Clinical Study on Fire Dragon Cupping and Moxibustion Therapy Combined with Conventional Western Medicine for Stage I Shoulder-Hand Syndrome After Ischemic Stroke
Abstract: Objective: To observe the clinical effect of fire dragon cupping and moxibustion therapy combined with conventional western medicine therapy for stage I shoulder-hand syndrome (SHS) with phlegm-stasis obstruction syndrome after ischemic stroke, and its effects on motor function, hemorheology, endothelin-1 (ET-1), and calcitonin gene-related peptide (CGRP) expression. Methods:A total of 100 cases of patients with stage I SHS with phlegm-stasis obstruction syndrome after ischemic stroke admitted to the Department of Rehabilitation of Hangzhou Linping District First People′s Hospital from April 2023 to November 2024 were selected and divided into the routine group and the combination group according to the random number table method, with 50 cases in each group. The routine group received conventional western medicine treatments such as neuroprotection, nutritional support, antihypertensive, hypoglycemic, lipid-regulating, and cerebral circulation-improving therapies, along with Bobath rehabilitation therapy. The combination group received fire dragon cupping combined with moxibustion therapy in addition to the treatment in the routine group. Both groups were treated for four weeks continuously. The clinical efficacy, Simplified McGill Pain Questionnaire (SF-MPQ) scores [Pain Rating Index (PRI),Visual Analogue Scale (VAS) of pain, and Present Pain Intensity (PPI)], edema severity scores, Shoulder-Hand Syndrome Scale (SHSS) scores, upper limb motor function, activities of daily living, hemorheological parameters, and pain mediator levels were compared between the two groups before and after treatment. Results:After treatment,the total effective rate in the combination group was 92.00%( 46/50),which was significantly higher than 76.00%( 38/50) in the routine group( P< 0.05). The scores of PRI, VAS of pain, PPI, and SF-MPQ in the two groups were decreased when compared with those before treatment (P<0.05),with the combination group showing lower scores than the routine group (P<0.05). The upper limb Fugl-Meyer Assessment (FMA-UE) and Modified Barthel Index (MBI) scores in the two groups were increased when compared with those before treatment(P<0.05), with the combination group showing higher scores than the routine group (P<0.05). The edema severity scores in the two groups were decreased when compared with those before treatment (P<0.05),with the combination group showing lower scores than the routine group (P<0.05). The sensory,autonomic,motor,and total SHSS scores in the two groups were decreased when compared with those before treatment (P<0.05),with the combination group showing lower scores than the routine group (P<0.05). The hemorheological parameters, including high-shear whole blood viscosity, low-shear whole blood viscosity, plasma viscosity, fibrinogen concentration, and hematocrit, decreased in the two groups compared with those before treatment (P<0.05),with the combination group showing lower values than the routine group (P<0.05). The CGRP levels in the two groups were increased compared with those before treatment, with the combination group showing higher levels than the routine group (P<0.05). The substance P (SP) and ET-1 levels in the two groups were reduced compared with those before treatment (P<0.05), with the combination group showing lower levels than the routine group (P<0.05). Conclusion: Fire dragon cupping and moxibustion therapy combined with conventional western medicine for patients with stage I SHS with phlegm-stasis obstruction syndrome after ischemic stroke can alleviate pain and swelling and improve upper limb motor function and activities of daily living, with superior efficacy compared to conventional western medicine alone.