针刺结合运动再学习技术对中风康复影响的临床研究  

Effect of Acupuncture Combined Physical Training and Relearning on Stroke Rehabilitation: a Multi-center Randomized Controlled Clinical Study

作　　者：吴晓亮 糜中平 王和生 徐道明 裴丽霞 刘景 石雯 潘伟超 张丽霞[2] 陈丽萍[3] 张音 孙建华 

机构地区：[1]南京中医药大学附属医院针灸康复科,南京210000 [2]江苏省人民医院康复医学科,南京210000 [3]连云港市中医院针灸科,江苏222000 [4]苏州市中医院针灸科,江苏215000

出　　处：《中国中西医结合杂志》2015年第5期549-554,共6页Chinese Journal of Integrated Traditional and Western Medicine

基　　金：国家自然科学基金资助项目(No.81273839);江苏省科技支撑计划--社会发展临床研究(No.BE2009695);江苏省中医药领军人才项目(No.LJ200905)

摘　　要：目的观察针刺结合运动再学习技术应用中风患者的疗效。方法采用多中心、随机对照试验设计,共纳入364例患者,通过中央随机分为试验组(184例)与对照组(180例),试验组予以针刺结合运动再学习技术,对照组予以运动再学习技术,两组均治疗4周,分别于治疗前、治疗后、随访第2、5个月,比较两组FuglMeyer运动功能、神经功能缺损、日常生活活动能力的疗效差异。结果最终完成试验353例,其中试验组179例,对照组174例。(1)与治疗前比较,两组治疗后、随访第2、5个月简化Fugl-Meyer量表评分、FIM量表评分均明显增加,神经功能缺损评分明显降低,且试验组随访第2、5个月简化Fugl-Meyer量表评分增加明显高于对照组,神经功能缺损评分低于对照组,随访第5个月FIM量表评分增加明显高于对照组,差异均有统计学意义(P<0.05,P<0.01)。(2)两组总体Fugl-Meyer量表、FIM量表及神经功能缺损等级组内不同时间比较差异均有统计学意义(P<0.01);随访第2、5个月试验组Fugl-Meyer运动功能等级、神经缺损功能等级的改善优于对照组,随访第5个月FIM量表等级分布亦优于对照组,差异均有统计学意义(P<0.05,P<0.01)。结论针灸结合运动再学习训练与单纯的运动再学习训练均能有效地促进中风患者的康复,可降低患者神经功能缺损程度,改善运动功能,提高独立功能,远期疗效明显优于单纯运动再学习训练。Objective To observe the effect of acupuncture combined physical training and rele- arning on stroke patients. Methods A multi-center, randomized controlled trial design was adopted. A total of 364 stroke patients were recruited and randomly assigned to the experimental group （184 cases） and the control group （180 cases）. Patients in the experimental group received acupuncture combined with physical training and relearning, while those in the control group only received physical training and relearning. All received four weeks of treatment. Effects on FugI-Meyer motor function, neurological impairment, activities of daily living difference were compared before treatment, after treatment, 2 and 5 months after follow-ups between the two groups. Results Totally 353 patients completed this trial, 179 in the experimental group and 174 in the control group. （1） Compared with before treatment, brief FugI-Meyer motor functions scores and FIM scores obviously increased, and scores for neurological impairment obviously decreased in the two groups. Besides, the increment of brief FugI-Meyer motor functions scores and FIM scores was obviously higher in the experimental group than in the control group at month 2 and 5 of follow-ups ; scores for neurological impairment was obviously lower in the experimental group than in the control group. The increment of FIM scores was obviously higher in the experimental group than in the control group at month 5 of follow-ups （P 〈0.05,P 〈0.01 ）. （2） There was statistical difference in inter-group comparison of total FugI-Meyer motor functions scores and FIM scores, or scores for neurological impairment （P 〈0.01 ）. The improvement of FugI-Meyer motor functions grading and neurological impairment grading was obviously superior in the experimental group at month 2 and 5 of follow-ups. The distribution of FIM grading was also better in the experimental group at month 5 of follow-ups （P 〈0.05,P 〈 0.01 ）. Conclusions Both acupuncture combined exercise train

关 键 词：针刺 中风 康复 运动再学习 

分 类 号：R246.6[医药卫生—针灸推拿学]