Parkinson's disease (PD) , as one of the most common neurodegenerative diseases, has become a global medical problem due to the obvious adverse reaction of drug treatment and the reduced efficacy of long-term use. Guasha is one of the widely used non-drug therapies of traditional Chinese medicine (TCM) with unique advantages in the treatment of nervous system diseases. At present, there are few studies on the treatment of idiopathic PD with Guasha combined with drug therapy.
To explore the short-term clinical effect of Guasha combined with drug therapy for idiopathic PD.
Sixteen patients with idiopathic PD in the early and middle stages selected by the purposive sampling method from March 2021 to September 2021 in outpatients of Nanjing Hospital of Chinese Medicine and Jiangsu Province Hospital were selected as the observation group, and another 16 patients with idiopathic PD were selected as the control group according to the principle of matching gender, age, course of disease and Hoehn-Yahr stage. The observation group was treated with Guasha combined with western medicine orally for 4 weeks as a course of treatment; after 3 courses of treatment, Guasha was stopped and western medicine orally continued for 1 course of treatment as follow-up. The control group was treated with simple western medicine orally for 4 weeks as a course of treatment, and the last one of 4 courses of treatment was recorded as follow-up. After 3 months of treatment and 1 month of follow-up, the Movement Disorder Society-Unified Parkinson's Disease Rating ScaleⅢ (MDS-UPDRSⅢ) score, Non-motor Symptom Score (NMSS) and clinical efficacy were observed. The levels of serum interleukin-1β (IL-1β) and nuclear transcription factor κB (NF-κB) were observed after 3 months of treatment.
After 3 months of treatment, the scores of MDS-UPDRS Ⅲ and NMSS, and the levels of serum IL-1β and NF-κB in two groups were lower than those before treatment (P<0.05) . After 1 month of follow-up, the scores of MDS-UPDRS Ⅲ and NMSS in two groups were lower than those before treatment (P<0.001) . The score of MDS-UPDRSⅢ of the control group at 1-month follow-up was lower than that at 3 months (P<0.001) . The score of NMSS of the observation group at 1-month follow-up was higher than that at 3 months (P=0.002) . The scores of MDS-UPDRSⅢ and NMSS in the observation group were lower than those in the control group after 3 months of treatment and 1 month of follow-up, and the differences were all statistically significant (P<0.05) . The levels of serum IL-1β and NF-κB in the observation group were lower than those in the control group after treatment (P<0.05) . After 3 months of treatment and 1 month of follow-up, the clinical efficacy of the observation group was better than that of the control group (Z=-3.651, -3.468, P<0.05) .
It is safe and feasible for Guasha combined with drug therapy in the treatment of idiopathic PD patients at the early and middle stage, which can improve some motor dysfunction and alleviate non-motor symptoms and significantly improve the clinical efficacy. However, its long-term efficacy needs to be further explored by large sample and multi-center studies.
Cerebral infarction often leads to lower limb motor dysfunction and reduces patients' quality of life. Previous studies have shown that acupuncture combined with mirror therapy can improve lower limb dysfunction in patients with cerebral infarction, but there are few studies and the evaluation methods need to be supplemented.
To analyse the clinical efficacy of Jin's three needles therapy combined with mirror therapy in the treatment of lower limb dysfunction in patients with cerebral infarction based on surface electromyography (sEMG) .
Ninety lower limb dysfunction with cerebral infarction patients in the Department of Rehabilitation Medicine and the Department of Neurology of Shenzhen Hospital of Southern Medical University from July to December in 2022 were selected as the study subjects and divided into the Jin's three needles therapy group, mirror therapy group and Jin's three needles therapy combined with mirror therapy group. Patients in all three groups received basic treatment, Jin's three needles therapy was added to the Jin's three needles therapy group, knee mirror training was added to the mirror therapy group, and the Jin's three needles therapy and knee mirror training were both added to the Jin's three needles therapy combined with mirror therapy group. All three groups were treated once/d, 5 times/week, for a total of 4 weeks. sEMG was used to evaluate the function of the lower limb muscle and nervous system of the affected side before and after treatment, including time-domain index〔root mean square (RMS) 〕 and frequency-domain index〔median frequency (MF) 〕. Lower limb motor function was assessed using the Fugl-Meyer Assessment-Lower Extremity (FMA-LE) .
There was no statistically significant difference in the scores of RMS and MF of biceps femoris, anterior tibial muscle, rectus femoris and gastrocnemius muscle in the affected side after 4 weeks of treatment between the mirror therapy group and the Jin's three-needle therapy group (P>0.05) . The scores of RMS and MF of biceps femoris, anterior tibial muscle, rectus femoris and gastrocnemius of the affected side after 4 weeks of treatment in the Jin's three-needle therapy combined with mirror therapy group were higher than those in the Jin's three needles therapy and mirror therapy group (P<0.05) . The FMA-LE scores of patients after 4 weeks of treatment in the Jin's three needles therapy combined with mirror therapy group were higher than those in the Jin's three-needle therapy and mirror therapy groups (P<0.05) .
Compared with the Jin's three-needle therapy or mirror therapy, Jin's three-needle therapy combined with mirror therapy can more effectively improve the lower limb muscle nervous system function and motor function of patients with cerebral infarction.
