电针结合运动想象疗法对脑梗死后偏瘫的临床疗效观察  

Clinical efficacy of electroacupuncture combined with motor imagery therapy on hemiplegic cerebral infarction

作　　者：朱峰[1,2] 高建芸[2] 高润[3] 何逸康[2] 柳丽[2] 艾炳蔚[4] ZHU Feng GAO Jianyun GAO Run HE Yikang LIU Li AI Bingwei(Nanjing University of CM, Nanjing 210023, Jiangsu Province, China Department of Acupuncture-Moxibustion, Zhongda Hospital of Southeast University, Nanjing 210029, Jiangsu Province Nanjing Brain Hospital Affiliated to Nanjing Medical University Department of Acupuncture-Moxibustion and Rehabilitation, Jiangsu Hospital ofTCM, Nanjing University ofCM, Nanjing 210029)

机构地区：[1]南京中医药大学,江苏南京210023 [2]东南大学附属中大医院针灸科,江苏南京210029 [3]南京医科大学附属南京脑科医院 [4]南京中医药大学附属江苏省中医院针灸康复科,南京210029

出　　处：《中国针灸》2017年第9期927-931,共5页Chinese Acupuncture & Moxibustion

摘　　要：目的:探讨电针结合运动想象疗法对脑梗死患者偏瘫侧运动功能和生活自理能力恢复的影响。方法:将90例脑梗死偏瘫患者随机分为康复组、电针组和综合组,每组30例。康复组采用脑梗死的常规护理、药物治疗以及常规康复治疗;电针组在康复组基础上加用电针治疗,取穴以百会、顶颞前斜线、顶颞后斜线、肩髃、外关、风市、三阴交为主穴,得气后连接电针治疗仪,留针30 min;综合组在电针组基础上加用运动想象治疗,每次约20 min。3组治疗均每日1次,每周5次,共治疗4周。观察3组治疗前后Barthel指数和Brunnstrom评分的变化。结果:研究中共有3例未能完成试验,最终87例纳入统计,康复组30例,电针组29例,综合组28例。治疗后3组患者Barthel指数和Brunnstrom评分分级情况均较治疗前明显改善(均P<0.01);治疗后电针组、综合组Barthel指数较康复组明显升高(均P<0.01),综合组患者下肢Brunnstrom评分分级情况较电针组、康复组明显改善(均P<0.05)。结论:电针结合运动想象疗法与康复可以明显提高脑梗死患者偏瘫侧的肢体运动功能和生活自理能力,总体临床疗效优于单纯康复或电针治疗。Objective To explore the effects of electroacupuncture （EA） combined with motor imagery therapy on motor function and activity of daily living in patients with hemiplegic cerebral infarction.MethodsNinety patients with hemiplegic cerebral infarction were randomly divided into a rehabilitation group, an EA group and a comprehensive group, 30 patients in each one. The patients in the rehabilitation group were treated with regular care, medication and rehabilitation training; based on the rehabilitation group, the patients in the EA group were treated mainly with electroacupuncture at Baihui （GV 20）, Dingnieqianxiexian （MS 6）, Dingniehouxiexian （MS 7）, Jianyu （LI 15）, Waiguan （TE 5）, Fengshi （GB 31） and Sanyinjiao （SP 6）;with the arrival ofqi. EA device was connected for 30 min. The patients in the comprehensive group were treated with EA as the EA group and motor imagery therapy, 20 min per treatment. The treatment was given once a day, five treatments per week, and totally 4-week treatment was performed. The Barthel index and Brunnstrom score before and after treatment were observed in the three groups.ResultsThree cases did not finish the trial and finally 87 cases were included into analysis, including 30 cases in the rehabilitation group, 29 cases in the EA group and 28 cases in the comprehensive group. Compared before treatment, the Barthel index and Brunnstrom score were significantly improved after treatment in the three groups （allP〈0.01）;after treatment, the Barthel index in the EA group and comprehensive group was significantly higher than that in the rehabilitation group （bothP〈0.01）; the lower extremity score of Brunnstrom score in the comprehensive group was better than those in the EA group and rehabilitation group （bothP〈0.05）.Conclusion EA combined with motor imagery therapy and rehabilitation can significantly improve the motor function and activity of daily living in patients with hemiplegic cerebral infarction, which is superior to rehabilitation

关 键 词：偏瘫 电针 运动想象 运动功能 生活自理能力 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]