针刺结合镜像疗法治疗卒中后偏瘫上肢功能障碍的疗效观察  

Therapeutic Observation of Acupuncture plus Mirror Therapy for Upper-limb Dysfunction of Post-stroke Hemiplegia

作　　者：谢晶军[1] 李金霞[2] 孙琦[1] 马妍洁[1] XIE Jing-jun;LI Jin-xia;SUN Qi;MA Yan-jie(The First People’s Hospital of Huzhou, Huzhou 313000, China;Huzhou Hospital of Traditional Chinese Medicine, Huzhou 313000, China)

机构地区：[1]湖州市第一人民医院,湖州313000 [2]湖州市中医院,湖州313000

出　　处：《上海针灸杂志》2018年第5期494-498,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：湖州市科技局项目(2014GYB27;2015GYB11);湖州市中医药重点专科(2016ZZ04)

摘　　要：目的评价针刺结合镜像疗法治疗脑卒中后偏瘫患者上肢功能障碍的临床疗效。方法将90例脑卒中后偏瘫患者随机分为治疗组和对照组,每组45例。两组患者均接受西医基础治疗和常规康复训练,治疗组采用针刺结合镜像疗法,对照组采用镜像疗法。每星期5次,4星期为1个疗程。观察两组治疗前后上肢Fugle-Meyer运动功能评定量表(FMA)评分、简易上肢机能检查(STEF)评分及改良Barthel指数(MBI)评分变化,并比较两组临床疗效。结果两组治疗后FMA、MBI、STEF评分均高于同组治疗前(P<0.01);治疗组治疗后FMA评分、STEF评分及MBI评分均高于对照组(P<0.01);治疗组治疗前后FMA评分、STEF评分及MBI评分的差值均高于对照组(P<0.01)。治疗组总有效率为88.9%,对照组为68.9%,治疗组总有效率显著高于对照组(P<0.05)。结论在西医基础治疗和常规康复训练的基础上,针刺结合镜像疗法和镜像疗法均有助于脑卒中后偏瘫患者上肢功能的恢复,针刺结合镜像疗法效果更为显著。Objective To observe the clinical efficacy of acupuncture plus mirror therapy in treating upper-limb dysfunction of post-stroke hemiplegia. Method A total of 90 post-stroke hemiplegia patients were randomized into a treatment group and a control group, 45 cases in each group. The two groups both received basic treatment of Western medicine and conventional rehabilitation training. The treatment group was additionally given acupuncture plus mirror therapy, and the control group was additionally given mirror therapy. The treatment was given five times a week, four weeks as a treatment course. The scores of the upper-limb Fugl-Meyer Assessment（FMA）, the simple test for evaluating hand function（STEF） and the Modified Barthel Index（MBI） were observed before and after the treatment, and the clinical efficacies were compared between the two groups. Result After the treatment, the FMA, MBI and STEF scores in the two groups were significantly higher compared to the scores before the treatment（P0.01）, and the FMA, MBI and STEF scores in the treatment group were significantly higher than those in the control group（P0.01）. The changes of the FMA, MBI and STEF scores in the treatment group were significantly higher than those in the control group（P0.01）. The total effective rate was 88.9% in the treatment group versus 68.9% in the control group, and the total effective rate in the treatment group was significantly higher than that in the control group（P0.05）. Conclusion Acupuncture plus mirror therapy and mirror therapy in addition to the basic treatment of Western medicine and conventional rehabilitation training both can benefit the recovery of upper-limb function in post-stroke hemiplegia patients, and acupuncture plus mirror therapy in addition to the basic treatment of Western medicine and conventional rehabilitation training produces a more significant clinical efficacy.

关 键 词：针刺疗法 头针 康复训练 镜像疗法 中风并发症 针药并用 偏瘫 

分 类 号：R246.6[医药卫生—针灸推拿学]