透刺联合运动疗法治疗脑卒中后手痉挛：随机对照研究  

Post-stroke hand spasm treated with penetrating acupuncture combined with kinesiotherapy: a randomized controlled trial

作　　者：王晓春 刘通[2] 王俊华[2] 张俊杰[2] WANG Xiao-chun;LIU Tong;WANG Jun-hua;ZHANG Jun-jie(Department of Acupuncture-Moxibustion and Rehabilitation,Fifth Clinical Medical College,Guangzhou University of CM,Guangzhou 510405,Guangdong Province,China;Department of Acupuncture-Moxibustion and Rehabilitation,Guangdong Second Hospital of TCM,Guangzhou 510095)

机构地区：[1]广州中医药大学第五临床医学院针灸康复科,广东广州510405 [2]广东省第二中医院针灸康复科,广州510095

出　　处：《中国针灸》2020年第1期21-25,共5页Chinese Acupuncture & Moxibustion

基　　金：广东省中医药局科研项目：20171020

摘　　要：目的:比较透刺联合运动疗法与单纯透刺、单纯运动疗法治疗脑卒中后手痉挛的临床疗效。方法:将105例脑卒中后手痉挛患者随机分为透刺组、运动组和联合组,每组35例,其中联合组和透刺组各脱落2例,运动组脱落1例。3组均行常规作业疗法、Bobath运动等康复训练及药物治疗。透刺组行患侧合谷与后溪、外关与四渎相互透刺;运动组行腕关节、掌指关节及指间关节的持续主动或被动运动;联合组予透刺(同透刺组)结合运动疗法(同运动组)。各组治疗均每日1次,每次30min,每周治疗6次,休息1d,2周为一疗程,共治疗2个疗程。比较各组患者治疗前后手痉挛指数、手腕运动功能及日常生活活动能力评分变化。结果:3组治疗后手痉挛指数评分均较治疗前降低(P<0.05),手腕运动功能评分、日常生活活动能力评分均较治疗前显著增高(P<0.05);且联合组治疗后手痉挛指数评分降低幅度大于透刺组及运动组(P<0.01),手腕运动功能评分、日常生活活动能力评分增高幅度大于透刺组及运动组(P<0.01),运动组及透刺组各指标改善幅度比较差异无统计学意义(P>0.05)。结论:与单纯透刺及运动疗法相比,透刺联合运动疗法更能显著改善脑卒中患者手痉挛程度、手腕运动功能及日常生活活动能力。Objective To compare the differences in the clinical effect on post-stroke hand spasm among the combined treatment of penetrating acupuncture and kinesiotherapy, the simple application of penetrating acupuncture and the simple application of kinesiotherapy. Methods A total of 105 patients with post-stroke hand spasm were randomized into a penetrating acupuncture group, a kinesiotherapy group and a combined treatment group, 35 cases in each one, of which, 2 cases were dropped out in either the combined treatment group and the penetrating acupuncture group, and 1 case dropped out in the kinesiotherapy group. The routine rehabilitation training, e.g. occupational therapy and Bobath exercise and medication were adopted in all of the three groups. In the penetrating acupuncture group, the penetrating needling technique was exerted from Hegu(LI 4) to Houxi(SI 3) and from Waiguan(TE 5) to Sidu(TE 9) on the affected side. In the kinesiotherapy group, the persistent movement or passive movement was exerted on the wrist joint, the metacarpophalangeal joints and the interphalangeal joints. In the combined treatment group, the penetrating acupuncture(the same as the penetrating acupuncture group) was exerted combined with kinesiotherapy(the same as the kinesiotherapy group). In each group, the treatment was given once a day, 30 min in each time, 6 treatments a week in total, with the interval of 1 day between the courses. The treatment for 2 weeks was as one course and 2 courses were required totally. Before and after treatment, the scores of hand spasm index, hand-wrist motor function and the activity of daily living(ADL) were compared in each group. Results After treatment, the scores of hand spasm index were reduced as compared with those before treatment in each group(P<0.05) and the scores of hand-wrist motor function and ADL were increased significantly as compared with those before treatment in each group(P<0.05). After treatment, the reducing degree of the score of hand spasm index in the combined treatment group was

关 键 词：脑卒中 手痉挛 手功能 透刺 运动疗法 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]