巨刺法配合中药熏洗及痉挛治疗仪治疗中风后痉挛性瘫痪的临床研究  

Clinical Study of Opposing Needling Combined with Herbal Fumigation and Spastic Therapeutic Apparatus in Treatment of Post-Stroke Spastic Paralysis

作　　者：陈文平[1] 李琳 孙益民 刘世杰[1] 杨世锋[2] CHEN Wenping;LI Lin;SUN Yimin;LIU Shijie;YANG Shifeng(The Fifth People's Hospital of Hengshui,Hengshui 053000,China;Hengshui Hospital of Traditional Chinese Medicine,Hengshui 053000,China)

机构地区：[1]衡水市第五人民医院,河北衡水053000 [2]衡水市中医院,河北衡水053000

出　　处：《针灸临床杂志》2022年第5期10-14,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：河北省衡水市科技计划项目,编号:2019014093Z。

摘　　要：目的:观察巨刺法配合中药熏洗及痉挛治疗仪治疗中风后痉挛性瘫痪的临床效果。方法:选择2019年12月—2021年5月于本院就诊的220例中风后痉挛性瘫痪患者作为研究对象,采用随机数字表法将其分为治疗组112例和对照组108例。对照组采用常规针刺+痉挛治疗仪治疗,治疗组采用中药熏洗+巨刺法+痉挛治疗仪治疗,均治疗4周。比较两组治疗后的总有效率、治疗前后的血脂[甘油三酯(TG)、总胆固醇(TC)、高密度脂蛋白(HDL-C)及低密度脂蛋白(LDL-C)]水平、临床痉挛指数量表(CSI)评分、改良Ashworth痉挛量表(MAS)评分、Fugl-Meyer运动量表(FMA)评分、Barthel指数(BI评分)、基于中风痉挛性瘫痪患者报告的临床结局(PRO)评分及关节前屈、外展和后伸的活动度。结果:治疗后,治疗组的总有效率为97.32%(109/112),明显高于对照组的89.81%(97/108)(P<0.05);同时,治疗组患者CSI评分和上肢、下肢MAS评分均低于对照组(P<0.05),关节前屈、后伸和外展活动度均高于对照组(P<0.05),治疗组患者BI评分、PRO评分和上肢、下肢FMA评分均高于对照组(P<0.05),LDL-C、TC和TG水平均低于对照组(P<0.05),HDL-C高于对照组(P<0.05)。结论:采用巨刺法配合中药熏洗及痉挛治疗仪治疗中风后痉挛性瘫痪,可明显抑制患者痉挛程度,扩大关节活动范围,改善生活能力、运动功能和生活质量,疗效显著。Objective: To observe the clinical curative effect of opposing needling combined with herbal fumigation and spastic therapeutic apparatus in the treatment of post-stroke spastic paralysis. Methods: A total of 220 patients with post-stroke spastic paralysis were randomly divided into the treatment group(n=112) and the control group(n=108). The control group was treated with routine acupuncture and spastic therapeutic apparatus, whereas the treatment group was treated with herbal fumigation, opposing needling and spastic therapeutic apparatus. The treatment duration was 4 weeks in both groups. The total effective rate was compared between the two groups after the treatment. The levels of TG, TC, HDL-C and LDL-C, the scores of clinical Spasticity Index(CSI), modified Ashworth Spasticity Scale(MAS), Fugl-Meyer Assessment(FMA), Barthel Index(BI) and Patient-Reproted Outcome(PRO), as well as range of motion(ROM) of joint antexion, abduction and rear protraction were compared between before and after the treatment in the two groups. Results: The total effective rate of the treatment group was 97.32%(109/112), which was significantly higher than 89.81%(97/108) of the control group(P<0.05). The scores of CSI and MAS of upper and lower limbs were lower in the treatment group than those in the control group after the treatment(P<0.05). The ROM of joint antexion, abduction and rear protraction were higher in the treatment group than those in the control group after the treatment(P<0.05). The scores of BI, PRO, and FMA of upper and lower limbs were higher in the treatment group than those in the control group after the treatment(P<0.05). The levels of LDL-C, TC and TG were lower in the treatment group than those in the control group(P<0.05), whereas the level of HDL-C was higher in the treatment group than that in the control group(P<0.05). Conclusion: The application of opposing needling combined with herbal fumigation and spastic therapeutic apparatus can significantly inhibit spasticity, expand ROM, improve living ability,

关 键 词：中风 痉挛性瘫痪 巨刺法 中药熏洗 痉挛治疗仪 运动功能 

分 类 号：R246.6[医药卫生—针灸推拿学]