麦粒灸十宣穴联合康复训练治疗中风后手指痉挛:随机对照试验  

Treatment of finger spasm after stroke with wheat grain moxibustion at Shixuan(EX-UE 11)combined with rehabilitation training:a randomized controlled trial

作　　者：牛丽[1] 李彦杰 秦合伟 郭宁 刘昊源 华晓琼 张淑芹 孙钰斌 NIU Li;LI Yan-jie;QIN He-wei;GUO Ning;LIU Hao-yuan;HUA Xiao-qiong;ZHANG Shu-qin;SUN Yu-bin(Henan University of TCM,Zhengzhou 450046,China;Henan Provincial Hospital of TCM,Second Affiliated Hospital of Henan University of TCM,Zhengzhou 450002)

机构地区：[1]河南中医药大学,郑州450046 [2]河南省中医院/河南中医药大学第二附属医院,郑州450002

出　　处：《中国针灸》2022年第6期613-617,共5页Chinese Acupuncture & Moxibustion

基　　金：河南省中医药科学研究专项课题项目:2019ZYBJ14;河南省中医药文化与管理研究项目:TCM2020016;河南省中医药拔尖人才培养项目:豫中医科教[2018]。

摘　　要：目的:比较麦粒灸十宣穴联合康复训练与单纯康复训练治疗中风后手指痉挛的临床疗效。方法:将80例中风后手指痉挛患者随机分为观察组和对照组,各40例。对照组予常规康复训练,每日1次,每次30 min;观察组在对照组基础上予麦粒灸十宣穴,每穴灸8~10壮,每日1次。两组均6 d为一疗程,共治疗4个疗程。比较两组患者治疗前后Fugl-Meyer运动功能评定量表(FMA)评分、改良Ashworth痉挛程度量表(MAS)分级、表面肌电图指标[腕背伸肌、腕掌屈肌均方根值(RMS)]、神经功能缺损程度评分(NDS)和改良Barthel指数(MBI)评分,并评定临床疗效。结果:治疗后,两组患者FMA、MBI评分均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05);两组患者放松、被动功能测试腕背伸肌、腕掌屈肌RMS值及NDS评分均较治疗前降低(P<0.05),且观察组低于对照组(P<0.05);两组患者MAS分级均较治疗前改善(P<0.05),且观察组优于对照组(P<0.05)。观察组总有效率为92.5%(37/40),高于对照组的80.0%(32/40,P<0.05)。结论:麦粒灸十宣穴联合康复训练可提高中风后手指痉挛患者手部运动功能和日常生活能力,改善痉挛程度和腕背伸肌、腕掌屈肌功能,临床疗效优于单纯康复训练。Objective To compare the clinical effect of wheat grain moxibustion combined with rehabilitation training and simple rehabilitation training on finger spasm after stroke.Methods A total of 80 patients with finger spasm after stroke were randomly divided into an observation group and a control group,40 cases in each group.The control group was given routine rehabilitation training,once a day,30 min each time.The observation group was given wheat grain moxibustion at Shixuan(EX-UE 11)on the basis of the control group,8~10 moxibustion cones at each point,once a day.Both groups were treated for 6 days as one course of treatment for 4 courses.The motor function of the affected hand(Fugl-Meyer assessment[FMA]score)and muscle tension(modified Ashworth scale[MAS]grading),surface EMG indexes(wrist dorsiflexor muscle and flexor carpal metacarpal muscle mean square[RMS]value),hand muscle strength(neurological deficit score[NDS])and daily living ability(modified Barthel index[MBI]score)were compared between the two groups before and after treatment,and clinical efficacy was evaluated.Results After treatment,FMA and MBI scores in the 2 groups were increased compared with before treatment(P<0.05),and those in the observation group were higher than the control group(P<0.05).The RMS value of wrist dorsiflexor muscle and flexor carpal metacarpal muscle in relaxation and passive function testsand and NDS in the 2 groups were lower than those before treatment(P<0.05),and those in the observation group were lower than the control group(P<0.05).MAS grading in the 2 groups was improved compared with before treatment(P<0.05),and that in the observation group was better than the control group(P<0.05).The total effective rate of the observation group was 92.5%(37/40),which was higher than that of the control group(80.0%,32/40,P<0.05).Conclusion Wheat grain moxibustion at Shixuan(EX-UE 11)combined with rehabilitation training can improve the hand motor function and daily living ability of patients with finger spasm after stroke,improve th

关 键 词：中风 手指痉挛 痉挛性瘫痪 麦粒灸 十宣穴 康复疗法 

分 类 号：R246.6[医药卫生—针灸推拿学]