Objective

2

To evaluate the effect of traditional Chinese medicine （TCM） comprehensive rehabilitation scheme on joint movement disorder after stroke.

Methods

2

A multicenter， prospective cohort study was conducted in five tertiary hospitals in Shaanxi Province from January 1， 2017 to December 1， 2020， and 1154 patients with joint movement disorder after stroke were included. Patients were divided into the trial group and the control group according to whether they received the TCM comprehensive rehabilitation scheme. Patients in the control group received western medicine， while those in the trial group additionally took TCM comprehensive rehabilitation scheme. Patients of abnormal exuberance of

Yin

（soft paralysis） were treated oral Mahai Capsule （马海胶囊）， 0.3 g per time for three times daily， plus needling with supplementation manipulation at Jian San Zhen （肩三针， three shoulder points）， Quchi （LI 11）， Houxi （SI 3）， Hegu （LI 4）， Neiguan （PC 6） of the affected upper limbs， and at Biguan （ST 31）， Xuehai （SP 10）， Yanglingquan （GB 34）， Shenmai （BL 62）， Zusanli （ST 36）， Sanyinjiao （SP 6）， and Taichong （LV 3） of the affected lower limbs， 30 min per time for five times weekly. For patients with abnormal exuberance of

yang

（hard paralysis），

Roujing Capsule

（柔筋胶囊） was taken orally， 0.9 g per time for three times daily， together with needling at mentioned above acupoints but with drainage manipulation， 30min per time for five times weekly. Both groups received treatment for three months. Fugl-Meyer joint range of motion， Fugl-Meyer joint pain evaluation scale， and Modified Rankin scale were used to measure the joint activity of the patients at seven time points： before treatment， after 1- and 3-month treatment， and during 6-， 12-， 18- and 24-month follow-up. The propensity score was used to match and control the confounding factors of the two groups. Analysis of variance of repeated measurements was used to compare the effect differences between two groups at multiple time points.

Results

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Totally， 982 cases were finally included， with 686 cases in the trial group and 296 cases in the control group. After propensity score matching， 292 cases in each group were matched successfully. The results of within-subject repeated measurements showed that there were significant differences in Fugl-Meyer joint activity scale score， Fugl-Meyer joint pain score and Modified Rankin score between different time points （

P

＜0.01）. Significant differences were also found in the scores of Fugl-Meyer joint activity scale between groups at the 5th， 6th， and 7th time points （

P

＜0.05）. At the first four time points， the score of Fugl-Meyer joint pain scale in the trial group was significantly lower than that in the control group （

P

＜0.05）. The scores of Modified Rankin scale in the trial group were significantly higher than those in the control group at all time points （

P

＜0.01）.

Conclusion

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TCM comprehensive rehabilitation scheme combined with basic western medicine is significantly better than western medicine alone in improving joint mobility and pain in patients with joint mobility disorder after stroke.