靳三针联合站立数字OT训练对脑卒中偏瘫患者上肢运动功能的影响  

Effect of Jin’s Three-Needle Therapy Combined with Standing Digital OT Training on Upper Extremity Motor Function of Patients with Hemiplegia after Stroke

作　　者：陈宣芳 王程灵 郑焕驰 傅文康 麦韵怡 王俊华[3,4] CHEN Xuanfang;WANG Chengling;ZHENG Huanchi;FU Wenkang;MAI Yunyi;WANG Junhua(The Fifth Clinical Medical College of Guangzhou University of Chinese Medicine,Guangzhou,Guangdong 510405,China;Guangzhou Xinhua University,Guangzhou,Guangdong 510520,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou,Guangdong 510095,China;Guangdong Province Engineering Technology Research Institute of TCM,Guangzhou,Guangdong 510095,China)

机构地区：[1]广州中医药大学第五临床医学院,广东广州510405 [2]广州新华学院,广东广州510520 [3]广东省第二中医院,广东广州510095 [4]广东省中医药工程技术研究院,广东广州510095

出　　处：《康复学报》2022年第6期496-501,共6页Rehabilitation Medicine

基　　金：广东省科技计划项目(2017B020210009);广州市科技计划项目(201704020110)。

摘　　要：目的:观察靳三针疗法结合站立数字OT训练对脑卒中后偏瘫患者上肢运动功能的影响。方法:选择2021年1—6月在广东省第二中医院针灸康复科住院部治疗的卒中后上肢偏瘫患者60例,采用随机数字表法分为对照组和观察组,每组30例。2组均接受常规药物治疗和常规康复训练;对照组在常规治疗基础上采用靳三针治疗,选择患肢对侧颞三针、患肢肩三针、手三针(曲池、外关、合谷)、百会、水沟穴进行针刺,以平补平泻手法施针,以患者得气为度,留针30 min,1次/d,6次/周,持续治疗8周;观察组在对照组的基础上接受站立数字OT训练,20 min/次,1次/d,6次/周,持续治疗8周。在干预前、干预8周后采用Fugl-Meyer运动功能评定表上肢部分(FMA-UE)评定上肢运动功能;采用Wolf上肢运动功能评价量表(WMFT)评定上肢运动完成量;采用改良Barthel指数(MBI)评定日常生活活动能力。结果:与治疗前比较,2组治疗后FMA-UE、WMFT、MBI评分均明显升高,差异均具有统计学意义(P<0.05)。与对照组比较,观察组治疗后FMA-UE、WMFT、MBI评分均明显更高,差异均具有统计学意义(P<0.05)。结论:靳三针联合站立数字OT训练能有效地改善脑卒中偏瘫患者上肢运动功能和日常生活活动能力。Objective:To observe the effect of Jin’s three-needle therapy combined with standing digital OT training on upper extremity motor function of patients with hemiplegia after stroke.Methods:A total of 60 patients with upper extremity hemiplegia after stroke in the inpatient department of acupuncture-moxibustion and rehabilitation of Guangdong Second Traditional Chinese Medicine Hospital from January to June 2021 were divided randomly into control group and observation group,with 30 cases in each group.Both groups received routine medication and routine rehabilitation training.The control group received Jin’s three-needle therapy on the basis of routine medication and routine rehabilitation training,and the three-needle points were selected at the contralateral temporal,the affected shoulder and hand [Quchi(LI11),Waiguan(TE6),Hegu(LI04)],Baihui(DU20) and Shuigou(DU26) acupoints.The even reinforcing-reducing method was conducted,and when the patients brought about the desired sensation,the needle was retained for 30 minutes,once a day,six times a week,lasting for eight weeks.The observation group received standing digital OT training on the basis of the control group,20 minutes a time,once a day,six times a week,lasting for eight weeks.Before treatment and eight weeks after treatment,Fugl-Meyer assessment-upper extremity(FMA-UE) was used to evaluate upper extremity motor function;Wolf motor function test(WMFT) was used to quantify the upper extremity motor ability;modified Barthel index(MBI) was used to assess the ability of activities of daily living.Results:Compared with that before treatment,the FMA-UE,WMFT and MBI scores of both groups increased significantly after treatment(P<0.05).Compared with the control group,the FMAUE,WMFT and MBI scores of the observation group increased significantly after treatment,and the difference was statistically significant(P<0.05).Conclusion:Jin’s three-needle therapy combined with standing digital OT training can effectively improve the motor function of upper extremity and

关 键 词：脑卒中 偏瘫 靳三针 站立数字OT 上肢运动功能 日常生活活动能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R496[医药卫生—临床医学]