Introduced in this issue
Stroke is "stroke", because of its rapid onset and rapid change characteristics, this kind of disease is like the wind in nature, "good deeds change", "unpredictable", ancient doctors analogy and called "stroke", in Chinese medicine treatment has a long history.
The program group of "Face to Face with Famous Doctors" specially invited Zhang Chong, deputy chief physician of the Acupuncture Rehabilitation Center of the First Affiliated Hospital of Guangzhou University of Chinese Medicine, to give you the understanding and prevention of stroke (stroke) in popular Chinese medicine.
1
Timing of rehabilitation intervention
After the onset of stroke, the condition is stable for 24 hours, and comprehensive rehabilitation can be carried out, and the golden period of rehabilitation is high within 3 months, and the sequelae period is called after 6 months, which can continue to promote the recovery of the patient's living ability.
Traditional Chinese medicine and acupuncture treatment, massage therapy, traditional Chinese medicine fumigation therapy, syndrome differentiation and treatment can be intervened in the whole process.
2
Good limb positioning, body position transfer, and range of motion training in the early stage of stroke
1. During stroke and bed rest, the patient should be placed in the good limb position: the affected side should be encouraged to lie in the appropriate healthy side position, the supine position should be used as little as possible, the semi-recumbent position should be avoided as much as possible, and the correct sitting posture should be maintained (level I recommendation).
2. Patients in the bedridden stage of stroke should gradually carry out postural transfer training with the help of nursing staff as soon as possible, and pay attention to safety issues (Level I recommendation).
3. Patients in the bedridden stage of stroke should adhere to limb joint range of motion training, and pay attention to protecting the affected limb to avoid mechanical injury (level I recommendation).
TCM Treatment:
Awaken the mind and open the body acupuncture
Middle meridians
Main acupoints: Neiguan, water ditch, three yin jiao.
Middle viscera (phlegm heat internal closure pattern, phlegm clear body pattern)
Acupuncture point selection: Neiguan, water ditch, twelve well points.
Tuina therapy
Massage in the early stage of stroke can prevent the occurrence of joint mobility and muscle spasms, and after the patient is stabilized in the acute phase, massage should be performed as soon as possible. Avoiding strong stimulation of the muscle groups in the spasmodic group during massage is a problem that should be paid attention to in hemiplegic massage.
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
3
Rehabilitation training for standing and walking in the early stage of stroke
Stable condition means that vital signs are stable and there is no progression within 48 hours (level I recommendation, level A evidence), early out-of-bed training, early sitting, sit-up training, and standing training are safe and feasible.
TCM Treatment:
Exercise acupuncture.
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
4
Rehabilitation of early language function after stroke
Communication disorders and their associated cognitive impairment are present in up to 40% of patients after stroke, with the most common communication disorders being aphasia and dysarthria. The necessary interventions help to maximize the recovery of communication skills.
TCM Treatment:
Periacupuncture in the scalp reflex area of the lesion is used for the treatment of stroke aphasia.
Methods: CT scans showed that the periphery of the vertical projection area of the scalp on the same side of the lesion was the acupuncture site, and the millineedle and perineedle were punctured. With acupoints dumb door, Lianquan, Tongli acupoints with flat mending and laxative techniques.
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
5
Rehabilitation of cognitive impairment after stroke
For cognitive impairment after stroke, MMSE and MoCA can be used to screen and assess their impact on rehabilitation and care (level II. recommendation, level B evidence).
Further cognitive function examination and rehabilitation after stroke can be carried out after the acute phase for detailed evaluation of cognitive impairment and targeted rehabilitation.
TCM Treatment:
"Jin three needles" needle method
Head needle: three temporal needles, four divine needles.
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
6
Rehabilitation and nutritional management of dysphagia after stroke
1. Patients with stroke should complete the standard clinical bedside evaluation of swallowing function as soon as possible (level I recommendation).
2. The water test can be used as one of the screening methods for the risk of aspiration in stroke patients (level I recommendation, level B evidence).
3. Patients with a positive clinical test result of a drinking water test are advised to use VFSS or FEES for further testing (level I recommendation, level A evidence).
4. For patients with dysphagia, it is recommended to use orbicularis oris muscle training, tongue exercise training, swallowing reflex enhancement training, throat exercise training, empty swallowing training, ice stimulation, neuromuscular electrical stimulation and other methods for swallowing function training (level II. recommendation, level B evidence).
TCM Treatment:
"Jin three needles" needle method
Three needles in the tongue
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
7
Cardiac and respiratory rehabilitation after stroke
Bed stillness early in stroke can lead to severe cardiovascular dysfunction.
Meta-analyses suggest that task-specific cardiovascular acclimatization training is beneficial after stroke, and that post-stroke acclimatization improves workload, walking speed, walking distance, and aerobic capacity.
TCM Treatment:
"Governor and Tune Spirit" stitching
Dumai acupuncture points: water ditch, Shenting, Baihui, Fengfu, Zhiyang, waist Yangguan, lifemen, etc.
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
8
Rehabilitation of shoulder pain, shoulder subluxation, and shoulder-hand syndrome after stroke
The incidence of shoulder subluxation in stroke patients is 17%~81%, and most of them are caused by decreased peripheral muscle tone and joint capsule relaxation within 3 months of onset.
Shoulder subluxation can be caused by improper treatment and care, lack of support in the upright position, and inappropriate care to distract the upper extremity. Prevention of shoulder subluxation is important. Once shoulder subluxation occurs, the treatment strategy is to prevent further deterioration, and methods such as local shoulder support devices, percutaneous electrical stimulation, and continuous shoulder position maintenance training are conducive to the prevention and treatment of shoulder subluxation.
TCM Treatment:
Qihuang acupuncture therapy
"Jin three needles" needle method
Shoulder three stitches
For specific personal constitution, please consult a practicing TCM physician in a regular hospital.
This issue of "Face to Face with Famous Doctors" program was broadcast live on Guangdong Radio and Television Zhujiang Economic Channel, Southern Life Radio, as well as the official Weibo of Guangdong Radio and Television Station, Guangdong TV Electric Shock News APP, Guangdong Listening APP, and Famous Doctor Face to Face Video Audio and Video Live Simultaneously, with a total of 80,000 views.
The program "Face to Face with Famous Doctors" was broadcast live from 10:00 a.m. to 11:00 a.m. on Guangdong Radio and Television Station's Pearl River Economic Channel, and from 4:00 p.m. to 5:00 p.m. on Southern Life Radio.
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Editor: Chen Junchao, Shi Jiawen (intern)