针刺治疗脑卒中亚急性期步行障碍的临床研究  

Clinical Study on Acupuncture for Ambulation Disturbance in Subacute Stage of Cerebral Stroke

作　　者：曾友华[1] 包烨华[1] 朱敏[1] 陈顺喜[1] 方剑乔[2] 

机构地区：[1]杭州市中医院,杭州310005 [2]浙江中医药大学,杭州310053

出　　处：《上海针灸杂志》2016年第3期262-265,共4页Shanghai Journal of Acupuncture and Moxibustion

基　　金：浙江省中医药防治重大疾病攻关计划项目(2011ZGG003)

摘　　要：目的观察针刺对脑卒中亚急性期患者步行能力及下肢运动功能的影响。方法将100例脑梗死、脑出血亚急性期合并美国国立卫生研究院卒中量表（NIHSS）评分为4-24分的患者随机分为治疗组和对照组,每组50例。对照组采用单纯康复训练,治疗组在对照组基础上采用针刺治疗。观察两组治疗前后神经功能缺损程度（NIHSS评分）、下肢运动功能（FMA量表评分）、日常生活能力（Bathel指数评分）和步行能力（FAC评分）。结果治疗组治疗1个疗程后NIHSS量表评分与同组治疗前比较,差异均有统计学意义（P〈0.05）。两组治疗2个疗程后NIHSS量表评分与同组治疗前和治疗1个疗程后比较,差异均有统计学意义（P〈0.05）。两组治疗1个疗程及2个疗程后下肢FMA评分、Bathel指数评分和FAC评分与同组治疗前比较,差异均具有统计学意义（P〈0.05）。两组治疗2个疗程后下肢FMA评分和FAC评分与同组治疗1个疗程后比较,差异均有统计学意义（P〈0.05）。治疗组治疗2个疗程后NIHSS量表评分、下肢FMA评分、Bathel指数评分和FAC评分与对照组比较,差异均有统计学意义（P〈0.05）。结论针刺能改善脑卒中亚急性期偏瘫患者的步行能力、神经功能缺损程度、下肢运动功能及日常活动能力。Objective To observe the effect of acupuncture on walk ability and motor function of lower limbs in subacute stage of cerebral stroke. Method A hundred patients in subacute stage of cerebral infarction or hemorrhage and scored 4-24 according to the National Institute of Health Stroke Scale（NIHSS） were randomized into a treatment group and a control group, 50 cases in each group. The control group was intervened by rehabilitation training, while the treatment group was additionally intervened by acupuncture. The neural deficit degree（NIHSS score）, motor function of lower limbs [Fugl-Meyer Assessment（FMA）], activities of daily life [Barthel Index（BI）], and ambulation ability [Functional Ambulation Category（FAC）] were evaluated before and after intervention. Result After 1 treatment course, the NIHSS score was significantly changed in the treatment group compared to that before intervention（p〈0.05）. The NIHSS scores after 2 treatment courses were significantly different from that before intervention and that after 1 treatment course in both groups（p〈0.05）. In both groups, the FMA score, BI, and FAC score after 1 treatment course and 2 treatment courses were significantly different from that before intervention（p〈0.05）. The FMA and FAC scores after 2 treatment courses were significantly different from that after 1 treatment course in both groups（p〈0.05）. After 2 treatment courses, there were significant differences in comparing the NIHSS score, FMA, BI, and FAC scores between the two groups（p〈0.05）. Conclusion Acupuncture can improve the ambulation ability, neural deficit, motor function of lower limbs, and activities of daily life of hemiplegia patients in subacute stage of cerebral stroke.

关 键 词：针刺疗法 中风 步行障碍 头针 中风后遗症 康复训练 

分 类 号：R246.6[医药卫生—针灸推拿学]