隔药灸结合康复训练对脑卒中后上肢肢体痉挛患者的疗效观察  

Therapeutic Effect of Medicine Separated Moxibustion Combined with Rehabilitation Training on Patients with Upper Limb Spasm after Stroke

作　　者：丁翠梅[1] 童琳[1] 吴云霞[1] 王一楠[1] 闫冰莹[1] 郑永明[1] DING Cui-mei;TONG Lin;WU Yun-xia;WANG Yi-nan;YAN Bing-ying;ZHENG Yong-ming(Bengbu first people’s Hospital)

机构地区：[1]蚌埠市第一人民医院,安徽蚌埠233099

出　　处：《按摩与康复医学》2022年第20期13-16,21,共5页Chinese Manipulation and Rehabilitation Medicine

摘　　要：目的:观察隔药灸结合康复训练对脑卒中后上肢肢体痉挛的治疗作用,以期为中西医结合治疗脑卒中后上肢肢体痉挛提供可靠的临床依据。方法:选取2021年2月-2022年2月本院康复中心住院的脑卒中后上肢肢体痉挛患者共90例,采用随机数字表法分为观察组和对照组各45例。在常规内科治疗下,分别进行常规康复训练、隔药灸结合康复训练治疗。治疗前后采用改良Ashworth分级法(MAS)评估痉挛程度,表面肌电图评估患侧肱二头肌肌张力、Fugl-Meyer肢体运动功能评分、Barthel指数(BI)评定患者的日常生活活动能力。结果:治疗后,两组患者的痉挛程度MAS较治疗前降低(P<0.05)、肢体运动功能FMA评分、日常生活活动能力BI评分均较治疗前升高(P<0.05),且观察组治疗后的痉挛程度MAS低于对照组(P<0.05),肢体运动功能FMA评分、日常生活活动能力BI评分高于对照组(P<0.05)。治疗后,两组患者的肱二头、肱三头RMS值均较治疗前降低(P<0.05),且观察组治疗后的肱二头、肱三头RMS值均低于对照组(P<0.05)。结论:在常规内科治疗下,隔药灸结合康复训练可有效缓解脑卒中后上肢肢体痉挛状态,降低肌张力,改善患者肢体运动功能以及日常生活活动能力,值得推广。Objective:To observe the therapeutic effect of separation moxibustion combined with rehabilitation training on upper limb spasm after stroke,in order to provide reliable clinical basis for the treatment of upper limb spasm after stroke by integrated traditional Chinese and western medicine.Methods:A total of 90 patients with upper limb spasm after stroke hospitalized in the rehabilitation center of our hospital from February 2021 to February 2022 were selected and divided into observation group and control group by random number table method(45 cases in each group).Under the conventional medical treatment,routine rehabilitation training and moxibustion combined with rehabilitation training were carried out respectively.Before and after treatment,the degree of spasm was evaluated by modified Ashworth classification(MAS),the muscle tension of biceps brachii on the affected side was evaluated by surface dectromyography,Fugl Meyer limb motor function score and Barthel Index(BI).Results:After treatment,the degree of spasticity MAS of the two groups decreased compared with that before treatment(P<0.05),the FMA score of limb motor function and the Bi score of activities of daily living increased compared with that before treatment(P<0.05).The degree of spasticity MAS of the observation group was lower than that of the control group(P<0.05),and the FMA score of limb motor function and Bi score of activities of daily living were higher than that of the control group(P<0.05).After treatment,the RMS values of biceps and triceps in the two groups were lower than those before treatment(P<0.05),and the RMS values of biceps and triceps in the observation group were lower than those in the control group(P<0.05).Conclusion:Under routine medical treatment,medicine separated moxibustion combined with rehabilitation training can effectively alleviate the spasticity of upper limbs after stroke,reduce muscle tension,and improve the motor function and activities of daily living of patients,which is worthy of popularization.

关 键 词：脑卒中 上肢肢体痉挛 隔药灸 康复训练 痉挛程度 肌张力 

分 类 号：R743.3[医药卫生—神经病学与精神病学]