磁极针对极针刺联合Bobath法治疗创伤性颅脑损伤术后偏瘫临床研究  

Clinical study of magnetic pole acupuncture combined with Bobath method in treating hemiplegia after traumatic brain injury

作　　者：陈真 杨莉[1] 景蓉[1] 黄坤 雷海军 张贝贝 Chen Zhen;Yang Li;Jing Rong;Huang Kun;Lei Haijun;Zhang Beibei(Department of Rehabilitation Medicine,Yan'an University Affiliated Hospital,Yan'an 716000,China)

机构地区：[1]延安大学附属医院康复医学科,延安716000

出　　处：《国际中医中药杂志》2022年第11期1221-1226,共6页International Journal of Traditional Chinese Medicine

基　　金：咸阳市科学技术项目(2014K04-06)。

摘　　要：目的评价磁极针对极针刺联合Bobath法治疗创伤性颅脑损伤术后偏瘫患者的临床疗效。方法将符合入选标准的2019年1月-2020年12月本院142例创伤性颅脑损伤术后偏瘫患者,采用随机数字法分为Bobath组47例、磁极法组47例和Bobath磁极法组48例。Bobath组给予Bobath法治疗,磁极法组给予磁极针对极针刺法治疗,Bobath磁极法组给予磁极针对极针刺+Bobath法治疗。3组均治疗5个月。分别于治疗前后采用Fugl-Meyer运动功能评定量表评估四肢运动功能,Barthel指数评估日常生活能力,美国国立卫生研究院卒中量表(NIHSS)评估神经功能缺损程度;采用ELISA法检测血清5-羟色胺(5-HT)、肾上腺素(E)、多巴胺(DA)、去甲肾上腺素(NE)水平,评价康复效果。结果Bobath磁极法组总有效率为86.96%(40/46)、Bobath组为65.96%(31/47)、磁极法组为64.44%(29/45),3组比较差异有统计学意义(χ^(2)=5.84,P=0.016)。治疗后,Bobath磁极法组上肢功能、下肢功能评分高于Bobath组、磁极法组(F值分别为19.38、24.83,P值均<0.01),认知能力、语言能力、自理能力、社会适应能力评分及总分高于Bobath组、磁极法组(F值分别为14.91、15.87、18.71、18.88、32.62,P值均<0.001),NIHSS评分低于Bobath组、磁极法组(F=31.71,P<0.01)。治疗后,Bobath磁极法组NE[(58.29±9.82)μg/L比(86.29±12.35)μg/L、(88.34±12.87)μg/L,F=33.39]、DA[(204.29±20.26)μg/L比(278.72±27.56)μg/L、(281.14±27.82)μg/L,F=55.50]、5-HT[(231.27±20.12)μg/L比(294.74±29.34)μg/L、(298.19±28.73)μg/L,F=13.86]、E[(21.85±3.19)μg/L比(28.37±4.07)μg/L、(28.26±4.14)μg/L,F=9.34]水平均低于Bobath组、磁极法组(P<0.01)。结论磁极针对极针刺联合Bobath法可有效改善创伤性颅脑损伤术后偏瘫患者的四肢功能状况、日常生活能力及神经功能,提高康复效果。Objective Effects of pole-specific acupuncture combined with Bobath on upper limb function,daily life ability and nerve function after traumatic brain injury were observed.Methods A total of 142 patients with cerebral hemiplegia after traumatic brain injury from January 2019 to December 2020,were divided into the Bobath group(47 cases),the pole-specific acupuncture group(47 cases)and combination group(48 cases)by the random number method.Bobath group received Bobath rehabilitation,the pole-specific acupuncture group received pole-specific acupuncture rehabilitation,and combination group was given pole-specific acupuncture rehabilitation and Bobath treatment.The overall rehabilitation efficiency,limb function Fugl-Meyer scale score,Barthel index of daily life ability,nerve function,and other indicators were observed and compared.Results After treatment,the overall recovery efficiency(86.96%)in combination group was significantly higher than that of the Bobath group(65.96%)and acupuncture group(64.44%)(χ^(2)=5.84,P=0.016).After treatment,the limb function Fugl-Meyer scale(including upper limb and lower limb function scores)(F=19.38,24.83,all Ps<0.01),daily life ability Barthel index(including cognitive ability situation score,language ability score,self-care ability score,social adaptability score and total score)of combination group were significantly higher than those in the Bobath group and acupuncture group(F=14.91,15.87,18.71,18.88,32.62,all Ps<0.001),while the NIHSS score of combination group was significantly lower than that of the Bobath group and acupuncture group(F=31.71,P<0.01).After treatment,the NE[(58.29±9.82)μg/L vs.(86.29±12.35)μg/L,(88.34±12.87)μg/L,F=33.39],DA[(204.29±20.26)μg/L vs.(278.72±27.56)μg/L,(281.14±27.82)μg/L,F=55.50],5-HT[(231.27±20.12)μg/L vs.(294.74±29.34)μg/L,(298.19±28.73)μg/L,F=13.86],E[(21.85±3.19)μg/L vs.(28.37±4.07)μg/L,(28.26±4.14)μg/L,F=9.34]of combination group were significantly lower than those in the Bobath group and acupuncture group(P<0.01).Concl

关 键 词：颅脑损伤 偏瘫 经络磁场疗法 针刺疗法 BOBATH法 四肢功能 神经功能 

分 类 号：R246.2[医药卫生—针灸推拿学]