醒神调形针刺法联合常规疗法治疗中风后肢体痉挛临床研究  

Clinical Study of Xingshen Tiaoxing Acupuncture Method Combined with Routine Therapy for Post-stroke Spasticity

作　　者：马晓丽 张思雨 刘清伟 MA Xiaoli;ZHANG Siyu;LIU Qingwei(Xuchang Hospital of Traditional Chinese Medicine,Xuchang He'nan 461000,China)

机构地区：[1]许昌中医院,河南许昌461000

出　　处：《新中医》2023年第18期156-163,共8页New Chinese Medicine

摘　　要：目的:观察醒神调形针刺法联合常规疗法治疗中风后肢体痉挛的临床效果。方法:纳入106例气虚血瘀型中风后肢体痉挛患者,随机分为观察组及对照组各53例,2组均给予控制血压及血糖、调节血脂、防止血小板聚集等基础治疗,并予痉挛期康复方案干预,观察组加予醒神调形针刺法治疗,2组均干预4周。治疗前后评定中医证候评分、上下肢痉挛状态[改良Ashworth痉挛量表(MAS)评分]、肢体运动功能[简式Fugl-Meyer运动功能评测表(FMA)评分]和日常生活能力[改良Barthel指数(MBI)评分],检测肱二头肌、股四头肌的表面肌电均方根(RMS)值、脑血管血流速度指标[大脑中动脉(MCA)、后动脉(PCA)、椎动脉(VA)、前动脉(ACA)、基底动脉(BA)]以及血管活性物质指标[血浆内皮素(ET-1)、6-酮-前列环素F1α(6-K-PGF_(1α))、血栓素B_(2)(TXB_(2))、一氧化氮(NO)]。比较2组的临床疗效。结果:治疗后,观察组总有效率88.68%,对照组总有效率69.81%,2组比较,差异有统计学意义(P<0.05)。2组半身不遂、口舌歪斜、言语謇涩、肢体麻木、头痛、头晕目眩、肢体颤抖、目珠震动评分及总分均较治疗前降低,差异均有统计学意义(P<0.05)。观察组以上8项评分及总分均低于对照组,差异均有统计学意义(P<0.05)。2组上肢、下肢的痉挛状态均较治疗前改善,差异均有统计学意义(P<0.05)。观察组上肢、下肢痉挛状态的改善均优于对照组,差异均有统计学意义(P<0.05)。2组FMA评分、MBI评分均较治疗前升高,差异均有统计学意义(P<0.05)。观察组FMA评分、MBI评分均高于对照组,差异均有统计学意义(P<0.05)。2组肱二头肌、股四头肌的表面肌电RMS值均较治疗前降低,差异均有统计学意义(P<0.05)。观察组肱二头肌、股四头肌的表面肌电RMS值均低于对照组,差异均有统计学意义(P<0.05)。2组MCA、PCA、ACA、BA、VA均较治疗前增加,差异均有统计学意义(P<0.05)�Objective:To observe the clinical effect of the therapy of Xingshen Tiaoxing acupuncture method combined with routine therapy on post-stroke spasticity.Methods:A total of 106 patients with post-stroke spasticity with syndrome of qi deficiency with blood stasis were included and randomly divided into the observation group and the control group,with 53 cases in each group.The two groups were given basic treatment for controlling blood pressure and blood sugar,regulating blood fat and preventing platelet aggregation,and intervention of rehabilitation plan in convulsion period,and the observation group was additionally treated with Xingshen Tiaoxing acupuncture method.The two groups were given intervention for 4 weeks.The clinical effects were compared between the two groups;the traditional Chinese medicine syndrome scores,spasticity of upper and lower limbs,including scores of Modified Ashworth Scale(MAS),motor function of limbs,including scores of simplified Fugl-Meyer Assessment Scale(FMA) and activity of daily living,including scores of Modified Barthel Index(MBI) were evaluated before and after treatment;the root mean square(RMS) of surface electromyography of bicipital muscle of arm and quadriceps,indexes of cardiovascular blood flow velocity,including middle cerebral artery(MCA),posterior cerebral artery(PCA),vertebral artery(VA),anterior cerebral artery(ACA) and basilar artery(BA),and indexes of vasoactive substances,including endothelin-1(ET-1),6-ketone-prostaglondin F1α(6-KPGF_(1α)),thromboxane B2(TXB_(2)) and nitric oxide(NO) were detected.Results:After treatment,the total effective rate was 88.68% in the observation group,and 69.81% in the control group,the difference being significant(P<0.05).The scores of hemiplegia,deviated mouth and tongue,sluggish speech,numbness of limbs,headache,dizziness and dizzy vision,limb shaking and eyeball vibrating and the total scores in the two groups were decreased when compared with those before treatment,differences being significant(P<0.05).The above eight scores an

关 键 词：中风后肢体痉挛 气虚血瘀证 醒神调形针刺法 运动功能 日常生活能力 脑血管血流速度 血管活性物质 

分 类 号：R246.6[医药卫生—针灸推拿学]