“治痿独取阳明”指导下康复锻炼配合针刺、电针改善脑卒中患者足下垂的临床研究  

Rehabilitation Exercise Combined with Acupuncture and Electroacupuncture to Improve Foot Ptosis in Stroke Patients under Guidance of"Treating Flaccidity-Syndrome by Taking Yangming Alone"

作　　者：颜玲玲[1] 陈媛 王欣宇 吴佳 王馨瑶 芮晓东[1] 陈麒阳 刘康[1] YAN Ling-ling;CHEN Yuan;WANG Xing-yu;WU Jia;WANG Xing-yao;RUI Xiao-dong;CHEN Qi-yang;LIU Kang(Liyang Municipal People's Hospital,Changzhou,Jiangsu 213300)

机构地区：[1]溧阳市人民医院,江苏常州213300

出　　处：《按摩与康复医学》2022年第11期6-10,共5页Chinese Manipulation and Rehabilitation Medicine

摘　　要：目的:探究“治痿独取阳明”原则指导下应用针刺、电针合康复锻炼改善脑卒中患者足下垂的疗效。方法:选取2016年10月~2020年11月在我科诊断为脑卒中后遗症期并足下垂的382例患者,并随机分为对照组和观察组各191例。对照组采用康复锻炼治疗,2次/天;观察组加用针刺阳明经相应穴位,同时电针刺激足三里和阳陵泉,1次/天,5~6次/周。治疗8周后比较两组下肢神经肌电活动差异,应用Fugl-Meyer运动量表(下肢部分)及Brunnstrom分期比较两组疗效差异。结果:与对照组比较,观察组胫神经、腓总神经运动神经末端潜伏期(DML)、感觉神经传导速度(SCV)和电位(SNAP)均显著改善(P<0.01),运动神经传导速度(MCV)改善(P<0.05)。相比对照组,观察组下肢Fugl-Meyer运动量表评分及Brunnstrom分期均较高(P<0.05)。结论:“治痿独取阳明”理论指导下的综合治疗可以有效治疗脑卒中后遗症期的足下垂。Objective:To explore the effect of acupuncture,electroacupuncture and rehabilitation exercise on foot ptosis in stroke patients under the guidance of the principle of"treating flaccidity-syndrome by taking Yangming alone".Methods:From Octomber 2016 to November 2020,total 382 cases diagnosed as stroke sequalae stage in our department were randomly and averagely divided into control group(n=191)and observation group(n=191).The control group was treated with rehabilitation exercise,twice a day;The observation group was treated with acupuncture at the corresponding acupoints of Yangming Meridian and electroacupuncture at Zusanli and Yanglingquan,once a day,5~6 times a week.After 8 weeks of treatment,the differences of lower limb neuroelectromyographic activities between the two groups were compared,and the curative effects of the two groups were compared by Fugl-Meyer assessment(lower limb part)and Brunnstrom stage.Results:Compared with the control group,the tibial nerve,common peroneal nerve,motor nerve terminal latency(DML),sensory nerve conduction velocity(SCV)and potential(SNAP)in the observation group were significantly improved(P<0.01),and motor nerve conduction velocity(MCV)was improved(P<0.05).Compared with the control group,the scores of Fugl-Meyer score and Brunnstrom stage of lower limbs in observation group were higher(P<0.05).Conclusion:Comprehensive treatment under the guidance of the theory of"treating flaccidity-syndrome by taking Yangming alone"can effectively treat foot ptosis in the sequelae of stroke.

关 键 词：脑卒中 后遗症期 足下垂 治痿独取阳明 针刺、电针 康复锻炼 肌电活动 

分 类 号：R493[医药卫生—康复医学] R246[医药卫生—临床医学]