“醒脑开窍”针刺联合改良强制性运动疗法对卒中偏瘫患者脑地形图、脑血流和患肢功能的影响  

Effects of"Xingnao Kaiqiao"acupuncture combined with modified constraint induced movement therapy on brain electrical activity mapping,cerebral blood flow and function of affected limbs in patients with stroke hemiplegia

作　　者：徐渊 顾伟 李南京 王佳伟 XU Yuan;GU Wei;LI Nanjing;WANG Jiawei(Department of Rehabilitation Medicine,the Sixth People's Hospital of Fuyang,Fuyang,Anhui 236000)

机构地区：[1]安徽省阜阳市第六人民医院康复医学科,安徽阜阳236000

出　　处：《河北中医》2023年第8期1358-1362,共5页Hebei Journal of Traditional Chinese Medicine

摘　　要：目的观察“醒脑开窍”针刺联合改良强制性运动疗法(m-CIMT)对卒中偏瘫患者脑地形图、脑血流和患肢功能的影响。方法将100例卒中偏瘫患者按照随机数字表法分为2组,治疗组50例予“醒脑开窍”针刺联合m-CIMT治疗,对照组50例予假针刺治疗联合m-CIMT治疗。2组均治疗6个月。比较2组治疗前后脑地形图指标[β频段、δ频段和θ频段的功率电压],血流动力学指标[大脑中动脉平均血流速度(Vm)、峰值速度(Vp)]及Fugl-Meyer运动功能评定量表(FMA)评分、Berg平衡量表(BBS)评分、日常生活能力量表(ADL)评分,并统计2组临床疗效。结果治疗组总有效率96.00%(48/50),对照组总有效率76.00%(38/50),治疗组临床疗效优于对照组(P<0.05)。2组治疗后β频段功率电压均较本组治疗前升高(P<0.05),δ频段和θ频段电压均降低(P<0.05),且治疗组治疗后β频段功率电压高于对照组(P<0.05),δ频段和θ频段功率电压均低于对照组(P<0.05)。2组治疗后大脑中动脉Vm、Vp均较本组治疗前升高(P<0.05),且治疗组治疗后均高于对照组(P<0.05)。2组治疗后FMA、BSS、ADL评分均较本组治疗前升高(P<0.05),且治疗组治疗后FMA、BSS、ADL评分均高于对照组(P<0.05)。结论“醒脑开窍”针刺联合m-CIMT治疗卒中偏瘫疗效显著,可显著改善患者脑部循环,改善其肢体运动功能。Objective To observe the effects of"Xingnao Kaiqiao"acupuncture combined with modified constraint induced movement therapy(m-CIMT)on brain electrical activity mapping,cerebral blood flow and affected limb function in patients with stroke hemiplegia.Methods Totally 100 patients with stroke hemiplegia were randomized 1∶1 to receive"Xingnao Kaiqiao"acupuncture combined with m-CIMT(treatment group)or sham acupuncture combined with m-CIMT therapy(contorl group)for 6 months.The brain electrical activity mapping indicators(power voltages ofβfrequency band,δfrequency band andθfrequency band),hemodynamic indicators mean blood flow velocity[Vm]and peak velocity[Vp]of middle cerebral artery,as well as the score of Fugl-Meyer motor assessment(FMA),Berg balance scale(BBS),and Activities of Daily Living(ADL)before and after treatment were included as comparisons between groups,and the clinical efficacy was statistically ananlyzed in both groups.Results After treatment,the total effective rate in the treatment group was better than that in the control group(96.00%[48/50]vs 76.00%[38/50],P<0.05).The power voltage ofβfrequency band in the treatment group was significantly higher than that in the control group(P<0.05),while the power voltages ofδfrequency band andθfrequency band were significantly lower than those in the control group(P<0.05).There was statistical difference in power voltages ofβfrequency band,δfrequency band andθfrequency band between the two groups(P<0.05).The Vm and Vp of middle cerebral artery were significantly increased in the both groups(P<0.05),and the increase was more significant in the treatment group than in the control group(P<0.05).The scores of FMA,BSS and ADL were significantly elevated in the both groups(P<0.05),and the improvment was more obvious in the treatment group than in the control group(P<0.05).Conclusion"Xingnao Kaiqiao"acupuncture combined with m-CIMT has significant value for stroke hemiplegia,and it can significantly promote the cerebral circulation and improve the limb mot

关 键 词：卒中 偏瘫 醒脑开窍 针刺 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R245.31[医药卫生—临床医学]