Objective: To observe the effect of standardized Jin's three-needle therapy on limb motor function and nerve function defect in stroke patients, and to evaluate the placebo control method.
Methods: A total of 66 patients with stroke were randomly divided into a Jin's three-needle group (33 cases, 3 cases dropped off) and a placebo needle group (33 cases, 4 cases dropped off). All the patients were treated with conventional medication and rehabilitation treatment. In addition, the patients in the Jin's three-needle group were treated with standardized Jin's three-needle therapy at temporal three points, spirit four points, hand three points, foot three points, upper extremity spasm three points, lower extremity spasm three points, etc.; while the patients in the placebo needle group were treated with placebo needling at identical points. All the treatments were given once a day, 5 days a week, and 3-week treatment was given with an interval of 2 days between weeks. The scores of Fugl-Meyer assessment scale (FMA) and National Institutes of Health stroke scale (NIHSS) were observed before treatment, 10 d and 21 d into treatment, and the blind evaluation was conducted after treatment.
Results: On the 10 d and 21 d into treatment, the FMA scores in both groups were higher than those before treatment (P<0.01), and the NIHSS scores were lower than those before treatment (P<0.01). On the 10 d and 21 d into treatment, the FMA scores in the Jin's three-needle group were higher than those in the placebo needle group (P<0.05); on the 10 d into treatment, the NIHSS score in the Jin's three-needle group was were lower than that in the placebo needle group (P<0.05). There was no significant difference between the two groups on judging the type of treatment (P>0.05), and the consistency with the real situation was poor (Cohen's kappa coefficient<0.20).
Conclusion: The standardized Jin's three-needle therapy could effectively improve the limb motor function and nerve function defect in stroke patients. The placebo control method used in this study shows good clinical operability and masking effect.
目的：观察规范化靳三针对脑卒中患者肢体运动功能及神经功能缺损的影响，评价安慰对照方法。方法：将66例脑卒中患者随机分为靳三针组（33例，脱落3例）和安慰针组（33例，脱落4例）。两组均接受常规药物及康复治疗，靳三针组予规范化靳三针治疗，穴取四神针、颞三针、手三针、足三针、上肢挛三针、下肢挛三针等；安慰针组予安慰针治疗，取穴同靳三针组，均每天1次，每周5 d，休息2 d，共治疗3周。观察两组患者治疗前、治疗第10天、治疗第21天Fugl-Meyer评定量表（FMA）、美国国立卫生研究院卒中量表（NIHSS）评分，并于治疗结束后对患者进行盲态测评。结果：治疗第10、21天，两组FMA评分均较治疗前升高（P<0.01），NIHSS评分均较治疗前降低（P<0.01）。治疗第10、21天，靳三针组FMA评分高于安慰针组（P<0.05）；治疗第10天，靳三针组NIHSS评分低于安慰针组（P<0.05）。两组患者对治疗类型的判断差异无统计学意义（P>0.05），且与真实情况的一致性差（Cohen's kappa系数<0.20）。结论：规范化靳三针治疗能有效改善脑卒中患者肢体运动功能及神经功能缺损，本研究所采用的安慰对照方法具有较好的临床可操作性及蒙蔽效应。.
Keywords: Jin's three-needle; motor function; nerve function defect; placebo needling; stroke.