针刺时间不同对脑卒中下肢痉挛患者治疗效果的影响  

Effect of Needle Retention Time on Lower Limbs Spasm of Post Stroke in Patients

作　　者：王飞[1] 王民集[2] 

机构地区：[1]河南中医药大学针推学院,河南郑州450008 [2]河南中医药大学第三附属医院,河南郑州450008

出　　处：《辽宁中医杂志》2018年第1期144-147,共4页Liaoning Journal of Traditional Chinese Medicine

基　　金：河南中医学院博士科研基金项目(BSJJ2014-21)

摘　　要：目的：探讨针刺治疗脑卒中下肢痉挛患者不同留针时间对疗效的影响。方法：选取102例2011年1月—2015年1月来院诊治的脑卒中下肢痉挛患者,随机分为A、B、C 3组各34例,均行平补平泻的提插捻转手法进行针刺治疗,以得气为度,其中A组得气后立即拔针,B组留针30 min,C组留针60 min,观察记录3组治疗前及治疗1个疗程后临床痉挛指数（CSI）、简式Fugl-Meyer运动功能（FMA）及脑卒中专用生活质量量表（SS-QOL）评分以及3组痉挛下肢膝屈曲及踝背屈最大等长收缩状态时主动肌、拮抗肌积分肌电值（IEMG）、肢体协同收缩率（CO）,H反射潜伏期及H反射最大波幅和M波最大波幅比值（H/M）。结果：治疗后CSI上B组显著低于A、C两组,差异有统计学意义（q=5.58,6.28;P〈0.05）,FMA上B组显著高于A、C组（q=5.57,6.59;P〈0.05）,SS-QOL上B组也高于A、C组（q=5.07,7.22;P〈0.05）差异有统计学意义,H反射潜伏期上B组也高于A、C组（q=5.23,6.63;P〈0.05）,H/M上B组低于A、C组（q=6.51,7.54;P〈0.05）,差异有统计学意义;治疗后3组间胫前肌IEMG比较B组低于A、C组（q=4.88,5.51;P〈0.05）,腓肠肌内侧IEMG比较,B组低于A、C组（q=4.65,5.78;P〈0.05）,踝背屈CO比较B组也低于A、C组（q=7.97,9.08;P〈0.05）,差异有统计学意义,股二头肌IMEG比较B组低于A、C组（q=5.90,6.99;P〈0.05）,股直肌IMEG上B组也低于A、C组（q=5.25,6.22;P〈0.05）而膝屈曲CO上,B组仍低于A、C组（q=6.57,6.25;P〈0.05）,差异均有统计学意义。结论：不同针刺时间均对脑卒中下肢痉挛患者有良好效果,但留针30 min疗效最好。Objective： To observe the effect of needle retention time on lower limbs spasm of stroke patients. Methods： The treated 102 cases of patients with lower limbs spasm of stroke were chosen and randomly divided into A,B and C groups（all groups n= 34）. Three groups were all given the same acupuncture point selection once a day,but the needle retention time was 0 min in A,30 min in B and 60 min in C. The scores were recorded by applying the CSI,FMA and SS-QOL,while the change of H reflex of lower limbs with antagonistic muscle and at the same time agonist and antagonist muscle integrated electromyography（IEMG）scores of the knee buckling and ankle dorsiflexion were recorded by surface EMG before and after treatment for one course. Results： The B was lower than the A and C in CSI（q = 5. 58,6. 28; P 0. 05）,H/M（q = 6. 51,7. 54; P 0. 05）,IEMG of the pretibial muscle（q = 4. 88,5. 51; P 0. 05）,gastrocnemius muscle（q = 4. 65,5. 78; P 0. 05）,biceps femoris muscle（q = 5. 90,6. 99; P 0. 05）,rectus muscleq = 5. 25,6. 22; P 0. 05）,and the CO of knee buckling（q = 6. 57,6. 25; P 0. 05） and ankle dorsiflexion（q = 7. 97,9. 08; P 0. 05）,while higher than the A and C in FMA（q = 5. 57,6. 59; P 0. 05）,SS-QOL（q = 5. 07,7. 22; P 0. 05） and latency of H reflex（q = 5. 23,6. 63; P 0. 05）. Conclusion： All of the different needle retention time on lower limbs spasm of stroke in patients can get the good effect,but the 30 min needle retention time can achieve the most satisfactory result.

关 键 词：留针时间 针刺 脑卒中 下肢痉挛 

分 类 号：R246.1[医药卫生—针灸推拿学]