针灸联合Bobath康复训练对中风后偏瘫患者神经功能的影响  

Efect of Acupuncture and Moxibustion Combined with Bobath Rehabilitation Training on Nerve Function of Patients with Poststroke Hemiplegia

作　　者：芦艳晨[1] 芦艳艳[1] LU Yanchen;LU Yanyan(Traditional Chinese Medicine Hospital in Linyi,Linyi 276002,China)

机构地区：[1]山东省临沂市中医医院,山东临沂276002

出　　处：《基层中医药》2023年第11期31-36,共6页Basic Traditional Chinese Medicine

摘　　要：目的观察针灸联合Bobath康复训练对中风后偏瘫患者神经功能的影响。方法选取90例2021年1月—2022年12月山东省临沂市中医医院治疗的中风后偏瘫患者,依照随机数字表法分为观察组和对照组各45例。对照组给予西医常规药物治疗及Bobath康复训练治疗。观察组在对照组基础上给予针灸治疗。连续治疗8周。比较患者治疗前后半身不遂、神识昏蒙、舌强语謇、口舌歪斜等中医证候积分,Fugl-Meyer运动功能量表(FMA)、改良Barthel指数(MBI)评分、脑卒中专用生活质量量表(SS-QOL)评分、美国国立卫生研究院卒中量表(NIHSS)以及神经生长因子(NGF)、脑源性神经营养因子(BDNF)及神经营养素-3(NT-3)水平。结果两组患者治疗后与治疗前相比半身不遂、神识昏蒙、舌强语謇、口舌歪斜证候积分相比均降低(P<0.05),FMA、MBI评分及SS-QOL评分均增加(P<0.05),NIHSS评分降低(P<0.05),NGF、BDNF、NT-3水平均升高(P<0.05),且观察组优于对照组(P<0.05或P<0.01)。结论针灸联合Bobath康复训练能够改善患者临床症状、提升运动功能和日常生活能力,提高神经营养因子水平,缓解神经功能缺损,提高患者生活质量,临床上值得进一步推广应用。Objective To observe the effect of acupuncture and moxibustion combined with Bobath rehabilitation training on the nerve function of patients with poststroke hemiplegia.Methods A total of 90 patients with poststroke hemiplegia treated at Traditional Chinese Medicine Hospital in Linyi from January 2021 to December 2022 were selected and divided into an observation group and a control group with 45 cases in each group according to the random number table method.The control group was treated with conventional Western medicine and Bobath rehabilitation training.The observation group was given acupuncture and moxibustion treatment on the basis of the control group.The treatment continued for eight weeks.The scores of TCM syndromes such as hemiplegia,confusion of consciousness,stiff tongue and impeded speech,and deviation of mouth and tongue before and after treatment were compared.Fugl-Meyer motor function scale(FMA),modifed Barthel index(MBI)score,stroke-specific quality of life scale(SS-QOL)score,National Institutes of Health Stroke Scale(NIHSS),nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),and neurotrophin-3(NT-3)level were compared.Results Compared with those before treatment,the scores of hemiplegia,confusion of consciousness,stif tongue and impeded speech,and deviation of mouth and tongue were signifcantly decreased(P<0.05),and the scores of FMA,MBI,and SS-QOL were significantly increased(P<0.05);the scores of NIHSS were significantly decreased(P<0.05).The levels of NGF,BDNF,and NT-3 were signifcantly increased(P<0.05),and the observation group was signifcantly better than the control group(P<0.05 or P<0.01).Conclusion Acupuncture and moxibustion combined with Bobath rehabilitation training can improve the clinical symptoms of patients,enhance the motor function and daily living ability,increase the level of neurotrophic factors,relieve nerve function defects,and improve the quality of life of patients,and it is worthy of further promotion and application in clinical practice.

关 键 词：针灸 Bobath康复训练 中风后偏瘫 运动功能 神经功能 

分 类 号：R74[医药卫生—神经病学与精神病学]