电针联合超声引导下冲击波和振动训练治疗卒中后肌痉挛的疗效观察及对血清GABA和Glu含量的影响  

Observation of the effect of electroacupuncture combined with ultrasound-guided shock wave and vibration training on post-stroke muscle spasticity and its influence on serum GABA and Glu contents

作　　者：孟海超[1] 王正田 王腾 王晓娜 MENG Haichao;WANG Zhengtian;WANG Teng;WANG Xiaona(The First Affiliated Hospital of Hebei North University,Zhangjiakou 075000,China)

机构地区：[1]河北北方学院附属第一医院,张家口075000

出　　处：《上海针灸杂志》2023年第8期808-813,共6页Shanghai Journal of Acupuncture and Moxibustion

基　　金：河北省医学科学研究基金项目(20200540);河北省卫生健康委医学科学研究基金项目(20190887)。

摘　　要：目的 观察电针跷脉穴联合超声引导下冲击波和振动训练治疗卒中后肌痉挛的临床疗效及其对患者血清γ-氨基丁酸(γ-aminobutyric acid,GABA)和谷氨酸(glutamic acid,Glu)含量的影响。方法 采用随机数字表法将80例卒中后肌痉挛患者随机分为研究组与对照组,每组40例。两组均接受康复训练,对照组另予振动训练及超声引导下冲击波治疗,研究组在对照组治疗基础上联合电针跷脉穴治疗。观察治疗前后两组中医证候积分各单项评分、Fugl-Meyer运动功能量表(Fugl-Meyer assessment,FMA)评分、卒中专用生活质量量表(stroke specific quality of life scale,SS-QOL)评分、上肢动作研究量表(action research arm test,ARAT)评分、美国国立卫生院卒中量表(National Institutes of Health stroke scale,NIHSS)评分和改良Barthel指数(modified Barthel index,MBI)评分的变化,观察治疗前后两组患者血清GABA和Glu水平的变化,比较两组临床疗效。结果 治疗后,两组中医证候积分各单项评分、FMA评分、SS-WOL评分、ARAT评分、NIHSS评分和MBI评分以及血清GABA和Glu水平均较治疗前改善(P<0.05)。研究组治疗后中医证候积分、NIHSS评分和血清Glu水平均低于对照组(P<0.05),SS-QOL、FMA、MBI和ARAT评分以及血清GABA水平均高于对照组(P<0.05)。研究组总有效率高于对照组(P<0.05)。结论 在康复训练基础上,电针跷脉穴联合超声引导下冲击波和振动训练治疗卒中后肌痉挛能有效改善患者的神经症状、生活质量与肢体运动能力,改善Glu和GABA表达水平,从而缓解肌肉痉挛症状,疗效优于单纯超声引导下冲击波和振动训练治疗。Objective To observe the clinical efficacy of electroacupuncture at Qiao meridians acupoints combined with ultrasound-guided shock wave and vibration training in the treatment of post-stroke muscle spasm and its influence on serum γ-aminobutyric acid(GABA) and glutamic acid(Glu) contents.Method The 80 patients with post-stroke muscle spasm were randomly divided into a study group and a control group by using the random number table method,with 40 patients in each group.Both groups received rehabilitation training,the control group was given vibration training and ultrasound-guided shockwave therapy,and the study group was given electroacupuncture at Qiao meridians acupoints in addition to the treatment of the control group.The single item score of TCM syndrome score,Fugl-Meyer assessment(FMA) score and stroke specific quality of life scale(SS-QOL) score,action research arm test(ARAT) score,National Institutes of Health stroke scale(NIHSS) score and modified Barthel index(MBI)score were observed in the two groups before and after treatment.Serum GABA and Glu levels were observed in the two groups before and after treatment.The clinical efficacy was compared between the two groups.Result After treatment,the single item score of TCM syndrome score,FMA score,SS-QOL score,ARAT score,NIHSS score and MBI score,and serum GABA and Glu levels of the two groups were improved as compared with those before treatment(P<0.05).After treatment,the TCM syndrome score,NIHSS score and serum Glu level in the study group were lower than those in the control group(P<0.05),and the SS-QOL,FMA,MBI and ARAT scores and serum GABA level were higher than those in the control group(P<0.05).The total response rate of the study group was higher than that of the control group(P<0.05).Conclusion In addition to the rehabilitation training,electroacupuncture at Qiao meridians acupoints combined with ultrasound-guided shock wave and vibration training can effectively improve the neurological symptoms,quality of life,limb motor ability,and improve th

关 键 词：针刺疗法 电针 阴跷脉 阳跷脉 中风后遗症 痉挛 偏瘫 康复训练 

分 类 号：R743.3[医药卫生—神经病学与精神病学]