关刺法结合头针治疗中风后上肢痉挛性偏瘫的临床研究  

Clinical Study on Articular Needling Combined with Scalp Acupuncture in Treatment of Spastic Hemiplegia of Upper Limbs after Stroke

作　　者：杨晨曦 张闻东[2] 杨义萍 巢春燕 YANG Chenxi;ZHANG Wendong;YANG Yiping;CHAO Chunyan(Anhui University of Chinese Medicine,Hefei 230038,China;The Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,China)

机构地区：[1]安徽中医药大学,安徽合肥230038 [2]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《中医药学报》2023年第4期67-73,共7页Acta Chinese Medicine and Pharmacology

基　　金：安徽省省级中医发展专项经费项目张闻东名老中医工作室(卫办秘〔2016〕680号);安徽省中医药领军人才及领军人才培养对象(中医药发展秘〔2018〕23号);安徽省第13批115产业创新团队“针药结合防治脑病产业创新团队”项目(皖人才办〔2020〕4号)。

摘　　要：目的:评价关刺法结合头针法对改善缺血性中风后上肢痉挛性偏瘫患者的上肢痉挛程度、运动功能及日常生活能力的临床疗效。方法:将筛选出的72例缺血性中风后上肢痉挛性偏瘫患者按随机数字表法分为治疗组和对照组,每组36例。治疗组采用关刺法结合头针法治疗,对照组采用传统针刺法结合头针法治疗,每周治疗6次,每天1次,共4周。分别在治疗前后对患者运用改良Ashworth痉挛评定量表(MAS)评估患肢痉挛程度,简化Fugl-Meyer上肢功能评定量表(FMA-UE)评估患肢运动功能,改良Barthel指数评定量表(MBI)评估日常生活能力,并比较各组之间临床疗效。结果:治疗前两组MAS痉挛评级、FMA-UE评分、MBI评分比较均无显著差异(P>0.05),具有可比性。治疗后,两组患者MAS痉挛评级均明显降低(P<0.01),且治疗组优于对照组(P<0.05);两组患者FMA-UE评分及MBI评分均有明显提高,且治疗组高于对照组(P<0.01);治疗组的总有效率为91.18%(31/34),而对照组为74.29%(26/35),差异有统计学意义(P<0.01)。结论:关刺法结合头针法可以有效改善缺血性中风后上肢痉挛性偏瘫患者的上肢痉挛程度、运动功能及日常生活能力,临床疗效肯定。Objective:To evaluate the clinical effect of articular needling combined with scalp acupuncture on improving the degree of upper limbs spasm,motor function and quality of life in patients with spastic hemiplegia of upper limbs after ischemic stroke.Methods:A total of 72 patients with spastic hemiplegia of upper limbs after ischemic stroke were randomly divided into the treatment group and the control group,with 36 patients in each group.The treatment group was treated with articular needling combined with scalp acupuncture,whereas the control group was treated with traditional acupuncture combined with scalp acupuncture.Both groups were treated once a day,six times a week for four weeks.Before and after the treatment,the motor function of the affected limbs were assessed by the Modified Ashworth Scale(MAS),Simplified Fugl-Meyer Assessment Upper Extremity Scale(FMA-UE),and Modified Barthel Index Assessment(MBI)in the two groups.The clinical efficacy was compared between the two groups.Results:There were no statistical differences in the scores of MAS,FMA-UE and MBI between the two groups before the treatment(P>0.05);the score of MAS was significantly decreased after the treatment in the two groups(P<0.01),of which the treatment group was superior to the control group(P<0.05);the scores of FMA-UE and MBI were significantly increased after the treatment in the two groups,and the scores were higher in the treatment group than those in the control group(P<0.01).The total effective rate of treatment group was 91.18%(31/34),which was significantly higher than 74.29%(26/35)of the control group(P<0.01).Conclusion:Articular needling combined with scalp acupuncture can effectively improve the spasm degree of upper limbs,motor function and daily living ability of the patients with spastic hemiplegia of upper limbs after ischemic stroke.

关 键 词：缺血性中风 痉挛性偏瘫 经筋理论 关刺法 头针法 

分 类 号：R255.2[医药卫生—中医内科学]