1
|
Li XY, Liu SH, Liu C, Zu HM, Guo XQ, Xiang HL, Huang Y, Yan ZL, Li YJ, Sun J, Song RX, Yan JQ, Ye Q, Liu F, Huang L, Meng FP, Zhang XN, Yang SS, Hu SJ, Ruan JG, Li YL, Wang NN, Cui HP, Wang YM, Lei C, Wang QH, Tian HL, Qu ZS, Yuan M, Shi RC, Yang XT, Jin D, Su D, Liu YJ, Chen Y, Xia YX, Li YZ, Yang QH, Li H, Zhao XL, Tian ZM, Yu HJ, Zhang XJ, Wu CX, Wu ZJ, Li SS, Shen Q, Liu XM, Hu JP, Wu MQ, Dang T, Wang J, Meng XM, Wang HY, Jiang ZY, Liu YY, Liu Y, Qu SX, Tao H, Yan DM, Liu J, Fu W, Yu J, Wang FS, Qi XL, Fu JL. [Impact of different diagnostic criteria for assessing mild micro-hepatic encephalopathy in liver cirrhosis: an analysis based on a prospective, multicenter, real-world study]. Zhonghua Gan Zang Bing Za Zhi 2023; 31:961-968. [PMID: 37872092 DOI: 10.3760/cma.j.cn501113-20220602-00298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Objective: To compare the differences in the prevalence of mild micro-hepatic encephalopathy (MHE) among patients with cirrhosis by using the psychometric hepatic encephalopathy score (PHES) and the Stroop smartphone application (Encephal App) test. Methods: This prospective, multi-center, real-world study was initiated by the National Clinical Medical Research Center for Infectious Diseases and the Portal Hypertension Alliance and registered with International ClinicalTrials.gov (NCT05140837). 354 cases of cirrhosis were enrolled in 19 hospitals across the country. PHES (including digital connection tests A and B, digital symbol tests, trajectory drawing tests, and serial management tests) and the Stroop test were conducted in all of them. PHES was differentiated using standard diagnostic criteria established by the two studies in China and South Korea. The Stroop test was evaluated based on the criteria of the research and development team. The impact of different diagnostic standards or methods on the incidence of MHE in patients with cirrhosis was analyzed. Data between groups were differentiated using the t-test, Mann-Whitney U test, and χ (2) test. A kappa test was used to compare the consistency between groups. Results: After PHES, the prevalence of MHE among 354 cases of cirrhosis was 78.53% and 15.25%, respectively, based on Chinese research standards and Korean research normal value standards. However, the prevalence of MHE was 56.78% based on the Stroop test, and the differences in pairwise comparisons among the three groups were statistically significant (kappa = -0.064, P < 0.001). Stratified analysis revealed that the MHE prevalence in three groups of patients with Child-Pugh classes A, B, and C was 74.14%, 83.33%, and 88.24%, respectively, according to the normal value standards of Chinese researchers, while the MHE prevalence rates in three groups of patients with Child-Pugh classes A, B, and C were 8.29%, 23.53%, and 38.24%, respectively, according to the normal value standards of Korean researchers. Furthermore, the prevalence rates of MHE in the three groups of patients with Child-Pugh grades A, B, and C were 52.68%, 58.82%, and 73.53%, respectively, according to the Stroop test standard. However, among the results of each diagnostic standard, the prevalence of MHE showed an increasing trend with an increasing Child-Pugh grade. Further comparison demonstrated that the scores obtained by the number connection test A and the number symbol test were consistent according to the normal value standards of the two studies in China and South Korea (Z = -0.982, -1.702; P = 0.326, 0.089), while the other three sub-tests had significant differences (P < 0.001). Conclusion: The prevalence rate of MHE in the cirrhotic population is high, but the prevalence of MHE obtained by using different diagnostic criteria or methods varies greatly. Therefore, in line with the current changes in demographics and disease spectrum, it is necessary to enroll a larger sample size of a healthy population as a control. Moreover, the establishment of more reliable diagnostic scoring criteria will serve as a basis for obtaining accurate MHE incidence and formulating diagnosis and treatment strategies in cirrhotic populations.
Collapse
Affiliation(s)
- X Y Li
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - S H Liu
- The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China
| | - C Liu
- Department of Radiology, Affiliated Zhongda Hospital, Southeast University, Nanjing 210000, China
| | - H M Zu
- Department of Gastroenterology, Qinghai Provincial Fourth People's Hospital, Xining 810000, China
| | - X Q Guo
- Department of Hepatology, the Third People's Hospital of Taiyuan, Taiyuan 030000, China
| | - H L Xiang
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - Y Huang
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha 410000, China
| | - Z L Yan
- Department of Gastroenterology, Qinghai Provincial Fourth People's Hospital, Xining 810000, China
| | - Y J Li
- Department of Gastroenterology, Qinghai Provincial Fourth People's Hospital, Xining 810000, China
| | - J Sun
- Department of Hepatology, the Third People's Hospital of Taiyuan, Taiyuan 030000, China
| | - R X Song
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - J Q Yan
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - Q Ye
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Artificial Cell Engineering Technology Research Center, Institute of Hepatobiliary Disease, Tianjin 300000, China
| | - F Liu
- Department of Infectious Diseases, Hunan Key Laboratory of Viral Hepatitis, Xiangya Hospital, Central South University, Changsha 410000, China
| | - L Huang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - F P Meng
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - X N Zhang
- Medical School of Chinese PLA, Beijing 100853, China
| | - S S Yang
- Department of Gastroenterology, General Hospital of Ningxia Medical University, Yinchuan 750000, China
| | - S J Hu
- Department of Gastroenterology, People's Hospital of Ningxia Hui Autonomous Region, Yinchuan 750000, China
| | - J G Ruan
- Branch Hospital for Diseases of the Heart, Brain, and Blood Vessels of General Hospital of Ningxia Medical University, Yinchuan 750000, China
| | - Y L Li
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - N N Wang
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - H P Cui
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - Y M Wang
- Department of Gastroenterology, the First Affiliated Hospital of China Medical University, Shenyang 110000, China
| | - C Lei
- Department of Hepatology, the First People's Hospital of Changde City, Changde 415000, China
| | - Q H Wang
- Department of Hepatology, the First People's Hospital of Changde City, Changde 415000, China
| | - H L Tian
- Department of Hepatology, the First People's Hospital of Changde City, Changde 415000, China
| | - Z S Qu
- Department of Infectious Diseases, Xiangxi People's Hospital, Jishou 416000, China
| | - M Yuan
- Department of Infectious Diseases, Xiangxi People's Hospital, Jishou 416000, China
| | - R C Shi
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - X T Yang
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - D Jin
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - D Su
- Department of Gastroenterology, Wuzhong People's Hospital, Wuzhong 751100, China
| | - Y J Liu
- Department of Hepatology, Hunan Provinces Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou 412000, China
| | - Y Chen
- Department of Hepatology, Hunan Provinces Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou 412000, China
| | - Y X Xia
- Department of Hepatology, Hunan Provinces Directly Affiliated Traditional Chinese Medicine Hospital, Zhuzhou 412000, China
| | - Y Z Li
- Department of Infectious Diseases, the First People's Hospital, Huaihua City, Huaihua 418000, China
| | - Q H Yang
- Department of Infectious Diseases, the First People's Hospital, Huaihua City, Huaihua 418000, China
| | - H Li
- Department of Infectious Diseases, the First People's Hospital, Huaihua City, Huaihua 418000, China
| | - X L Zhao
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - Z M Tian
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - H J Yu
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - X J Zhang
- Department of Hepatology, Chongqing Public Health Medical Center, Chongqing 400000, China
| | - C X Wu
- Liver Disease Diagnosis and Treatment Center, the Fourth People's Hospital of Yiyang City, Yiyang 413000, China
| | - Z J Wu
- Liver Disease Diagnosis and Treatment Center, the Fourth People's Hospital of Yiyang City, Yiyang 413000, China
| | - S S Li
- Liver Disease Diagnosis and Treatment Center, the Fourth People's Hospital of Yiyang City, Yiyang 413000, China
| | - Q Shen
- Department of Gastroenterology, Yinchuan Second People's Hospital, Yinchuan 750000, China
| | - X M Liu
- Department of Gastroenterology, Yinchuan Second People's Hospital, Yinchuan 750000, China
| | - J P Hu
- Department of Gastroenterology, Yinchuan First People's Hospital, Yinchuan 750000, China
| | - M Q Wu
- Department of Gastroenterology, Yinchuan First People's Hospital, Yinchuan 750000, China
| | - T Dang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - J Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - X M Meng
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - H Y Wang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - Z Y Jiang
- Department of Gastroenterology, the Second Affiliated Hospital of Baotou Medical College, Baotou 014000, China
| | - Y Y Liu
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - Y Liu
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - S X Qu
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - H Tao
- Department of Gastroenterology, Dandong Central Hospital, Dandong 118000, China
| | - D M Yan
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - J Liu
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - W Fu
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - J Yu
- Department of Hepatology, Shenyang 739 Hospital, Shenyang 110000, China
| | - F S Wang
- Senior Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, National Clinical Research Center for Infectious Diseases, Beijing 100039, China Medical School of Chinese PLA, Beijing 100853, China
| | - X L Qi
- The First School of Clinical Medicine of Lanzhou University, Lanzhou 730000, China Department of Radiology, Affiliated Zhongda Hospital, Southeast University, Nanjing 210000, China
| | - J L Fu
- Medical School of Chinese PLA, Beijing 100853, China Department of Infectious Diseases, the Fifth Medical Center of Chinese PLA General Hospital, Beijing 100039, China
| |
Collapse
|
3
|
Li M, Zhu SS, Wan QR, Ruan JG, Wang YJ, Xu TS. [Effect of warm acupuncture at Yifeng (TE 17) on facial paralysis with periauricular pain during pregnancy]. Zhongguo Zhen Jiu 2021; 40:1281-5. [PMID: 33415868 DOI: 10.13703/j.0255-2930.20191128-k0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To compare the curative effect between the warm acupuncture at Yifeng (TE 17) combined with conventional acupuncture and TDP plus conventional acupuncture on facial paralysis with periauricular pain during pregnancy. METHODS A total of 68 patients were randomized into an observation group (36 cases, 3 cases dropped off) and a control group (32 cases, 1 case dropped off). First week, TDP light was used on the affected side in the control group, and warm acupuncture at Yinfeng (TE 17) on the affected side was used in the observation group, both once a day. From the second week, both groups were given acupuncture at Chengjiang (CV 24) and the affected side of Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Dicang (ST 4), etc. and electroacupuncture (continuous wave, 2 Hz in frequency) was connected at Cuanzhu (BL 2) and Taiyang (EX-HN 5), Jiache (ST 6) and Dicang (ST 4). Both treatments were given every other day for 4 weeks totally. The visual analogue scale (VAS) score of the periauricular pain degree before treatment and after 1 week of treatment, the House-Brackmann (H-B) facial nerve function grading scale and facial disability index (FDI) score before treatment and after 2, 4 weeks of treatment were compared between the two groups. RESULTS After 1 week of treatment, the VAS scores of both groups decreased (P<0.001), and the variation in the observation group was larger than the control group (P<0.01). After 2 and 4 weeks of treatment, the H-B grading of both groups were improved (P<0.01, P<0.05), and those in the observation group were better than the control group (P<0.05). After 2 and 4 weeks of treatment, the FDI physical function (FDIP) scores of both groups were higher (P<0.01), and the FDI social life function (FDIS) scores were lower than before treatment (P<0.05, P<0.01), and the FDIP scores in the observation group were higher than those in the control group (P<0.05). CONCLUSION Warm acupuncture at Yinfeng (TE 17) combined with conventional acupuncture can effectively improve the periauricular pain and facial nerve function in patients of facial paralysis with periauricular pain during pregnancy, and the curative effect is better than TDP plus conventional acupuncture.
Collapse
Affiliation(s)
- Ming Li
- Drum Tower Clinical Medical College, Nanjing University of Chinese Medicine, Nanjing 210008, Jiangsu Province, China; Department of TCM, Drum Tower Hospital, Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, Jiangsu Province
| | - Shan-Shan Zhu
- Department of Acupuncture-Moxibustion and Physiotherapy, Nanjing Xuanwu Hospital
| | - Qian-Rong Wan
- Department of Acupuncture and Moxibustion, Zhenjiang Hospital of Traditional Chinese and Western Medicine
| | - Jian-Guo Ruan
- Department of TCM, Drum Tower Hospital, Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, Jiangsu Province
| | - Yu-Juan Wang
- Department of TCM, Drum Tower Hospital, Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, Jiangsu Province
| | - Tian-Shu Xu
- Department of TCM, Drum Tower Hospital, Affiliated Hospital of Medical School of Nanjing University, Nanjing 210008, Jiangsu Province
| |
Collapse
|
4
|
Li M, Zhu SS, Ruan JG, Wang YJ, Xu TS. [Clinical observation on time-effect of electroacupuncture for idiopathic facial paralysis]. Zhongguo Zhen Jiu 2019; 39:1059-62. [PMID: 31621257 DOI: 10.13703/j.0255-2930.2019.10.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To observe the effect of different acupuncture frequency and duration of needle retention on idiopathic facial paralysis, and optimize the acupuncture treatment plan. METHODS A total of 140 patients were randomized into a group A (37 cases, 3 cases dropped off), a group B (35 cases, 3 cases dropped off), a group C (34 cases, 1 case dropped off) and a group D (34 cases, 1 case dropped off). Under the same basic treatment, acupuncture intervention time (day 8 of morbidity), acupoint selection [Cuanzhu (BL 2), Yangbai (GB 14), Taiyang (EX-HN 5), Yingxiang (LI 20), Jiache (ST 6), Dicang (ST 4) on the affected side, Chengjiang (CV 24) and Hegu (LI 4) on the unaffected side] and electroacupuncture intervention, different acupuncture interval time and duration of needle retention were applied. In the group A, the treatment was given 20 min once a day, while the group B 30 min once a day, the group C 20 min once every 2 days, the group D 30 min once every 2 days. Totally 20-day treatment were required. The House-Brackmann (H-B) facial nerve function grading system was used to evaluate the improvement of clinical symptom, the situation and latency periods of the R1 wave in blink reflex and facial nerve motor conduction before and after treatment were observed in the 4 groups. RESULTS After treatment, the cured rates in the 4 groups were 44.1% (15/34), 46.9% (15/32), 57.6% (19/33) and 51.5% (17/33), there was no significant difference among 4 groups (P>0.05). The situation and latency periods of the R1 wave in blink reflex and latency periods and amplitude of facial nerve motor conduction after treatment were improved in the 4 groups (P<0.01, P<0.05), there was no significant difference among 4 groups (P>0.05). CONCLUSION Acupuncture 20 min once a day, 30 min once a day, 20 min once every 2 days and 30 min once every 2 days have significant effect on the recovery of idiopathic facial paralysis, and the effect is comparable.
Collapse
Affiliation(s)
- Ming Li
- Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China; Drum Tower Clinical Medical College of Integrated Chinese and Western Medicine, Nanjing University of CM, Nanjing 210008, Jiangsu Province
| | | | - Jian-Guo Ruan
- Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
| | - Yu-Juan Wang
- Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
| | - Tian-Shu Xu
- Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, Jiangsu Province, China
| |
Collapse
|