透穴针刺联合Bobath技术治疗脑卒中后偏瘫肢体痉挛的临床疗效观察  

Clinical Observation on Acupuncture Combining Bobath in the Treatment of Spastic Hemiplegia after Stroke

作　　者：谭世洪[1] Tan Shihong(Pujiang People′s Hospital,Pujiang 611630,Sichuan,China)

机构地区：[1]蒲江县人民医院,四川蒲江61163

出　　处：《中西医结合心脑血管病杂志》2018年第20期3044-3047,共4页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

摘　　要：目的探讨透穴针刺联合Bobath技术治疗脑卒中后偏瘫肢体痉挛的临床疗效。方法选取我院收治的88例卒中后偏瘫肢体痉挛病人,随机分为对照组与治疗组,各44例。两组均予内科基础及对症处理,对照组予Bobath技术疗法,治疗组在上述基础上予透穴针刺,以4周为1个疗程,两组均治疗3个疗程。使用美国国立卫生研究院卒中量表(NIHSS)评估神经缺损功能、改良Ashworth痉挛量表(MAS)评估肢体痉挛状况、简化Fugl-Meyer量表(FMA)量表评估肢体运动功能、改良Barthel指数量表(MBI)评估日常生活能力,比较两组临床疗效。结果与治疗前比较,两组治疗后4周、8周、12周NIHSS评分降低(P <0.05),上肢、下肢MAS及FMA评分均降低(P <0.05),MBI评分降低(P <0.05);与同时间对照组比较,治疗组治疗后4周、8周、12周NIHSS评分较低(P<0.01),上肢、下肢MAS及FMA评分均较低(P <0.05),MBI评分较低(P <0.05)。治疗组总有效率高于对照组(P <0.05)。结论透穴针刺联合Bobath技术可显著改善脑卒中病人偏瘫肢体的痉挛状态。Objective To investigate the clinical effect of acupuncture combining Bobath on the treatment of spastic hemiplegia afterstroke.Methods Eighty eight patients with spastic hemiplegia after stroke were randomly divided into the control group and thetreatment group,each group with 44 cases.All the patients were treated with routine and symptomatic therapy, the control group wastreated with Bobath technique,the treatment group was treated with acupuncture plus Bobath technique,and all patients were treatedfor 3 courses with 4 weeks as a treatment course.NIHSS scale was used to evaluate the neurological deficits,the MAS scale was usedto evaluate the spasticity of limbs,the FMA scale was used to evaluate the motor function of the limbs,and the MBI scale was used toevaluate the quality of life.Results Compared with data before treatment,the NIHSS scores of the two groups decreased at the endof the 4,8 and 12 weeks after treatment （P 〈0.05）,The MAS and FMA scores of upper limbs and lower limbs were decreased （P 〈0.05）,MBI score decreased （ P 〈0.05）.Compared with the control group at the same time, the NIHSS score of the treatment groupwere lower at 4,8 and 12 weeks after treatment（P 〈0.01）,MAS and FMA scores of upper limbs and lower limbs were lower（P 〈0.05）,The MBI score was lower （P 〈0.05）,and the total effective rate was higher （ P 〈0.05）.Conclusion Acupuncture combining Bobathcould significantly improve spasticity of hemiplegic limbs in patients after stroke.

关 键 词：脑卒中 偏瘫 肢体痉挛 透穴 BOBATH技术 美国国立卫生研究院卒中量表 改良Ashworth痉挛量表 简化FuglMeyer量表 改良Barthel指数量表 

分 类 号：R743[医药卫生—神经病学与精神病学] R255.2[医药卫生—临床医学]