不同穴位与肌肉运动点针刺在脑卒中患者腕手功能重建中的对比研究  

Comparative Study of Wrist-hand Function Rebuilding Between Acupuncture at Different Acupoints and at Muscular Motor Points in Cerebral Stroke Patients

作　　者：王东岩[1] 王岩[2] 杨晓东[2] 

机构地区：[1]黑龙江中医药大学附属第二医院,哈尔滨150001 [2]黑龙江中医药大学,哈尔滨150040

出　　处：《上海针灸杂志》2009年第5期253-255,共3页Shanghai Journal of Acupuncture and Moxibustion

基　　金：黑龙江省中医药;中西医结合科研项目(2006ZHYYR12);哈尔滨市青年科学基金(2004AFQXJ017)

摘　　要：目的在客观准确评价脑卒中患者上肢运动功能的基础上,观察不同穴位与肌肉运动点针刺对脑卒中患者腕手功能重建的影响。方法选择符合纳入标准的脑卒中患者40例,随机分为四组,分别给予伸肌运动点针刺(运动点1组),伸-屈肌交替运动点针刺(运动点2组),针刺肩髃、臂臑、手三里、外关(穴位1组),针刺肩髃、臂臑、手三里、外关、尺泽、内关(穴位2组)。以上肢表面肌电信号(sEMG)特征值、Fugl-Meyer功能评定表及Barthel ADL指数评价表评价各组治疗前后的患侧上肢运动功能。结果采用伸-屈肌交替运动点针刺可以使上肢sEMG的峰值(MAX)、积分肌电值(IEMG)、Fugl-Meyer运动功能分值、Bar the l ADL提高较明显。结论不同针刺部位治疗脑卒中后腕手运动功能疗效的影响不同。伸-屈肌交替运动点针刺在临床治疗中具有明确疗效。Objective To investigate the effects of acupuncture at different acupoints and at muscular motor points on wrist-hand function rebuilding on the basis of objective assessment of upper limb motor function in cerebral stroke patients. Methods Forty cerebral stroke patients meeting the inclusion criteria were enrolled and randomly allocated to four groups. They were given acupuncture at extensor motor points （motor point group 1）, acupuncture at extensor-flexor alternate motor points （motor point group 2）, acupuncture at Jianyu（LI15）, Binao（LI14）, Shousanli（LI10） and： waiguan（TE5） （acupoint group 1）and acupuncture at Jianyu（LI15）, Binao（LI14）, Shousanli（LI10）, waiguan（TE5）, Chize（LU5） and Neiguan（PC6） （acupoint group 2）. The affected upper limb motor function was assessed using upper surface electromyogram （sEMG） characteristic value, the Fugl-Meyer motor scale and the Barthel＇ ADL index in each group before and after treatment. Results Acupuncture at extensor-flexor alternate motor points could obviously increase upper limb sEMG maximum value （MAX）, integral electromyogram value （IEMG）, Fugl-Meyer motor function score and Barthel ADL score. Conclusion Different acupunctured spots produce different effects on postapoplectic wrist-hand motor function. Acupuncture at extensor-flexor alternate motor points has clinically an exact therapeutic effect.

关 键 词：针刺 中风后遗症 脑卒中 表面肌电信号 腕手功能 肌肉运动点 

分 类 号：R246.6[医药卫生—针灸推拿学]