经筋结点电针联合活络伸筋方对老年中风上肢痉挛患者肌张力控制及神经元修复作用研究  

Effect of Electroacupuncture at Nodes of Meridians and Muscles Combined with Huoluo Shenjin Prescription(活络伸筋方)on Muscle Tension Control and Neuron Repair in Elderly Stroke Patients with Upper Extremity Spasm

作　　者：荣姗姗[1] 张建强 王少众 RONG Shanshan;ZHANG Jianqiang;WANG Shaozhong(The First Affiliated Hospital of Henan University of Science and Technology,Luoyang 471000,Henan,China;Yiyang County People's Hospital,Luoyang 471000,Henan,China)

机构地区：[1]河南科技大学第一附属医院,河南洛阳471000 [2]宜阳县人民医院,河南洛阳471000

出　　处：《辽宁中医杂志》2023年第11期155-158,共4页Liaoning Journal of Traditional Chinese Medicine

摘　　要：目的探讨经筋结点电针联合活络伸筋方对老年中风上肢痉挛患者肌张力控制及神经元修复作用。方法将2019年5月—2022年2月在该院进行治疗的90例老年中风上肢痉挛患者采用随机数字表法分为两组。对照组45例给予活络伸筋方治疗,观察组在活络伸筋方基础上联合经筋结点电针治疗。比较两组中医证候积分、改良Ashworth(MAS)评级、上肢和下肢Fugl-Meyer(FMA)评分、日常生活能力(ADL)评分、欧洲卒中量表(ESS)评分的差异,检测两组相关因子的表达情况,统计不良反应发生率。结果治疗前,两组各项评分及MAS评级比较,差异无统计学意义(P>0.05)。治疗后,两组中医证候积分明显较治疗前下降,FMA评分(包括上肢和下肢)、ADL评分、ESS评分明显较治疗前升高,MAS评级明显较治疗前改善,且观察组上述评分及MAS评级优于对照组(P<0.05)。治疗前,两组甘氨酸(Gly)、神经元特异性烯醇化酶(NSE)等相关因子的比较,差异无统计学意义(P>0.05)。治疗后,两组Gly、γ-氨基丁酸(GABA)明显较治疗前升高,NSE、CXC趋化因子16(CXCL16)明显较治疗前下降,神经生长因子(NGF)与治疗前比较,差异无统计学意义(P>0.05),观察组Gly、GABA升高后的数值和NSE、CXCL16下降后的数值均优于对照组,但NGF与对照组比较,差异无统计学意义(P>0.05)。观察组累计不良反应率为6.67%(3/45)与对照组的8.89%(4/45)比较,差异无统计学意义(P>0.05)。结论经筋结点电针联合活络伸筋方用于老年中风上肢痉挛患者可通过修复神经元,改善肌张力和神经功能,加强日常生活能力。Objective To investigate the effect of electroacupuncture at the nodes of meridians and tendons combined with Huoluo Shenjin Prescription(活络伸筋方)on muscle tension control and neuron repair in elderly stroke patients with upper ex-tremity spasm.Methods A total of 90 elderly stroke patients with upper extremity spasm who were treated in the hospital from May 2019 to February 2022 were divided into two groups by random number table method.Forty-five cases in the control group were treated with Huoluo Shenjin Prescription,while the observation group was treated with Huoluo Shenjin Prescription combined with electroacupuncture at the nodes of meridians and tendons.The TCM syndrome scores,modified Ashworth(MAS)rating,upper and lower extremity Fugl-Meyer(FMA)scores,activities of daily living(ADL)scores and European Stroke Scale(ESS)scores were compared between the two groups,and the related factors were detected between the two groups.The incidence of adverse reactions was counted.Results Before treatment,there was no statistical significance in the comparison of scores or MAS between the two groups(P>0.05).After treatment,TCM syndrome scores in the two groups were significantly decreased compared with those be-fore treatment.FMA scores(including upper and lower limbs),ADL scores and ESS scores were significantly higher than those be-fore treatment,and MAS scores were significantly improved compared with those before treatment.The MAS rating was better than that of the control group(P<0.05).Before treatment,there was no statistical significance in the comparison of glycine(Gly),neuron-specific enolase(NSE)or other related factors between the two groups(P>0.05).After treatment,the levels of Gly andγ-aminobutyric acid(GABA)in the two groups were significantly higher than those before treatment,the levels of NSE and CXC chemokine 16(CXCL16)were significantly lower than those before treatment,and the level of nerve growth factor(NGF)was sig-nificantly lower than before treatment(P<0.05),the levels of Gly and GABA

关 键 词：经筋结点电针 活络伸筋方 老年 中风 上肢痉挛 肌张力 

分 类 号：R255.2[医药卫生—中医内科学]