牵引技术结合针刺治疗脑梗塞后肌痉挛的临床疗效及作用机制研究  

Clinical Curative Effect and Mechanism Study of Applying Traction Technology Combined with Needling in the Treatment of Muscle Spasm after Cerebral Infarction

作　　者：杨慧琳[1] 胡纪可[2] 

机构地区：[1]成都中医药大学针灸推拿学院,四川成都610000 [2]成都中医药大学附属医院针灸康复科,四川成都610000

出　　处：《四川中医》2017年第12期213-216,共4页Journal of Sichuan of Traditional Chinese Medicine

摘　　要：目的:观察现代康复牵引技术结合针刺治疗脑梗塞后肌痉挛的作用机制及临床疗效。方法:采用随机分配法将30例确诊为脑梗塞后出现肌痉挛的患者随机分为试验组(康复牵引技术结合针刺治疗)组和对照组(单纯针刺组),分别于治疗前后进行Ashworth量表评分及DTI(Diffusion Tensor Imaging)扫描采集患者病灶的纤维束特征及原始图像,并获得相应部位的FA(Fractional Anisotropy)及MD(Mean Diffusivity)值进行分析。结果:经3个月治疗后,两组患者Ashworth评分均数较治疗前有明显降低,且试验组较对照组显著降低(P<0.05),具有统计学意义;试验组和对照组治疗前后梗死区域的FA及MD值对比显示:治疗后两组患者梗死区FA值较治疗前显著增加(P<0.05),梗死区与健侧脑区MD值较治疗前有所降低,但无统计学意义(P>0.05)。治疗前后试验组较对照组梗死区FA值升高显著,具有统计学意义(P<0.05),MD值亦有显著降低,但无统计学意义(P>0.05),治疗前后试验组双侧皮质脊髓束区FA值较对照组显著增加,且具有统计学意义(P<0.05)。结论:现代康复牵引技术结合针刺治疗与单纯运用针刺治疗脑梗塞后肌痉挛均有临床疗效,但前者对于脑梗塞后肌痉挛症状的改善更为显著。Objective： Using diffusion tensor imaging to explore and analyze muscle spasm of patients after cerebral infarction who through traction technology combined with acupuncture. Methods ： Recruiting 30muscle spasm after stroke patients were randomly divided into two groups, the targeted-trial group （using physical therapy combining acupuncture） and the controlled group （simple acupuncture therapy）. Respectively before and after treatment for DTI scan and the modified Ashworth asticity Scale, by DTI scanning by lesions in DTI fiber bundle features original image input of the workstation, anisotropic scores obtained with Functool Software （FA） and the average amount of dispersion （MD）. Results： After the treatment, the Ashworth asticity Scale difference between the two groups of patients before treatment had no statistical significance, the treatment group was better than the controlled group （P〈0. 05）. In each group patients, FA value of infarcts area were lower than the corresponding normal area before the treatment, FA value of infarcts area after treatment significantly increased more than before treatment （P〈0. 05）. MD value of infarcts area were lower than the corresponding normal area, but the difference was not statistically significant （ P〉 0. 05）. The treatment group of FA value of infarcts area between the controlled group had significant difference （P〈0. 05）. Conclusion： Using the physical therapy combined with acupuncture and simple acupuncture for the treatment of the cerebra infarction patients complicated with muscle spasm both have good clinical efficacy. The physical therapy combined with acupuncture can change the symptoms of muscle spasm, it is more effective than the simple treatment.

关 键 词：康复牵引技术 针刺治疗 脑梗塞 肌痉挛 DTI 

分 类 号：R246.6[医药卫生—针灸推拿学]