《内经》恢刺和关刺法治疗中风后痉挛性偏瘫临床观察  

Clinical Observation of Relaxing Needling plus Joint Needling from the Internal Medicine for Post-stroke Spastic Hemiplegia

作　　者：严睿峻 程波[1] 陈麓圣 沈雪勇[1] 宗蕾[1] 

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437

出　　处：《上海针灸杂志》2016年第8期930-934,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家自然科学基金项目(81320108028);国家重点基础研究发展计划(2015CB554505);国家中医药管理局重点学科建设项目(ZYSNXD-CC-ZDXK-07);上海高校工程研究中心建设项目(GCZX14013)

摘　　要：目的观察《内经》恢刺和关刺法治疗中风后痉挛性偏瘫的临床疗效。方法将符合纳入标准的121例患者随机分为常规针刺组(61例)和恢关刺组(60例)。每组治疗2星期,每星期5次。用四肢简化Fugl-Meyer量表、改良Ashworth量表、Tardieu量表、日常生活活动能力量表分别对两组患者治疗前及治疗后下肢痉挛情况进行评估。并且,在常规针刺组和恢关刺组中,分别随机抽取4例患者,共计8例,在治疗前、治疗后进行三维步态分析,选取踝背伸角、踝关节活动度、足内翻角、足跟抬离地面高度进行观察。结果与结论恢关刺法和常规针刺法对中风后痉挛性偏瘫均有明显临床疗效。恢刺和关刺法在对中风后痉挛性偏瘫的肢体平衡能力、关节活动情况、肌张力、下肢阵挛等方面明显优于常规针刺法。恢刺和关刺法可能通过改善中风后偏瘫的肢体平衡能力、关节活动情况、肌张力、下肢阵挛而改善患者足内翻和偏瘫步态。三维步态分析踝背伸角、足内翻角、足跟抬离地面高度,可用以更为客观、细致、精确地评估中风后偏瘫的痉挛性步态的变化情况。Objective To observe the clinical efficacy of relaxing needling plus joint needling from the Internal Medicine in treating post-stroke spastic hemiplegia.Method Totally 121 eligible subjects were randomized into an ordinary acupuncture group（61 cases） and a relaxing-joint needling group（60 cases）.The two groups were treated for 2 weeks,5 sessions each week.The spasm of the lower limb was evaluated by using Fugl-Meyer Assessment Scale（FMA）,modified Ashworth Scale（MAS）,Tardieu Scale,and Activities of Daily Living（ADL） before and after treatment.Besides,4 patients from each group were randomly selected for the three-dimensional gait analysis,and the dorsi-extension,range of motion（ROM） of ankle,strephenopodia,and heel-raising height were observed.Result and Conclusion Relaxing-joint needling and ordinary acupuncture both can produce significant efficacies in treating post-stroke spastic hemiplegia.The relaxing-joint needling produced more significant efficacies in improving the body balance,ROM,muscular tension,and lower limb spasticity compared to ordinary acupuncture.It＇s plausible that relaxing-joint needling improves the strephenopodia and hemiplagia gait through renovating body balance,ROM,muscular tension,and lower limb spasticity.Since the three-dimensional gait analysis can analyze the dorsi-extension,strephenopodia,and heel-raising height,thus it can be used to evaluate the change of the spastic gait of post-stroke hemiplegia in a more objective,elaborate,and correct way.

关 键 词：中风后遗症 偏瘫 肌痉挛 刺法 三维步态分析 

分 类 号：R246.6[医药卫生—针灸推拿学]