恢刺经筋结点联合督脉隔姜灸对中风后上肢屈肌痉挛协调功能、表面肌电图以及TrkB蛋白表达的影响  

Effects of Relaxing Needling Acupuncture at the Tendon Node and Moxibustion at the Du Channel Separated by Ginger on the Coordination Function,Surface Electromyography and TrkB Protein Expression of Upper Limb Spastic Hemiplegia after Stroke

作　　者：孙成雪 董宝强[1] SUN Chengxue;DONG Baoqiang(Liaoning University of Traditional Chinese Medicine,Shenyang 110847,Liaoning,China;Northeast International Hospital,Shenyang 110623,Liaoning,China)

机构地区：[1]辽宁中医药大学,辽宁沈阳110847 [2]东北国际医院,辽宁沈阳110623

出　　处：《辽宁中医药大学学报》2023年第8期185-191,共7页Journal of Liaoning University of Traditional Chinese Medicine

基　　金：辽宁省“兴辽英才计划”科技创新领军人才项目(XLYC1902115);辽宁省科技厅重点研发计划项目(2019JH2/10300012)。

摘　　要：目的观察恢刺法联合督脉隔姜灸对中风后上肢屈肌痉挛协调功能、表面肌电图以及TrkB蛋白表达的影响。方法将80例中风后上肢痉挛性偏瘫患者随机分为恢刺经筋结点联合督脉隔姜灸组、单一经筋针刺组,每组各40例,均每天治疗1次,每周治疗5 d,5次为1个疗程,疗程间休息1 d,共治疗4个疗程。运用改良Ashworth量表(MAS)、Fugl-Meyer肢体运动功能量表(FMA)、日常生活活动能力量表(BI),表面肌电技术检测治疗前与治疗后健患侧肌肉的sEMG信号,选择指标为中位频率(MF)与积分肌电值(IEMG)以及血清中TrkB的含量对患者进行量表评定及疗效评价。结果MAS、FMA、BI、MF、IEMG及TrkB评定结果显示:恢刺法联合督脉隔姜灸组总体的评分优于单一经筋针刺组,两组比较差异有统计学意义(P<0.05);疗效评价结果显示:恢刺法联合督脉隔姜灸组总有效率为92.5%(37/40);单一经筋针刺组总有效率为87.5%(35/40);两组对比差异有统计学意义(P<0.05)。结论督脉隔姜灸联合恢刺经筋结点对于改善中风后上肢屈肌痉挛协调功能、表面肌电图状态以及TrkB蛋白表达状态有非常重要的临床意义。Objective To observe the effect of relaxing needling method combined with Du channel ginger separated moxibustion on the coordination function of flexor spasm,surface electromyography(sEMG)and TrkB protein expression of upper limb spastic hemiplegia after stroke.Methods 80 patients with spastic hemiplegia of the upper limbs after stroke were randomly divided into two groups,one group was treated once a day,the other group was treated 5 days a week,the other was treated 5 times a week,and the other group was treated 4 times a week.The Modified Ashworth Scale(MAS),Fugl Meyer Limb Motor Function Scale(FMA),activity of daily living scale(BI)and surface electromyography(sEMG)were used to detect the sEMG signal of the healthy side muscle before and after treatment.The selected indexes were median frequency(MF)and integrated electromyography(IEMG)and the content of TrkB in the serum.The patients were assessed with the scale and the efficacy was evaluated.Results The evaluation results of MAS,FMA,BI,MF,IEMG and TrkB showed that the overall score of the restoring acupuncture method combined with Du channel ginger separated moxibustion group was better than that of the single meridian acupuncture group,and there was a significant difference between the two groups(P<0.05);The results of curative effect evaluation showed that the total effective rate of the restoring acupuncture method combined with Du channel ginger separated moxibustion group was 92.5%(37/40);The total effective rate of single meridian acupuncture group was 87.5%(35/40);There was significant difference between the two groups(P<0.05).Conclusion It is very important for Du channel ginger separated moxibustion combined with relaxing needling acupuncture at the tendon nodes to improve the coordination function of upper limb spastic hemiplegia after stroke,the state of surface electromyography and the expression of TrkB protein.

关 键 词：中风 上肢痉挛性偏瘫 督脉隔姜灸 经筋 恢刺 

分 类 号：R246.6[医药卫生—针灸推拿学]