脊穴点段针刺疗法对中风上肢痉挛患者上肢动脉血流速度作用机制分析  

Analysis of Mechanism of the Acupuncture Therapy at Peri-jiaji Acupoints on Arterial Blood Flow Velocity of Upper Limb in Treating Patients with Upper-limb Spasticity

作　　者：张婷[1] 刘莉莉[1] 陈月桥[2] ZHANG Ting;LIU Li-Li;CHEN Yue-Qiao(Liuzhou Workers’Hospital,Liuzhou 545005 Guangxi,China;The First Affiliated Hospital of Guangxi University of Chinese Medicine,Nanning 530022 Guangxi,China)

机构地区：[1]柳州市工人医院,广西柳州545005 [2]广西中医药大学第一附属医院,广西南宁530022

出　　处：《广州中医药大学学报》2023年第5期1140-1146,共7页Journal of Guangzhou University of Traditional Chinese Medicine

基　　金：国家自然科学基金项目(编号:81603550);广西壮族自治区中医药管理局科研项目(编号:GXZYB20220432)。

摘　　要：【目的】分析脊穴点段针刺疗法对中风上肢痉挛患者上肢动脉血流速度的作用机制。【方法】将110例中风上肢痉挛患者随机分为观察组和对照组,每组各55例。对照组给予Bobath疗法治疗,观察组在对照组的基础上给予脊穴点段针刺疗法治疗,疗程为8周。观察2组患者治疗前后改良Ashworth痉挛分级、临床痉挛指数(CSI)评分、改良Barthel指数(MBI)评分、上肢动脉血流速度及血清神经生长因子(NGF)、钙结合蛋白S100β(S100β)水平的变化情况,并评价2组患者的临床疗效。【结果】(1)治疗8周后,观察组的总有效率为96.36%(53/55),对照组为76.36%(42/55),组间比较,观察组的疗效明显优于对照组(P<0.01)。(2)治疗后,2组患者的改良Ashworth痉挛分级情况均较治疗前明显改善(P<0.05),且观察组对改良Ashworth痉挛分级情况的改善作用明显优于对照组(P<0.01)。(3)观察组治疗2周、4周、8周后和对照组治疗4周、8周后的桡动脉、肱动脉收缩期峰值血流速度(PSV)值均较治疗前明显升高(P<0.05),且观察组在治疗2周、4周、8周后对桡动脉、肱动脉PSV值的升高幅度均明显优于对照组(P<0.01)。(4)观察组治疗2周、4周、8周后和对照组治疗4周、8周后的血清NGF、S100β水平均较治疗前明显降低(P<0.05),且观察组在治疗2周、4周、8周后对血清NGF、S100β水平的降低幅度均明显优于对照组(P<0.01)。(5)观察组治疗2周、4周、8周后和对照组治疗4周、8周后的CSI评分均较治疗前明显降低(P<0.05),MBI评分均较治疗前明显升高(P<0.05),且观察组在治疗2周、4周、8周后对CSI评分的降低幅度和对MBI评分的升高幅度均明显优于对照组(P<0.01)。【结论】脊穴点段针刺疗法可有效提高中风上肢痉挛患者上肢动脉血流速度以及自理能力,改善痉挛程度,降低血清NGF、S100β水平,疗效显著。Objective To explore the mechanism of the acupuncture therapy at peri-jiaji acupoints on arterial blood flow velocity of upper limb in treating patients with post-stroke upper-limb spasticity.Methods A total of 110 patients with post-stroke upper-limb spasticity were randomly divided into the observation group and the control group,with 55 cases in each group.The control group was treated with Bobath therapy and the observation group was treated with acupuncture therapy at peri-jiaji acupoints combined with Bobath therapy.Both groups of patients were treated for a period of 8 weeks.The pre-and post-treatment changes in the modified Ashworth spasticity classification,clinical spasticity index(CSI)scores,modified Barthel index(MBI)scores,upper limb arterial blood flow velocity and serum levels of nerve growth factor(NGF)and calcium binding protein S100β(S100β)in the two groups were observed.After treatment,the clinical efficacy of the two groups was evaluated.Results(1)After 8 weeks of treatment,the overall effective rate of the observation group was 96.36%(53/55)and that of the control group was 76.36%(42/55),and the intergroup comparison showed that the efficacy of the observation group was significantly superior to that of the control group(P<0.01).(2)After treatment,the modified Ashworth spasticity classification of patients in both groups was significantly improved compared with that before treatment(P<0.05),and the improvement in the observation group was significantly superior to that in the control group(P<0.01).(3)The peak systolic velocity(PSV)values of blood flow of the radial and brachial arteries were significantly increased in the observation group after 2,4 and 8 weeks of treatment and in the control group after 4 and 8 weeks of treatment compared with those before treatment(P<0.05),and the increase of the PSV values of the radial and brachial arteries in the observation group was significantly superior to that in the control group after 2,4 and 8 weeks of treatment(P<0.01).(4)The serum NGF and S10

关 键 词：中风上肢痉挛 BOBATH疗法 脊穴点段针刺 上肢动脉血流速度 

分 类 号：R246.6[医药卫生—针灸推拿学]