头穴运动区经颅重复针刺治疗脑卒中急性期肢体运动功能障碍的临床研究  

Clinical Study of Repeated Transcranial Needling Scalp Motor Area in Treatment of Limb Motor Dysfunction during Acute Stage of Stroke

作　　者：谢兴国[1] 董旭[2] 张虹岩 王若愚 佟丹[1] 王东岩[2] XIE Xingguo;DONG Xu;ZHANG Hongyan;WANG Ruoyu;TONG Dan;WANG Dongyan(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001

出　　处：《针灸临床杂志》2022年第9期6-10,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：黑龙江省自然科学基金联合引导项目,编号:LH2019H113。

摘　　要：目的:观察经颅重复针刺头针对脑卒中急性期患者肢体运动功能障碍的影响。方法:将入组的BrunnstromⅠ、Ⅱ期60例患者随机分为经颅重复针刺组30例和康复组30例。两组患者均给予神经内科支持治疗、抗血小板聚集和改善循环治疗。康复组患者进行康复科常规功能训练。康复训练方法主要是根据患者病情情况对患者进行个性化治疗,患侧肢体上下肢主、被动关节功能训练、坐位和站立平衡等身体平衡协调训练,1次/d,40 min/次,1周治疗5 d,共治疗20 d。经颅重复针刺组患者在康复治疗基础上给予头穴运动区重复经颅针刺法治疗,1次/d,每次治疗30 min,1周治疗5 d,共治疗20 d。对患者治疗前后进行fugl-meyer(FMA)评分、BI指数评分、NIHSS评分和表面肌电均方根值(RMS)评分,比较两组患者临床疗效。结果:两组患者治疗前一般资料(性别、年龄、病程)比较差异无统计学意义(P>0.05),BI指数评分、NIHSS评分、两组患者肱二头肌、肱三头肌、腕伸肌及腕屈肌主动收缩的表面肌电均方根值(RMS)比较,差异无统计学意义(P>0.05)。两组患者治疗前后FMA评分组内比较、组间比较,差异有统计学意义(P<0.05);两组患者治疗前后BI指数评分,组内比较、组间比较,差异有统计学意义(P<0.05);两组患者治疗前后NIHSS评分组内比较、组间比较,经颅重复针刺组大于康复组,差异有统计学意义(P<0.05);两组患者治疗前后肱二头肌、肱三头肌和腕伸肌、腕屈肌主动收缩组内比较、组间比较,经颅重复针刺组优于康复组,差异有统计学意义(P<0.05)。结论:头针经颅重复针刺法对BrunnstromⅠ、Ⅱ期患者的患侧上肢屈肌影响大于伸肌。脑卒中急性期给予针刺和康复治疗对肢体功能有重要的影响,能够加快临床康复进度,同时减少并发症的发生。Objective:To observe the effects of repeated transcranial acupuncture(RTA)on dyskinesia after acute cerebral apoplexy.Methods:60 patients with Brunnstrom(stage I andⅡ)were randomly divided into the RTA group and the rehabilitation group,with 30 cases in each group.Both groups were given neurological supportive treatment,anti-platelet aggregation and circulation improvement treatment.The rehabilitation group received routine individual rehabilitation functional training based on the patient’s condition,in which joint function was exercised by active or passive upper and lower limbs training,body balance coordination training including sitting and standing balance.The treatment was conducted 40 minutes a day,5 treatments per week for a total of 20 treatments;on which basis,the RTA group was also treated with the repeated transcranial needling scalp motor area,30 minutes a day,5 treatment per week for total of 20 treatments.FMA score,BI index score,NIHSS score,and RMS score of surface electromyography were assessed before and after the treatment to evaluate clinical efficacy in the two groups.Results:There were no statistical differences in general data(gender,age,course of disease),BI index score,NIHSS score,and RMS values of active contraction of biceps brachii,triceps brachii,and wrist extensor and wrist flexor between the two groups before the treatment(P>0.05).FMA score and BI index score showed differences between before the treatment and after the treatment within the intra-groups,as well as between inter-groups after the treatment(P<0.05).There were statistical difference in NIHSS score between before the treatment and after the treatment within the intra-groups,as well as between the inter-groups after the treatment(P<0.05).There were statistical differences in active contractions of biceps brachii,triceps brachii,wrist extensor,and wrist flexor between before the treatment and after the treatment within the intra-groups,as well as between the inter-groups after the treatment(P<0.05).Conclusion:RTA has

关 键 词：脑卒中 经颅重复针刺 头穴运动区 表面肌电图 运动功能障碍 

分 类 号：R246.6[医药卫生—针灸推拿学]