早期针刺督脉穴、夹脊穴干预中风偏瘫痉挛状态临床观察  

Clinical Observation of Acupuncture at Governor Vessel Points and Jiaji(EX-B2) Points in Intervening Early-stage Post-stroke Spastic Hemiplegia

作　　者：林飞燕[1] 郑武熙 张文琪[1] 吴有玲 刘志华[1] 滕春光[1] LIN Fei-yan;ZHENG Wu-xi;ZHANG Wen-qi;WU You-ling;LIU Zhi-hua;TENG Chun-guang(Boai Hospital of Zhongshan of Guangdong Province,Zhongshan 528403,Chin)

机构地区：[1]广东省中山市博爱医院,中山528403

出　　处：《上海针灸杂志》2018年第6期614-618,共5页Shanghai Journal of Acupuncture and Moxibustion

基　　金：广东省中医药局科研项目(20162148);中山市社会公益科技研究项目(医疗卫生)(2016B1081)

摘　　要：目的观察针刺督脉穴、夹脊穴对中风偏瘫痉挛的发生及程度、肢体运动功能、日常生活活动能力的影响。方法将90例脑卒中软瘫期患者分为观察组(针刺督脉穴、夹脊穴)、针刺组(常规针刺)及康复组(单纯康复训练),每组30例。观察组针刺百会、风府、大椎、陶道、身柱、神道、命门穴及C1-7、T1-3、Ll-5、S1夹脊穴(双侧);针刺组针刺肩髃、曲池、外关、合谷、环跳、风市、足三里、阳陵泉、太冲穴;康复组单纯进行康复训练。治疗4周,分别于治疗前后观察改良的Ashworth分级、Fugl-Meyer评分、Barthel指数评分的变化。结果观察组Ashworth分级、Fugl-Meyer评分、Barthel指数评分较治疗前得到显著改善(P<0.01),在缓解肌痉挛方面,观察组疗效优于针刺组及康复组(P<0.01)。结论早期针刺督脉穴、夹脊穴干预中风偏瘫痉挛状态比常规针刺和单纯康复治疗疗效显著提高,同时更明显改善偏瘫患者的肢体运动功能及日常生活能力。Objective To observe the effect of acupuncture at Governor Vessel points and Jiaji（EX-B2） points on the onset, severity, limb motor function and activities of daily living（ADL） in post-stroke spastic hemiplegia. Method Ninety cerebral stroke patients at flaccid paralysis stage were allocated to an observation group（acupuncture at Governor Vessel points and Jiaji points）, an acupuncture group（ordinary acupuncture） and a rehabilitation group（rehabilitation training alone）, with 30 cases in each group. The observation group received acupuncture at Baihui（GV20）, Fengfu（GV16）, Dazhui（GV14）, Taodao（GV13）, Shenzhu（GV12）, Shendao（GV11） Mingmen（GV4） and bilateral Jiaji points（C1-7, T1-3, Ll-5 and S1）; the acupuncture group received acupuncture at Jianyu（LI15）, Quchi（LI11）, Waiguan（TE5）, Hegu（LI4）, Huantiao（GB30）, Fengshi（GB31）, Zusanli（ST36）, Yanglingquan（GB34）, and Taichong（LR3）; the rehabilitation group was intervened by rehabilitation training alone. The treatments lasted 4 weeks. The changes in the Modified Ashworth Scale（MAS）, Fugl-Meyer Assessment（FMA） and Barthel Index（BI） scores after the treatment were observed. Result The observation group showed significant improvements in the MAS, FMA and ADL-Barthel scores after the intervention（P〈0.01）; the therapeutic efficacy of the observation group was better than that of the acupuncture group and rehabilitation group in relieving spasm（P〈0.01）. Conclusion Acupuncture at Governor Vessel points and Jiaji points can produce a more significant efficacy in intervening the early-stage post-stroke spastic hemiplegia compared with ordinary acupuncture and single rehabilitation, and more significantly improve limb motor function and ADL of the hemiplegia patients.

关 键 词：针刺疗法 中风后遗症 偏瘫 肌痉挛 督脉 穴 夹脊 Ashworth评分 FUGL-MEYER评分 BARTHEL指数 

分 类 号：R246.6[医药卫生—针灸推拿学]