穴位埋线联合运动疗法对脑卒中后上肢痉挛气虚血瘀证患者康复效果的影响  

Influence of acupoint catgut embedding combined with exercise therapy on the rehabilitation effect of patients with upper limb spasticity after stroke and qi deficiency and blood stasis type

作　　者：顾晓丁 桂璟 Gu Xiaoding;Gui Jing(Huangpu Branch,Shanghai Ninth People's Hospital,Shanghai Jiao Tong University School of Medicine,Shanghai 200011,China)

机构地区：[1]上海交通大学医学院附属第九人民医院黄浦分院,上海200011

出　　处：《国际中医中药杂志》2022年第6期621-625,共5页International Journal of Traditional Chinese Medicine

基　　金：上海市黄浦区卫生健康系统培育专科课题(2019pyzk03)。

摘　　要：目的探讨穴位埋线联合运动疗法对脑卒中后上肢痉挛气虚血瘀证患者康复效果的影响。方法将符合入选标准的2018年5月-2020年5月本院76例脑卒中后上肢痉挛气虚血瘀证患者采用随机数字表法分为2组,每组38例。对照组给予常规康复治疗,观察组在对照组基础上结合穴位埋线及运动疗法治疗。2组均治疗6周,随访12个月。分别于治疗前后进行中医证候评分,采用改良Ashworth量表评估肘关节痉挛程度,偏瘫手功能分级评定量表评估偏瘫手功能,简化Fugl-Meyer量表评估肢体运动能力,改良Barthel指数评估日常活动能力,记录治疗期间的不良反应。结果观察组治疗后肘关节痉挛改善程度优于对照组(Z=2.29,P=0.022),偏瘫手功能分级情况优于对照组(Z=2.081,P=0.038);治疗后,观察组Fugl-Meyer量表上肢、下肢评分及总分均高于对照组(t值分别为7.17、7.40、11.39,P值均<0.001),半身不遂、神识昏蒙、肢软气短、面色萎黄评分均低于对照组(t值分别为7.82、12.87、12.55、7.95,P值均<0.001)。观察组随访6、12个月Barthel指数均高于对照组(t值分别为4.82、6.45,P值均<0.001)。结论给予中风后上肢痉挛气虚血瘀型患者穴位埋线联合运动疗法干预,可改善偏瘫手功能,提高肢体运动功能和日常生活能力。Objective To explore the influence of acupoint catgut embedding combined with exercise therapy on the rehabilitation effect of patients with upper limb spasticity after stroke and qi deficiency and blood stasis type.Methods A total of 76 patients with qi deficiency and blood stasis type of upper limb spasticity after stroke who met the inclusion criteria in the hospital were enrolled between May 2018 and May 2020,and they were divided into two groups according to the random number table method,with 38 in each group.The control group was given conventional rehabilitation treatment,while the observation group was combined with acupoint catgut embedding and exercise therapy intervention on the basis of the control group.The degree of elbow spasm was assessed by Modified Ashworth Scale and hemiplegic hand function was evaluated by Hemiplegic Hand Function Classification Scale.Simplified Fugl-Meyer Scale was used to evaluate the limb motor ability and Modified Barthel Index was used for ability of daily living,and the adverse events during treatment were recorded.Results After treatment,the improvement degree of elbow spasm in observation group was significantly better than that in control group(Z=2.29,P=0.022),and the hemiplegic hand function classification was significantly better than that in control group(Z=2.08,P=0.038).After treatment,the scores of upper and lower extremities and total score of Fugl-Meyer Scale in observation group were significantly higher than those in control group(t=7.17,7.40,11.39,all Ps<0.001).While the scores of hemiplegia,faintness,shortness of breath and sallow complexion in observation group were significantly lower than those in control group(t=7.82,12.87,12.55,7.95,all Ps<0.001).The Barthel index in observation group was significantly higher than that in control group at 6 and 12 months of follow-up(t=4.82.6.45,all Ps<0.001).Conclusion Acupoint catgut embedding combined with exercise therapy for intervention can improve the hemiplegic hand function,and enhance the limb motor function

关 键 词：卒中 中风(中医) 痉挛 中风后遗症 穴位埋线疗法 运动疗法 

分 类 号：R246.6[医药卫生—针灸推拿学]