运动针法对卒中后偏瘫患者下肢运动功能及步态的影响  

Effect of exercise acupuncture on lower limb motor function and gait in patients with post-stroke hemiplegia

作　　者：马爽 郭若耘 刘海霞 张超 鲍春龄[1] 东贵荣[1] 周亮[1] MA Shuang;GUO Ruoyun;LIU Haixia;ZHANG Chao;BAO Chunling;DONG Guirong;ZHOU Liang(Yueyang Hospital of Integrated Traditional Chinese and Western Medicine,Shanghai University of Traditional Chinese Medicine,Shanghai 200437,China;Shanghai Zhongye Hospital,Shanghai 201900,China)

机构地区：[1]上海中医药大学附属岳阳中西医结合医院,上海200437 [2]上海中冶医院,上海201900

出　　处：《上海针灸杂志》2023年第10期1048-1054,共7页Shanghai Journal of Acupuncture and Moxibustion

基　　金：上海市针灸临床医学研究中心项目(20MC1920500);上海市科学技术委员会科研计划项目(16401970400);国家重点研发计划项目(2019YFC1712204);上海市社区中医药适宜技术项目(SQ-SYJS-17);东氏针灸阴阳调衡针法及治疗中风功能障碍多流派优化方案验证项目[ZY(2021-2023)-0209-08]。

摘　　要：目的观察运动针法对卒中后偏瘫患者下肢运动功能及步态的影响。方法将符合纳入标准的80例卒中后偏瘫患者随机分为运动针法组和常规针刺组,每组40例。常规针刺组予常规针刺,运动针法组予运动针法治疗。观察两组治疗前后下肢Fugl-Meyer运动功能量表(Fugl-Meyer assessment,FMA)和Berg平衡量表(Berg balance scale,BBS)评分的变化,采用三维步态分析观察两组患者步态时空参数及步态对称性的变化情况。比较两组临床疗效。结果治疗后,运动针法组总有效率为90.0%,常规针刺组总有效率为72.5%,组间差异具有统计学意义(P<0.05)。治疗后,运动针法组下肢FMA评分和BBS评分高于常规针刺组(P<0.05);运动针法组步速、步频和步长均优于常规针刺组(P<0.05),步宽和摆动相百分比低于常规针刺组(P<0.05);运动针法组步长偏差、患健侧摆动相百分比明显低于常规针刺组(P<0.05)。结论运动针法能提高卒中后偏瘫患者下肢运动功能及平衡功能,改善步行能力和步态对称性,疗效优于常规针刺治疗。Objective To observe the effect of exercise acupuncture on lower limb motor function and gait in patients with post-stroke hemiplegia.Method Eighty patients with post-stroke hemiplegia meeting the inclusion criteria were randomized to an exercise acupuncture group and a conventional acupuncture group,with 40 cases in each group.The conventional acupuncture group received conventional acupuncture and the exercise acupuncture group received exercise acupuncture.The Fugl-Meyer assessment(FMA)and the Berg balance scale(BBS)scores for lower extremity were recorded in the two groups before and after treatment.Changes in gait spatio-temporal parameters and gait symmetry were observed using three-dimensional gait analysis in the two groups of patients.The clinical therapeutic efficacy was compared between the two groups.Result After treatment,the total effective rate was 90.0%in the exercise acupuncture group and 72.5%in the conventional acupuncture group with a statistically significant between-group difference(P<0.05).After treatment,lower extremity FMA and BBS scores were higher(P<0.05),pace,step frequency and step length were better(P<0.05),step width and swing phase percentage were lower(P<0.05)and step length deviation and swing phase percentage in the affected and healthy sides were significantly lower(P<0.05)in the exercise acupuncture group than in the conventional acupuncture group.Conclusion Exercise acupuncture can improve lower limb motor function,balance function,walking ability and gait symmetry in patients with post-stroke hemiplegia.Its therapeutic effect is superior to that of conventional acupuncture.

关 键 词：针刺疗法 运动针法 中风后遗症 偏瘫 步态 下肢运动功能 

分 类 号：R246.6[医药卫生—针灸推拿学]