苍龟探穴针法对卒中后小腿三头肌痉挛和步态的影响  

Effects of Cang Gui Tan Xue Acupuncture Method on Triceps Surae Spasm and Gait After Stroke

作　　者：张晓丽 王家艳[1] 唐林[2] 刘德浪 张云婷 赵瑾[1] ZHANG Xiao-li;WANG Jia-yan;TANG Lin;LIU De-lang;ZHANG Yun-ting;ZHAO Jin(Chinese Medicine Hospital of Hainan Province,Haikou 570203,China;Hainan General Hospital,Haikou 570311,China)

机构地区：[1]海南省中医院,海口570203 [2]海南省人民医院,海口570311

出　　处：《上海针灸杂志》2021年第1期38-43,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：海南自然科学基金面上项目(817344);国家自然科学基金青年项目(81661383)。

摘　　要：目的观察苍龟探穴针法对卒中后小腿三头肌痉挛和步态的影响。方法卒中后小腿三头肌痉挛患者112例,按随机平行双盲法平均分成对照组和治疗组,每组56例。对照组采用常规康复治疗,治疗组采用苍龟探穴法针刺治疗,均治疗8周。观察两组治疗前后步态时空参数和对称性参数、相关痉挛和卒中评分、神经电生理指标变化。结果两组治疗后步宽、步态周期、患侧支撑相时间、健侧支撑相时间、双支撑相时间较治疗前均显著下降,步速、患侧摆动相时间、健侧摆动相时间较治疗前均显著上升(P<0.05),且治疗组以上指标均显著优于对照组(P<0.05)。两组治疗后踝关节综合痉挛量表(CSS)评分、10米步行时间(10MWT)较治疗前显著下降,踝关节被动活动度(PROM)较治疗前显著上升(P<0.05),且治疗组显著优于对照组(P<0.05);但两组视觉模拟量表(VAS)评分治疗前后及治疗后比较差异无统计学意义(P>0.05)。两组治疗后傅格梅尔氏运动量表(FMMS)、Barthel指数(BI)、博格平衡量表(BBS)、Holden步行能力量表、Tinetti步态评估量表评分较治疗前显著上升(P<0.05),且治疗组显著优于对照组(P<0.05)。两组治疗后H反射潜伏期较治疗前均显著升高,Hmax/Mmax较治疗前显著下降(P<0.05),且治疗组显著优于对照组(P<0.05)。结论苍龟探穴针法能通过改善卒中患者神经电生理,从而缓解小腿三头肌痉挛状态和步态。Objective To observe the effects of Cang Gui Tan Xue(turtle probing cave)acupuncture method on triceps surae spasm and gait after stroke.Method A total of 112 patients with post-stroke triceps surae spasm were equally divided into a control group and a treatment group using the randomized double-blind parallel-group method,with 56 cases in each group.The control group was given conventional rehabilitation,while the treatment group was intervened by Cang Gui Tan Xue acupuncture,both for 8 weeks.The spatiotemporal gait and symmetry parameters,spasm-and stroke-related scores,and the electro-neurophysiological parameters were observed before and after treatment in both groups.Result The step width,gait cycle,stance phase of the affected side,stance phase of the healthy side and double stance phase decreased significantly,while the walking speed,swing phase of the affected side and swing phase of the healthy side increased significantly after treatment in both groups(P<0.05),and the above parameters in the treatment group were markedly superior to those in the control group(P<0.05).After treatment,the Composite Spasticity Scale(CSS)score of the ankle joint and 10-meter walk time decreased and the passive range of motion(PROM)of the ankle joint increased significantly after treatment in both groups(P<0.05),and the treatment group was significantly superior than the control group(P<0.05).The change in the Visual Analogue Scale(VAS)score was insignificant after treatment in both groups(P>0.05),and there was no significant difference between the two groups after treatment(P>0.05).The scores of Fugl-Meyer Assessment Scale(FMMS),Barthel Index(BI),Berg Balance Scale(BBS),Holden walking ability scale and Tinetti gait assessment scale increased significantly after treatment in both groups(P<0.05),and the treatment group was notably superior to the control group(P<0.05).The H-reflex latency increased and Hmax/Mmax decreased significantly after treatment in both groups(P<0.05),and the treatment group was significantly lower than

关 键 词：针刺疗法 苍龟探穴法 中风后遗症 肌痉挛 神经电生理 

分 类 号：R246.6[医药卫生—针灸推拿学]