透刺针法联合康复训练治疗脑卒中后软瘫期的临床研究  

Effect of Penetration Needling Combined with Rehabilitation Training on Limb Function in the Flaccid Paralysis Stageafter Stroke

作　　者：杨帅 秦丽那 潘维花 宋裕如 孙美杰 许嘉轩 孙玉杰 YANG Shuai;QIN Lina;PAN Weihua;SONG Yuru;SUN Mejie;XU Jiaxuan;SUN Yujie(Department of Rehabilitation Medicine,Beijing Daxing District Hospital of Integrated Chinese and Western Medicine,Beijing 100076,China;Department of Rehabilitation Medicine,Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China)

机构地区：[1]北京市大兴区中西医结合医院康复科,北京100076 [2]北京中医药大学附属第三医院康复科,北京100029

出　　处：《基层中医药》2023年第5期41-47,共7页Basic Traditional Chinese Medicine

基　　金：北京市大兴区中西医结合医院院级科研课题青年项目(DXZXYQ202011)。

摘　　要：目的 观察透刺肩髃、阳陵泉、悬钟,深刺风市,联合康复治疗,对脑卒中后软瘫期患者肢体功能的临床疗效。方法 将2021年9月—2022年9月北京市大兴区中西医结合医院收治的76例脑卒中患者采用SPSS 24.0随机分为治疗组与对照组,将分组结果装入信封中,每组各38例,实际完成对照组35例、治疗组33例。两组均接受西药基础治疗及康复治疗。在此基础上,对照组接受常规针刺治疗;治疗组选穴与对照组相同,透刺肩髃、阳陵泉、悬钟,深刺风市。两组针刺治疗均为1次/d,每周进行6 d,休息1 d,连续治疗4周。观察两组治疗后肌张力分级、简式Fugl-Meyer量表(FMA)评分、Barthel指数(BI)评分的变化,以及临床有效率。结果 治疗后,两组肌张力分级、FMA评分、BI评分均优于治疗前(P <0.05)。在前3周评定中,治疗组肌张力改善与对照组比较,差异均具有统计学意义(P <0.05);在第4周时,两组接近正常肌张力例数比较,差异无统计学意义(P> 0.05),且出现痉挛病例数相当。治疗组上肢、下肢软瘫期持续时间均少于对照组(P <0.05),FMA评分、BI评分均优于对照组(P <0.05);治疗组总有效率(96.9%)高于对照组(88.5%,P <0.05)。结论 透刺肩髃、阳陵泉、悬钟,深刺风市,联合康复治疗,治疗脑卒中后软瘫期功能障碍,比常规针刺联合康复治疗更为有效,可以有效促进脑卒中患者肢体功能的恢复,提高生活质量。Objective To observe the clinical effect of penetration needling at Jianyu(LI15),Yanglingquan(GB34),and Xuanzhong(GB39)and deep needling at Fengshi(GB31)combined with rehabilitation training on the limb function of patients in the flaccid paralysis stage after stroke.Methods Seventy-six patients with stroke treated in the Beijing Daxing District Hospital of Integrated Chinese and Western Medicine from September 2021 to September 2022 were randomized into an observation group(n=38)and a control group(n=38)in SPSS 24.0.The grouping results were enveloped.Due to the drop-outs,35 patients in the control group and 33 patients in the observation group were included for the study.Both groups received basic treatment of western medicine and rehabilitation training.In addition,the control group received routine acupuncture at Jianyu(Ll15),Yanglingquan(GB34),Xuanzhong(GB39),and Fengshi(GB31),and the observation group received penetration needling at Jianyu(LI15),Yanglingquan(GB34),and Xuanzhong(GB39)and deep needling at Fengshi(GB31).Both groups were treated with acupuncture once a day and 6 days a week for 4 continuous weeks.The muscle tone grade,Fugl-Meyer assessment(FMA)score,and Barthel index(Bl)were recorded before and after treatment,and the response rate was compared between the two groups.Results The treatment in both groups recovered the muscle tension grade,FMA score,and BI(P<0.05).The muscle tone showed significant differences between the two groups in the first three weeks(P<0.05).In the fourth week,the number of patients with muscle tone close to the normal value showed no significant difference between the two groups(P>0.05),and the number of patients with spasms was similar in the two groups.The duration of upper and lower limb flaccid paralysis in the observation group was shorter than that in the control group(P<0.05).The observation group outperformed the control group in terms of FMA score and Bl.The total response rate in the observation group was 96.9%,which was higher than that(88.5%)in the control gr

关 键 词：脑卒中 软瘫期 透刺 深刺 

分 类 号：R24[医药卫生—中医临床基础]