电针步行核心肌肉运动点对亚急性期脑卒中患者下肢运动功能重建的影响  

Effect of Electro-Needling Walking Core-Muscle Motor Points on Reconstruction of Lower Limb Motor Function in Patients with Sub-Acute Stroke

作　　者：张译尹 王东岩[2] 李慎微 张健[3] ZHANG Yiyin;WANG Dongyan;LI Shenwei;ZHANG Jian(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,China;The Third Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150060,China)

机构地区：[1]黑龙江中医药大学,黑龙江哈尔滨150040 [2]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150001 [3]黑龙江中医药大学附属第三医院,黑龙江哈尔滨150060

出　　处：《针灸临床杂志》2024年第2期36-41,共6页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金面上项目,编号:81774426;哈尔滨市科技计划自筹经费项目,编号:2022ZCZJNS062;黑龙江中医药大学创新团队建设项目,编号:2017sit01。

摘　　要：目的:观察电针步行核心肌肉运动点对亚急性期脑卒中患者下肢运动功能重建的影响。方法:选取符合纳入标准的脑卒中下肢运动功能障碍患者60例作为研究对象,根据Stata/SE 16.0生成的随机数序列,将患者随机分为两组,均给予中风病常规治疗。此外,对照组给予环跳、阳陵泉、阴陵泉、风市、足三里及太冲电针治疗,试验组给予股内侧肌、股外侧肌、胫骨前肌、腓骨长肌、股二头肌、半腱肌、腓肠内侧肌及比目鱼肌步行核心肌肉运动点电针治疗。治疗前后采用徒手肌力评定(MMT)测量下肢肌力、Holden步行功能分级量表(FAC)评定步行功能、改良Barthel量表(MBI)评定患者日常生活活动能力和表面肌电信号均方根值(RMS)评定肌肉实时收缩情况并对比两组治疗后的临床疗效。结果:两组患者MMT评分、FAC评分、MBI评分及RMS值治疗后分值均升高,治疗后两组患者MMT评分、FAC评分、MBI评分及RMS值组间比较,差异有统计学意义(P<0.05),且试验组总有效率为93.33%(28/30),优于对照组的70%(21/30)。结论:电针步行核心肌肉运动点能改善亚急性期脑卒中患者的下肢肌力、步行能力和日常生活活动能力,临床疗效明确。Objective:To observe the effect of electro-needling walking core-muscle motor points on reconstruction of lower limb motor function in patients with sub-acute stroke.Methods:60 patients with post-stroke lower limb motor dysfunction,who met the inclusion criteria,were randomly divided into the control group and the study group according to the random number sequence generated by Stata/SE 16.0.Both groups were given conventional treatment for stroke.In addition,the control group was given electro-needling Huantiao(GB30),Yanglingquan(GB34),Yinlingquan(SP9),Fengshi(GB31),Zusanli(ST36)and Taichong(LR3),and the study group was treated with electro-needling medial femoral,lateral femoral,tibialis anterior,peroneus longus,biceps femoris,semitendinosus,gastrocnemius medialis and soleus walking core muscle motor points.Lower limb muscle strength was measured by Manual Muscle Test(MMT),walking function was assessed by Functional Ambulation Category(FAC),daily life activity ability was assessed by Modified Barthel Index(MBI),and real-time muscle contraction was assessed by surface electromyographic signals’root mean square(RMS)before and after the treatment in the two groups.The clinical efficacy was compared between the two groups after the treatment.Results:The scores of MMT,FAC and MBI,as well as the RMS value increased in the two groups after the treatment,in which there were statistical differences between the two groups.The total effective rate was 93.33%(28/30)in the study group,which was higher than 70%(21/30)in the control group(P<0.05).Conclusion:Electro-needling walking core muscle motor points can improve lower limb muscle strength,walking ability,and activities of daily living in patients with sub-acute stroke,with a significant clinical efficacy.

关 键 词：亚急性期脑卒中 电针 核心肌肉运动点 下肢运动功能重建 

分 类 号：R246.6[医药卫生—针灸推拿学]