平衡灸法结合功能锻炼治疗缺血性脑卒中后下肢痉挛性瘫痪疗效及对血清谷氨酸、γ-氨基丁酸水平的影响  

Efficacy of balanced moxibustion combined with functional exercise on spastic paralysis of lower limbs after ischemic stroke and its effect on levels of serum glutamate andγ-aminobutyric acid

作　　者：熊丽 王伟贵 郝秀元 靳春蕾 霍丹 宋彩霞[2] 陈国杰[2] XIONG Li;WANG Weigui;HAO Xiuyuan;JIN Chunlei;HUO Dan;SONG Caixia;CHEN Guojie(Tangshan Hospital of Traditional Chinese Medicine,Tangshan 063000,Hebei,China;Xingtang County People’s Hospital,Xingtang 050600,Hebei,China)

机构地区：[1]唐山市中医医院,河北唐山063000 [2]行唐县人民医院,河北行唐050600

出　　处：《现代中西医结合杂志》2021年第35期3916-3919,3946,共5页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：河北省中医药管理局科研计划项目(2020390)。

摘　　要：目的观察平衡灸法结合功能锻炼治疗缺血性脑卒中后下肢痉挛性瘫痪的疗效及对血清谷氨酸(Glu)、γ-氨基丁酸(GABA)水平的影响。方法选择唐山市中医医院2019年2月—2020年11月接诊的124例缺血性脑卒中后下肢痉挛性瘫痪患者作为研究对象,随机分为观察组和对照组各62例。观察组予以平衡灸法结合功能锻炼,对照组予以功能锻炼,2组疗程均为6周。观察2组治疗前后下肢运动功能量表(FMA)、Berg平衡量表(BBS)、功能性步行量表(FAC)评分及血清Glu、GABA水平,根据下肢痉挛程度的改变情况评价临床疗效,记录2组并发症发生情况。结果治疗后,2组FMA评分、BBS评分及FAC分级均较治疗前提高(P均<0.05),观察组较对照组提高更明显(P均<0.05);治疗后,2组血清Glu水平均明显降低(P均<0.05),GABA水平均明显升高(P均<0.05),观察组较对照组改善更明显(P均<0.05)。观察组临床总有效率为88.7%(55/62),高于对照组的72.6%(45/62),差异有统计学意义(P<0.05);观察组并发症发生率为6.5%(4/62),低于对照组的19.5%(12/62),差异有统计学意义(P<0.05)。结论平衡灸法结合功能锻炼能协同提高缺血性脑卒中后下肢痉挛性瘫痪患者的运动和平衡功能,减少并发症发生,其作用机制推测与降低血清Glu水平和升高GABA水平有关。Objective It is to observe the curative effect of balancing moxibustion combined with functional exercise in the treatment of spastic paralysis of lower limbs after ischemic stroke and its effect on the levels of serum glutamate(Glu)andγ-aminobutyric acid(GABA).Methods A total of 124 patients with spastic paralysis of lower limbs after ischemic stroke who were admitted to Tangshan Hospital of Traditional Chinese Medicine from February 2019 to November 2020 were selected as the research objects,and they were randomly divided into an observation group and a control group,with 62 cases in each group.The observation group was given balanced moxibustion combined with functional exercises,and the control group was given functional exercises.The course of treatment in both groups was 6 weeks.The scores of lower limb motor function assessment(FMA),Berg balance scale(BBS),functional ambulation category scale(FAC)and the levels of serum Glu and GABA before and after treatment were observed in the two groups,the clinical efficacy was evaluated according to the changes in the degree of lower limb spasticity,and the complications occurred in the 2 groups were recorded.Results After treatment,the FMA score,BBS score and FAC classification of the two groups were all higher than those before treatment(all P<0.05),and the improvements in the observation group were more significant than those in the control group(all P<0.05);after treatment,the serum Glu level of the two groups was significantly reduced(all P<0.05),GABA level was significantly increased(all P<0.05),the indexes in the observation group improved more significantly than those in the control group(all P<0.05).The total clinical effective rate in the observation group was 88.7%(55/62),which was higher than 72.6%(45/62)in the control group,the difference was statistically significant(P<0.05);the complication rate in the observation group was 6.5%(4/62),which was lower than 19.5%in the control group(12/62),the difference was statistically significant(P<0.05).Conclusion

关 键 词：缺血性脑卒中 平衡灸法 功能锻炼 下肢痉挛性瘫痪 谷氨酸 Γ-氨基丁酸 

分 类 号：R742.3[医药卫生—神经病学与精神病学]