声触诊弹性测量对中风后痉挛的针刺干预评估  

Evaluation of Efficacy of Acupuncture Intervention for Post-stroke Spasm with Sound Touch Quantification

作　　者：刘薇[1] 皮敏[2] 翁妍珊 林少霞 LIU Wei;PI Min;WENG Yan-Shan;LIN Shao-Xia(The Fourth Clinical Medical School of Guangzhou University of Chinese Medicine,Shenzhen 518033 Guangdong,China;Shenzhen Traditional Chinese Medical Hospital,Shenzhen 518033 Guangdong,China)

机构地区：[1]广州中医药大学第四临床医学院,广东深圳518033 [2]深圳市中医院,广东深圳518033

出　　处：《广州中医药大学学报》2022年第6期1314-1318,共5页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：广东省中医药局科研项目(编号:20211322);“三名工程”中国中医科学院刘保延首席研究员中医针灸临床评价方法创新团队项目(编号:SZSM201612001)

摘　　要：【目的】观察调任通督针法对中风后上肢痉挛性偏瘫的临床疗效以及声触诊弹性测量(STQ)技术对肢体痉挛康复的评定作用。【方法】将48例中风后上肢痉挛性偏瘫患者随机分为治疗组和对照组,每组各24例。2组患者均给予相应的内科基础治疗和常规的康复训练,在此基础上,治疗组给予调任通督针刺治疗,对照组给予常规针刺治疗,疗程为2周。观察2组患者治疗前后患侧肱二头肌STQ值、改良Ashworth量表(MAS)评分和中医证候评分的变化情况,并进行一致性检验。【结果】(1)治疗前,2组患者患侧肱二头肌STQ值均显著高于健侧(P<0.05),治疗2周后,2组患者患侧肱二头肌STQ值、MAS评分均较治疗前显著下降(P<0.01),且治疗组患侧肱二头肌STQ值的下降程度较对照组更为显著(P<0.05)。(2)治疗后,治疗组的头晕目眩、肢体强急、肢体麻木、心烦易怒、便干便秘、气短乏力、自汗等证候评分及中医证候总积分均较治疗前改善(P<0.05或P<0.01),而对照组仅肢体强急、肢体麻木、心烦易怒、便干便秘等证候评分及中医证候总积分较治疗前改善(P<0.05或P<0.01)。组间比较,治疗组对头晕目眩、肢体强急、气短乏力、自汗等证候评分及中医证候总积分的改善程度均较对照组更为显著(P<0.05)。(3)一致性检验结果显示:患侧肱二头肌STQ值与MAS评分呈显著相关(r=0.908,P<0.01)。【结论】调任通督针法可有效改善中风后上肢痉挛水平及常见不适症状;相较于MAS量表评分,STQ技术可更直观灵敏地检测肌肉状态,可作为临床痉挛疗效评价的客观定量指标。Objective To observe the clinical efficacy of acupuncture method for regulating conception vessel and unblocking governor vessel on the post-stroke spastic hemiplegia of upper limb and to evaluate the rehabilitation effect of acupuncture for limb spasm with sound touch quantification(STQ)technique.Methods Forty-eight patients with post-stroke spastic hemiplegia of upper limb were randomly divided into treatment group and control group,with 24 cases in each group.Patients in both groups were given the basic medical treatment and conventional rehabilitation training.And additionally,the treatment group was given acupuncture treatment for regulating conception vessel and unblocking governor vessel,while the control group was given conventional acupuncture treatment.The treatment for the two groups lasted for 2 weeks.The changes in STQ value of the affected biceps brachii,scores of modified Ashworth scale(MAS)and scores of traditional Chinese medicine(TCM)syndrome in the two groups were observed before and after treatment.And then the consistency test was performed.Results(1)Before treatment,the STQ value of the affected biceps brachii in both groups was significantly higher than that of the healthy one(P<0.05).After 2 weeks of treatment,the STQ value and MAS scores of the affected biceps brachii in both groups were significantly lower than those before treatment(P<0.01),and the STQ value of the affected biceps brachii in the treatment group was more significantly decreased than that in the control group(P<0.05).(2)After treatment,the scores of TCM syndrome of dizziness,limb rigidity,numbness of limbs,vexation and irritability,constipation,shortness of breath and fatigure,and spontaneous sweating as well as the total TCM syndrome scores in the treatment group were improved compared with those before treatment(P<0.05 or P<0.01).In the control group,only the scores of stiffness of limbs,numbness of limbs,vexation and irritability,and constipation as well as the total TCM syndrome scores were improved(P<0.05 or P<0.01).

关 键 词：中风后上肢痉挛 调任通督针法 声触诊弹性测量(STQ) 改良Ashworth量表(MAS)评分 

分 类 号：R246.6[医药卫生—针灸推拿学]