同时电针拮抗肌与主动肌对中风后上肢痉挛患者运动功能的影响  

Effect of electroacupuncture at antagonistic muscle and agonistic muscle on motor function in patients with upper-extremity spasticity after stroke

作　　者：张建博 魏瑞鹏 杨虹 韩冰 ZHANG Jian-bo;WEI Rui-peng;YANG Hong;HAN Bing(Department of Rehabilitation Medicine,Ninth People′s Hospital of Shenzhen,Shenzhen 518116,Guangdong Province,China)

机构地区：[1]深圳市第九人民医院康复医学科,广东深圳518116

出　　处：《中国针灸》2022年第4期381-384,共4页Chinese Acupuncture & Moxibustion

基　　金：广东省中医药局科研项目:20191284。

摘　　要：目的:比较同时电针拮抗肌和主动肌与单纯电针拮抗肌对中风后上肢痉挛患者痉挛程度、上肢运动功能及日常生活活动能力的改善作用。方法:将60例中风后上肢痉挛患者随机分为综合组(30例,脱落1例)和拮抗肌组(30例,脱落2例)。拮抗肌组穴取肩髃、臂臑、肘髎、手三里、外关、后溪,于肩髃-臂臑、肘髎-手三里、外关-后溪连接电针,予断续波,频率15 Hz;综合组在拮抗肌组基础上,加用天泉、尺泽、间使、大陵,于天泉-尺泽、间使-大陵连接电针,予连续波,频率5 Hz。两组均每日治疗1次,每周6 d,共4周。分别于治疗前后观察两组改良Ashworth量表(MAS)、上肢Fugl-Meyer量表(FMA-UE)及改良Barthel指数(MBI)量表评分。结果:治疗后,两组患者屈肘肌群和屈腕肌群MAS评分均较治疗前降低(P<0.05),FMA-UE、MBI量表评分均较治疗前升高(P<0.05);综合组患者FMA-UE、MBI量表评分高于拮抗肌组(P<0.05)。结论:同时电针拮抗肌和主动肌与单纯电针拮抗肌均能改善中风后上肢痉挛患者的痉挛程度,但前者能更好地恢复运动功能,提高患者日常生活活动能力。Objective To compare the improvement effect between simultaneous electroacupuncture at antagonistic muscle and agonistic muscle and simple electroacupuncture at antagonistic muscle on spasticity degree,upper-extremity motor function and activity of daily living in patients with upper-extremity spasticity after stroke.Methods A total of 60patients with upper-extremity spasticity after stroke were randomized into a comprehensive group(30 cases,1 case dropped off)and an antagonistic muscle group(30 cases,2 cases dropped off).In the antagonistic muscle group,acupuncture was applied at Jianyu(LI 15),Binao(LI 14),Zhouliao(LI 12),Shousanli(LI 10),Waiguan(TE 5)and Houxi(SI 3),electric stimulation was attached to Jianyu(LI 15)-Binao(LI 14),Zhouliao(LI 12)-Shousanli(LI 10)and Waiguan(TE 5)-Houxi(SI 3),with discontinuous wave,15 Hz in frequency.On the basis of the treatment in the antagonistic muscle group,acupuncture was applied at Tianquan(PC 2),Chize(LU 5),Jianshi(PC 5)and Daling(PC 7)in the comprehensive group,electric stimulation was attached to Tianquan(PC 2)-Chize(LU 5)and Jianshi(PC 5)-Daling(PC 7),with continuous wave,5 Hz in frequency.The treatment was given once a day,6 days a week for 4 weeks in the two groups.Before and after treatment,the scores of modified Ashworth scale(MAS),Fugl-Meyer assessment upper extremity scale(FMA-UE)and modified Barthel index(MBI)scale were observed in the two groups.Results Compared before treatment,the MAS scores of elbow flexors and wrist flexors after treatment were decreased(P<0.05),the scores of FMA-UE and MBI scale after treatment were increased in the two groups(P<0.05).The scores of FMA-UE and MBI scale after treatment in the comprehensive group were higher than those in the antagonistic muscle group(P<0.05).Conclusion Simultaneous electroacupuncture at antagonistic muscle and agonistic muscle and simple electroacupuncture at antagonistic muscle can both improve the spasticity degree in patients with upper-extremity spasticity after stroke,however,the former can better rest

关 键 词：中风 上肢痉挛 电针 拮抗肌 主动肌 运动功能 

分 类 号：R246.6[医药卫生—针灸推拿学]