毫火针针刺夹脊穴治疗中风后上肢痉挛性瘫痪的临床研究  

Clinical Observation on Filiform-fire Needling at Jiaji Points in Treating Post-stroke Upper-limb Spastic Paralysis

作　　者：刘峻[1] 周鸿飞[1] 张威[1] 金鑫[1] LIU Jun;ZHOU Hong-Fei;ZHANG Wei;JIN Xin(The Affiliated Hospital of Liaoning University of Traditional Chinese Medicine, Shenyang 110032 Liaoning, China)

机构地区：[1]辽宁中医药大学附属医院,辽宁沈阳110032

出　　处：《广州中医药大学学报》2018年第3期430-435,共6页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：辽宁省科学技术计划项目(编号:2013226012);辽宁省教育厅科学技术研究项目(编号:L201627)

摘　　要：【目的】观察应用毫火针针刺夹脊穴治疗中风后上肢痉挛性瘫痪的临床疗效。【方法】将62例中风后上肢痉挛性瘫痪患者随机分为治疗组(毫火针组)和对照组(常规针刺组),每组各31例。治疗组给予毫火针针刺夹脊穴治疗,对照组给予常规针刺患侧肩髃、臂臑、极泉、曲池、手三里、外关、后溪等穴治疗,28 d为1个疗程,1个疗程后观察2组的临床疗效及治疗前后痉挛侧上肢肌张力及其运动功能的改变情况。【结果】(1)治疗后,2组患者上肢肌张力均较治疗前有不同程度改善,2种治疗方法均可降低患者改良Ashworth量表(MAS)分级(P<0.05),且治疗组对上肢肌张力(痉挛程度)的改善作用明显优于对照组(P<0.05)。(2)治疗后,2组患者上肢Fugl-Meyer评分均明显升高(P<0.05或P<0.01),且治疗组对上肢Fugl-Meyer评分的升高作用明显优于对照组(P<0.05)。(3)治疗组总有效率为87.1%,明显优于对照组的64.5%,差异有统计学意义(P<0.05)。【结论】毫火针针刺夹脊穴治疗中风后上肢痉挛性瘫痪,在降低中风后患者偏瘫侧上肢肌张力和改善患侧上肢肢体运动功能方面疗效显著。Objective To observe the clinical effect of filiform-fire needling at Jiaji points for the treatment ofupper-limb spastic paralysis after stroke. Methods Sixty-two post-stroke upper-limb spastic paralysis patientswere randomized into treatment group and control group,31 cases in each group. The treatment group was givenfiliform-fire needling at Jiaji points,and the control group was given conventional acupuncture at Jianyu（L115）,Binao（LI14）,Jiquan（HT1）,Quchi（LI11）,Shousanli（LI10）,Waiguan（SJ5）,Houxi（SI3）of the affectedupper limb. Twenty-eight days constituted one treatment course. After treatment for one course, the clinicalefficacy of the two groups was evaluated. The changes of upper-limb muscular tension and motor function in the twogroups before and after treatment were observed. The muscular tension was evaluated using modified AshworthScale（MAS）and the limb motor function was evaluated using Fugl-Meyer Assessment Scale（FMA）. Results（1）After treatment,the muscular tension of upper-limb in the two groups was significantly reduced,exhibiting as thedecreasing of MAS grading（P〈0.05）. The improvement muscular tension in the treatment group was superior tothat in the control group（P〈0.05）.（2）The upper-limb FMA scores of the two groups were remarkably increasedafter the treatment（P〈0.05 or P〈0.01 compared with those before treatment）,and the increase in the treatmentgroup was superior to that in the control group（P〈0.05）.（3）The total effective rate of the treatment group was87.1%and was 64.5%in the control group,the difference being significant（P〈0.05）. Conclusion Filiform-fire needling at Jiaji points is effective for the treatment of upper-limb spastic paralysis after stroke through reducingmuscular tension and improving motor function of the upper limb.

关 键 词：中风后上肢痉挛性瘫痪 毫火针 夹脊穴 临床研究 

分 类 号：R244.6[医药卫生—针灸推拿学]