头穴丛刺结合肌电生物反馈对脑梗死恢复期神经及运动功能障碍的临床效果研究  

Study on Clinical Effect of Cluster Needling of Scalp Points Combined with EMG Biofeedback on Neurological and Motor Dysfunction in Patients with Cerebral Infarction at Convalescence

作　　者：常永霞[1] 崔万森[1] 王晓娜 马崇[1] 邹玉安[1] 李姣[1] 贾晓静[1] CHANG Yongxia;CUI Wansen;WANG Xiaona;MA Chong;ZOU Yuan;LI Jiao;JIA Xiaojing(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,Hebei,China)

机构地区：[1]河北北方学院附属第一医院,河北张家口075000

出　　处：《中华中医药学刊》2021年第10期250-253,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：河北省中医药管理局中医药类科研计划(2017100);张家口市科技攻关计划(1421103D)。

摘　　要：目的研究头穴丛刺结合肌电生物反馈对脑梗死恢复期患者神经及运动功能障碍的临床效果,为临床治疗工作提供参考资料。方法选取2018年7月—2019年7月医院诊治的脑梗死恢复期患者60例,根据随机数字表法均分为两组,对照组30例进行常规康复治疗,实验组30例在对照组基础上进行头穴丛刺结合肌电生物反馈治疗,分别在入院时、2周、4周进行神经及运动功能障碍评估,并检测脑电地形图和血清基质金属蛋白酶-9(MMP-9)。神经功能采用美国国立卫生研究院卒中量表(NIHSS)评定,运动功能障碍采用Fugl-Meyer肢体运动功能评分(FMA)和日常生活活动能力评分Barthel指数法评定。结果入院时实验组和对照组的NIHSS、Fugl-Meyer、Barther指数以及脑电地形图、血清MMP-9比较,差异均无统计学意义(P>0.05),治疗后2、4周实验组的NIHSS、Fugl-Meyer、 Barther指数均显著优于对照组(P<0.05);治疗后2、4周实验组的δ、θ频带梗死区平均功率值显著高于对照组,α频带梗死区平均功率值显著低于对照组,组间差异有统计学意义(P<0.05);治疗后2、4周实验组的血清MMP-9水平显著低于对照组(P<0.05)。结论头穴丛刺结合肌电生物反馈在脑梗死恢复期应用效果满意,有利于恢复脑神经电生理活动、抑制炎性反应,进而显著改善患者的神经及运动功能障碍,促进患者康复。Objective To study the clinical effect of cluster needling of scalp points combined with EMG biofeedback on neurological and motor dysfunction in patients with cerebral infarction at convalescence and provide reference materials for clinical treatment. Methods Sixty patients with cerebral infarction at convalescence from July 2018 to July 2019 were selected and divided into two groups according to the random number table method. Thirty cases in the control group received routine rehabilitation treatment, and 30 cases in the experimental group received clinical effect of cluster needling of scalp points combined with EMG biofeedback based on the control group. The neurological and motor dysfunction assessments were performed at admission, 2 and 4 weeks after treatment, and electroencephalogram and serum matrix metalloproteinase-9(MMP-9) were detected. Nerve function was evaluated by the National Institutes of Health Stroke Scale(NIHSS), and motor dysfunction was evaluated by Fugl-meyer Motor Function Assessment(FMA) and daily life activity score(Barthel index method). Results There was no significant difference in NIHSS, FMA, Barther index, EEG topography or serum MMP-9 between the experimental group and the control group at admission(P>0.05), and the NIHSS, Fugl-Meyer and Barther index of the experimental group 2 and 4 weeks after treatment were significantly better than those of the control group(P<0.05). The average power value of δ and θ band infarction area of the experimental group 2 and 4 weeks after treatment were significantly higher than that of the control group. The average power value of α band infarction area was significantly lower than that of the control group, and the difference between two groups was statistically significant(P<0.05). The serum MMP-9 levels in the experimental group 2 and 4 weeks after treatment were significantly lower than those in the control group(P<0.05). Conclusion Cluster needling of scalp points combined with EMG biofeedback in patients with cerebral infarction at con

关 键 词：脑梗死 恢复期 头穴丛刺 肌电生物反馈 神经功能 运动功能 脑电地形图 基质金属蛋白酶-9 

分 类 号：R277.743.33[医药卫生—中医学]