all examined by CT and diagnosed as cerebral infarction in 72 cases, encephalorrhagia 50 cases, cerebral embolism 4 cases, postoperation of cerebroma 2 cases. The shortest duration of disease was below 3 months in 69 cases, those from 3 to 6 months in 35 cases, from 6 months to one year in 16 cases and above 1 year in 8 cases. Complete hemiplegia was found in 45 cases whose myodynamia of both upper and lower limbs were zero and incomplete hemiplegia found in 83 cases whose myodynamia was from I to III. All the patients were conscious in thinking, stable in the state of disease and could cooperate with the doctors and nurses.

TREATMENT METHODS:
 1. Scalp-points
 According to International Standard of Scalp-point Nomenclature Of the People’s Republic Of China, Dingzhongxian (MS 5 ) and Dingnie Qianxiexian (MS 6) were used as the main points, combined with Dingnie Houxiexian (MS 7) for patients with numbness sensation in the affected limbs. Bilateral sides of the former two main scalp-points were used alternately based on the different therapeutic courses.

2. Manipulations
 After routine sterilization of both acupoints and acupuncture needles, took a gauge-30 filiform needle was taken and inserted rapidly into the scalp to reach the subgaleal layer at an angle of about 15 degrees between the needle body and the scalp, then the needle body was leveled and slowly advanced about 1 -- 1.2 cun deep. The needle was manipulated with "drawing-adding" method of Catechism on Acupuncture and Moxibustion, i. e., holding the inserted needle handle to lift it outward about 3-fen with a sudden force, 3 times altogether, then slowly pushing the needle forward again. The procedure was repeated again and again for a moment and then the needle was retained for 8 -- 24 hours. The needle in Dingzhongxian (MS 5 ) was inserted from Qianding (GV 21 ) and pushed forrward to reach Baihui (GV 20) and Dingnie Qianxiexian (MS 6) and Dingnie Houxiexian (MS 7) were punctured with relaying penetration needling, from the vertex to the temple, segment by segment.

3. Thought Inducing Method Before treatment, the patient was taught about common knowledge of making thinking activity. The surrounding circumstances was kept quiet and do not talk to the patient. The patient was asked to sit straight (or take a supine position if the patient could not sit), to relax the whole body, close the eyes and get rid of any distracting thoughts. After manipulating the needle for while, the practitioner started to trigger patient's thinking activity, i. e., ask the patient to think about his or her normal movement before onset of wind-stroke and try his or her best to move the affected limbs in mind, the lower limbs first then the upper limbs. Simultaneousy, the practitioner himself or herself shou1d also keep complete quiet, concentrate upon the needle-holding finger tips. Like this, the patient and the practitioner cooperated closely, and the procedures were repeated again and again for about 10 min. If warmth, soreness, distension or ant-running-like feeling or slight involuntary movement appeared in the affected limbs, it suggested that this therapy worked well. During the day when the needles were retaining, this thought inducing method was repeated 2 or 3 times. The treatment was given once every other day, with 10 sessions being a therapeutic course. The interval between two courses was 2 weeks. In the second therapeutic course, body acupoint needling was used in combination. If the patient's original myodynamia was alright, or myodynamia increased and the patient could do some voluntary movement after treatment, ask him or her to conduct voluntary movement exercise while the practitioner is manipulating the needle to induce needling sensations. 

In this way, the therapeutic effect might be raised. After acupuncture treatment, the patient was asked to perform various kinds of functional exercise about 5 -- 10 min or longer each time based on their own physical strength, myodynamia and mental state.

By Yu Gueqiao

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