The Effect of Acupuncture Intervention at Different Time on Limb Motor Dysfunction of Acute Ischemic Stroke:A Multicenter,Prospective Cohort Study
Objectives To investigate the effect of acupuncture intervention at different time during the acute phase of ischemic stroke on limb motor dysfunction 6 months after onset.Methods The enrolled ischemic stroke patients from four tertiary hospitals all received western basic treatment for ≥ 14 days;additionally,they were given the cleaning-mind and opening-orifices acupuncture method,with acupuncture at bilateral Neiguan(PC 6),Shuigou(GV 26),and Sanyinjiao(SP 6)of the affected side,once a day for at least 2 times.Three cohorts were formed by the timing of acupuncture intervention of the onset of the disease within 10 days,namely,the acupuncture group of 1-3 days after onset of the disease(195 cases),the acupuncture group of 4-7 days after onset of the disease(171 cases),and the acupuncture group of 8-10 days after onset of the disease(96 cases).Propensity score matching was performed using R4.3.3 software,and there were 89 patients in each of the three groups after matching.Modified Rankin Scale(mRS)score,Fugl-Meyer Scale(FMA)score,EuroQoL 5-Dimension 5-Level(EQ-5D-5L)score and the proportion of good functional outcome were observed in the 3 groups of patients before treatment and 6 months after onset.A logistic regression model was constructed to analyse the effect of the timing of acupuncture intervention on the effectiveness of acupuncture treatment for limb motor dysfunction in ischaemic stroke.Results Compared with the pre-treatment of this group,mRS and EQ-5D-5L scores decreased and FMA increased in all three groups 6 months after onset(P＜0.01),and all the indexes of the onset 1-3 days acupuncture group and the onset 4-7 days acupunc-ture group were better than those of the onset 8-10 days acupuncture group(P＜0.05).The proportions of good func-tional outcome in the onset 1-3 days acupuncture group,the onset 4-7 days acupuncture group,and the onset 8-10 days acupuncture group were 76.40％,80.90％,and 57.30％,respectively,and the proportions of good functional outcome in the onset 1-3 days acupuncture group and the onset 4-7 days acupuncture group were significantly higher than those in the onset 8-10 days acupuncture group(P＜0.05).Multifactorial logistic analysis showed that compared with the group with 8-10 days of onset,the group with 1-3 days of onset(OR=2.796,95％CI:1.340～5.836,P=0.006),and the group with 4-7 days of onset(0R=3.482,95％CI:1.647～7.362,P=0.001)increased the likeli-hood that patients would be nondisabled 6 months after onset.Conclusion The intervention of cleaning-mind and opening-orifices acupuncture within 1-7 days of onset for patients with acute ischemic stroke can reduce the rate of disability 6 months after onset,improve limb motor function,and enhance the quality of life.
ischemic strokeacute phaselimb motor dysfunctionacupunctureclean the mind and open the orificestiming of interventioncohort study
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