本体感觉神经肌肉促进技术联合阴阳平衡透刺法治疗脑卒中后上肢痉挛性偏瘫患者的效果及其对上肢运动功能、肌肉积分肌电值的影响  

Efficacy of proprioceptive neuromuscular facilitation technique plus the Yin-Yang balance penetration acupuncture on patients with upper limb spastic hemiplegia after stroke and upper limb motor function and integral electromyography

作　　者：党永生 DANG Yongsheng

机构地区：[1]武威市人民医院,甘肃武威733000

出　　处：《中医临床研究》2022年第16期45-48,共4页Clinical Journal Of Chinese Medicine

基　　金：武威市科技局:针刺联合新Bobath技术治疗脑卒中患者上肢痉挛状态的临床研究(WW190137)。

摘　　要：目的:探究本体感觉神经肌肉促进技术联合阴阳平衡透刺法治疗脑卒中后上肢痉挛性偏瘫患者的效果及其对上肢运动功能、肌肉积分肌电值的影响。方法:选取武威市人民医院2019年8月-2021年5月115例脑卒中后上肢痉挛性偏瘫患者作为研究对象,依据治疗方式不同分为本体感觉神经肌肉促进技术组和透刺组,均给予常规药物治疗及康复干预,本体感觉神经肌肉促进技术组57例给予本体感觉神经肌肉促进技术治疗,透刺组58例在本体感觉神经肌肉促进技术组治疗基础上加用阴阳平衡透刺法,观察两组患者临床疗效,上肢痉挛程度,上肢运动功能及自理能力,上肢表面肌肉积分肌电值。结果:透刺组临床总有效率高于本体感觉神经肌肉促进技术组(P<0.05)。透刺组治疗3个月后改良Ashworth痉挛量表(Modified Ashworth Spasticity,MAS)评级水平优于本体感觉神经肌肉促进技术组(P<0.05)。两组患者治疗3个月后上肢Fugl-Meyer运动功能评定量表(Fugl-Meyer Assessment,FMA)、改良Barthel指数(Modified Barthel Index,MBI)评分水平较治疗前均升高,且透刺组高于本体感觉神经肌肉促进技术组(P<0.05)。两组患者治疗3个月后肱二头肌、腕伸肌、肱三头肌、拇短展肌、腕屈肌、指伸肌最大等长收缩时肌肉积分肌电值水平较治疗前均升高,且透刺组高于本体感觉神经肌肉促进技术组(P<0.05)。结论:本体感觉神经肌肉促进技术联合阴阳平衡透刺法治疗脑卒中后上肢痉挛性偏瘫患者,通过促使经络得到充足滋养改善肌肉拘急状态,调节上肢痉挛程度,改善上肢运动功能,提高自理能力,调节上肢表面肌肉积分肌电值,提高临床疗效。Objective:To investigate efficacy of proprioceptive neuromuscular facilitation plus the Yin-Yang(阴阳)balance penetration acupuncture on patients with upper limb spastic hemiplegia after stroke and upper limb motor function and integral electromyography.Methods:From August 2019 to May 2021,a total of 115 cases were divided into the proprioceptive neuromuscular facilitation technique group and the penetration needling group according to different treatment methods.All patients were given conventional drug treatment and rehabilitation intervention.Fifty-seven cases in the proprioceptive neuromuscular facilitation technique group were treated by proprioceptive neuromuscular facilitation technique,and 58 cases in the penetration needling group were treated by the Yin-Yang balance penetration needling plus proprioceptive neuromuscular facilitation technique group.The clinical efficacy,upper limb spasm degree,upper limb motor function and self-care ability,and integral EMG value of upper limb surface muscles were observed in the two groups.Results:The total clinical efficiency in the penetration needling group was higher than that in the proprioceptive neuromuscular facilitation technique group(P<0.05).The modified Ashworth spasticity(MAS)rating level in the penetration needling group was better than that in the proprioceptive neuromuscular facilitation technique group at the end of 3 months(P<0.05).At the end of 3 months of treatment,FMA and MBI scores of upper limbs in the two groups were higher than those before treatment,and those in the penetration needling group were higher than the proprioceptive neuromuscular facilitation technique group(P<0.05).At the end of 3 months of treatment,the muscle integral EMG levels of the biceps brachii,wrist extensors,triceps brachii,abductor pollicis brevis,wrist flexors,and finger extensors at the maximal isometric contraction in the two groups were all higher than those before treatment.And those in the penetration needling group were higher than the proprioceptive neuromuscu

关 键 词：本体感觉神经肌肉促进技术 阴阳平衡透刺法 脑卒中 上肢运动功能 

分 类 号：R743.33[医药卫生—神经病学与精神病学]