神经干刺激疗法在脑卒中恢复期患者下肢功能康复中的应用  

Application of nerve trunk stimulation therapy in functional rehabilitation of the lower limbs in the patients with cerebral apoplexy at convalescence stage

作　　者：陈佳旭 邵开超 鲁常武 CHEN Jia-xu;SHAO Kai-chao;LU Chang-wu(Department of Rehabilitation,Shenzhen Pingle Orthopedic Hospital,Pingshan Hospital of Traditional Chinese Medicine,Shenzhen 518101,Guangdong Province,China)

机构地区：[1]深圳平乐骨伤科医院(深圳市坪山区中医院)康复科,广东深圳518101

出　　处：《针刺研究》2020年第5期412-415,共4页Acupuncture Research

摘　　要：目的:探讨神经干刺激疗法在脑卒中恢复期患者下肢功能康复中的应用价值。方法:将脑卒中恢复期下肢功能障碍患者按照随机数字表法分为对照组和治疗组,每组42例。两组均给予药物治疗和常规康复训练。对照组同时给予常规针灸治疗;治疗组同时应用神经干刺激疗法,选择尺泽(桡神经刺激点)、内关(正中神经刺激点)、小海(尺神经刺激点)和极泉下1~2寸(臂丛神经刺激点)等。均30 min/d,每周治疗6 d,共治疗4周。比较两组治疗前后膝关节屈伸肌峰力矩、步态参数、改良Ashworth痉挛量表(MAS)评分、Fugl-Meyer运动功能评定量表(FMA)评分、Fugl-Meyer平衡量表(FBS)评分。结果:治疗后两组患者膝关节屈伸肌峰力矩、FMA评分、FBS评分、步频、步速均较治疗前明显提高(P<0.01),MAS评分、左右步幅差较治疗前明显降低(P<0.01)。治疗后治疗组膝关节屈伸肌峰力矩、FMA评分、FBS评分、步频、步速均明显高于对照组(P<0.01), MAS评分、左右步幅差明显小于对照组(P<0.01)。结论:神经干刺激疗法能更有效增强下肢肌力,缓解肌张力,改善下肢运动功能、平衡能力和步行模式,在脑卒中恢复期患者下肢功能康复中起重要作用。Objective To explore the value of nerve trunk stimulation in the rehabilitation of lower limb function in the patients with cerebral apoplexy at convalescence stage. Methods According the random number table, the patients with the lower limb dysfunction of cerebral apoplexy at convalescence stage were divided into a control group and a treatment group, 42 cases in each group. The drug therapy and the routine rehabilitation training were provided in the two groups. Additionally, in the treatment group, the nerve trunk stimulation therapy was adopted, in which, Chize(LU5,stimulating point of radial nerve), Neiguan(PC6, stimulating point of median nerve), Xiaohai(SI8, stimulating point of ulnar nerve) were selected. In the control group, acupuncture intervention was supplemented. Before and after treatment, the peak torque(PT) of the lower flexor-extensor muscle of the knee joint, gait parameters,the score of the modified Ashworth spasm scale(MAS), the score of Fugl-Meyer motor assessment(FMA) and the score of Fugl-Meyer balance scale(FBS) were recorded. Results After the treatment, the PT of the lower flexor-extensor muscle of the knee joint,the scores of FMA and FBS,the step speed and frequency were all increased, the score of MAS and the difference in the stride between the left and the right were decreased as compared with those before treatment(P<0.01). After the treatment, The PT of the lower flexor-extensor muscle of the knee joint,the scores of FMA and FBS,the step speed and frequency in the treatment group were higher than those in the control group(P<0.01). The score of MAS and the difference in the stride between the left and the right in the treatment group were lower than those in the control group(P<0.01). Conclusion Nerve trunk stimulation therapy quite effectively increases the muscle strength and relieves the muscle tension as well as improves the motor function, the balance and the walking pattern of the lower limbs. This therapy is significantly valuable in the rehabilitation of the lower limbs in

关 键 词：神经干刺激疗法 针灸 脑卒中恢复期 下肢功能 

分 类 号：R245.311[医药卫生—针灸推拿学]