火针联合皮肤针对脑卒中后痉挛性偏瘫患者肢体运动功能及日常生活活动能力的影响  

Effect of Fire needle combined with Skin needle tapping Therapy on Limb motor function and daily living activities in patients with post-stroke spastic hemiplegia

作　　者：路悦[1] 王玉宇[1] 陈罗西[2] LU Yue;WANG Yuyu;CHEN Luoxi(Changzhou Wujin Hospital of Traditional Chinese Medicine,Changzhou 213100,Jiangsu,China;Department of Rehabilitation,Sichuan Orthopedic Hospital Rehabilitation,Chengdu 610041,Sichuan,China)

机构地区：[1]常州市武进中医医院,江苏常州213100 [2]四川省骨科医院康复科,四川成都610041

出　　处：《贵州医科大学学报》2023年第12期1579-1584,共6页Journal of Guizhou Medical University

基　　金：常州市武进区科技项目(WS201933);四川省中医药管理局课科技研究项目课(2020LC0178)。

摘　　要：目的探讨火针联合皮肤针对脑卒中后痉挛性偏瘫患者肢体运动功能及日常生活活动能力的影响。方法收集脑卒中后痉挛性偏瘫患者109例的临床资料,随机数字表法分为观察组(n=55,火针联合皮肤针)和对照组(n=54,常规针刺),连续治疗4周时根据Ashworth痉挛量表评估两组临床疗效;于治疗前、连续治疗4周时采用FMA量表评估肢体运动功能,Barthel指数(BI)量表评估日常生活能力,健康状况调查问卷(SF-36)量表评估生活质量,肌电图刺激仪记录两组患者M波最大振幅(M)、H反射最大振幅(H)波最大值及M/H的变化情况,酶联免疫法检测血清超敏C反应蛋白(hs-CRP)、同型半胱氨酸(Hcy)水平等炎症状态指标。结果连续治疗4周时,观察组的总有效率高于对照组,差异有统计学意义(P<0.05);连续治疗4周时,两组患者Ashworth分级较治疗前均有所降低,且观察组Ash worth分级降低程度明显优于对照组(P<0.05);连续治疗4周时,两组FMA评分及SF-36量表各维度评分较治疗前均有所增高,观察组高于对照组(P<0.05);连续治疗4周时,两组患者Mmax较治疗前明显增高,Hmax、M/H明显下降、且观察组Mmax高于对照组,Hmax和M/H低于对照组(P<0.05);连续治疗4周时两组患者血清hs-CRP、Hcy水平下降,且观察组低于对照组(P<0.05)。结论火针联合皮肤针治疗脑卒中后痉挛性偏瘫患者效果显著,可减轻炎症状态,改善患者痉挛状态,提高其肢体运动功能、日常生活活动能力及生活质量。Objective To explore the effect of fire needle combined with skin needle tapping therapy on limb motor function and daily living activities in patients with post-stroke spastic hemiplegia.Methods Clinical data of 109 patients with post-stroke spastic hemiplegia were collected.They were randomly divided into an observation group(n=55,combined with fire needle and skin needle tapping)and a control group(n=54,conventional acupuncture)using a random number table method.After 4 weeks of continuous treatment,the clinical efficacy of two groups was evaluated using the Ashworth spasticity scale.FMA scale was applied to evaluate limb motor function before treatment and at 4 weeks of continuous treatment.Barthel Index(BI)was used to evaluate daily living ability.Short-form 36 health survey questionnaire(SF-36)was performed to assess quality of life.An electromyography stimulator was used to record the maximum amplitudeof M wave(Mmax),maximum amplitudeof H reflex(Hmax),and changes in M/H ratio in two groups.Enzyme-linked immunosorbent assay(EMSA)was used to measure inflammatory status indicators such as serum high-sensitivity C-reactive protein(hs-CRP)and homocysteine(Hcy).Results After 4 weeks of continuous treatment,the total effective rate of observation group was higher than that of control group(P<0.05).After 4 weeks of continuous treatment,Ashworth grades in both groups of patients were lower than those before treatment,and the degree of decrease in Ash worth grade was significantly better in observation group than that in control group(P<0.05).After 4 weeks of continuous treatment,FMA scores,and SF-36 scale scores of both groups were increased when compared to before treatment,and they were higher in observation group than those in control group(P<0.05).After 4 weeks of continuous treatment,the Mmax of both groups of patients was significantly increased when compared to before treatment,while Hmax and M/H ratio significantly were decreased.Moreover,Mmax of observation group was higher than that of control group,while

关 键 词：脑卒中 痉挛性偏瘫 火针 皮肤针 肢体运动功能 

分 类 号：R278[医药卫生—中医学]