针刺配合康复训练治疗中风后不同类型共济失调下肢功能障碍临床观察  

Clinical Observation of Acupuncture plus Rehabilitation for Lower-limb Dysfunction Due to Different Types of Ataxia After Stroke

作　　者：鲁海[1] 白玮婧[2] 马会靖 张苗[1] 高士宜 刘浩敏[1] 张春红[2] 武连仲[2] LU Hai BAI Wei-jing MA Hui-jing ZHANG Miao GAO Shi-yi LIU Hao-min ZHANG Chun-hong WU Lian-zhong(Graduate School, Tianjin University of Chinese Medicine,Tianjin 300193,China First Teaching Hospital of Tianjin University of TCM, Tianjin 300193,China)

机构地区：[1]天津中医药大学研究生院,天津300193 [2]天津中医药大学第一附属医院,天津300193

出　　处：《上海针灸杂志》2017年第4期374-378,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：国家中医药管理局国家中医临床研究基地业务建设科研专项(JDZX2012135)

摘　　要：目的观察醒脑开窍针刺法配合Frenkel平衡康复训练治疗中风后不同类型共济失调下肢功能障碍的临床疗效。方法将符合纳入标准的115例患者随机分为两组,其中治疗组57例,采用醒脑开窍针刺配合康复治疗方案;对照组58例,采用单纯醒脑开窍针刺治疗方案。治疗前后采用Berg平衡量表对不同类型共济失调下肢临床症状、患者平衡功能评分及疗效进行评价。结果治疗组小脑型、脑干型、基底节型,显效率分别为72.2%、83.3%、61.1%,总有效率分别为100.0%、94.4%、94.4%,对照组分别为21.1%、35.0%、58.8%,94.7%、85.0%、82.4%,差异有统计学意义(P<0.05)。两组患者治疗后Berg平衡量表评分显示,两组治疗前后组内比较差异均有统计学意义(P<0.01);治疗后组间比较,小脑型、脑干型有统计学差异(P<0.05)。结论醒脑开窍针刺法配合Frenkel平衡训练可以有效改善中风后下肢共济失调临床症状,尤其对于小脑型和脑干型共济失调,疗效更为显著。Objective To observe the clinical efficacy ofXing Nao Kai Qiao（brain-awakening orifice-opening） needling method plus Frenkel＇s balance rehabilitation exercise in treating lower-limb dysfunction due to different types of ataxia after stroke.MethodA total of 115 eligible patients were randomized into two groups. Fifty-seven cases in the treatment group were intervened by Xing Nao Kai Qiaoneedling plus rehabilitation training; 58 cases in the control group were intervened byXing Nao Kai Qiaoneedling method alone. Berg Balance Scale （BBS） was adopted to evaluate the symptoms, balance function, and therapeutic efficacy before and after the treatment.Result In the treatment group, the markedly effective rate was respectively 72.2%, 83.3% and 61.1% in the cerebella subtype, brainstem subtype and basal ganglia subtype, and the total effectiverate was respectively 100.0%, 94.4% and 94.4%; in the control group, the markedly effective rate was respectively 21.1%, 35.0% and 58.8%, and the total effective rate was respectively 94.7%, 85.0% and 82.4%, and the between-group differences were statistically significant （P〈0.05）. After the treatment, the BBS score showed significant intra-group differences in both groups （P〈0.01）; the between-group comparisons showed that there were significant differences in comparing the scores of cerebella and brainstem subtypes after the treatment （P〈0.05）.ConclusionXing Nao Kai Qiaoneedling method plus Frenkel＇s rehabilitation exercise can effectively improve the symptoms of poststroke lower-limb ataxia, especially for cerebella and brainstem subtypes.

关 键 词：中风后遗症 共济失调 脑梗死 针刺 Frenkel平衡康复训练法 BERG平衡量表 

分 类 号：R246.6[医药卫生—针灸推拿学]