芒针透刺联合针康法治疗中风后上肢痉挛性瘫痪的疗效及对血清GABA的影响  

Therapeutic Effect of Elongated Needle Penetrating Acupuncture Combined with Acupuncture-Rehabilitation Therapy in Treatment of Spastic Paralysis of Upper Limbs after Stroke and Its Influence to Serum GABA

作　　者：张金朋 赵彬[2] 陈慧杰[2] 李季[2] 关莹[2] 朱路文[2] 李保龙[2] 王亚楠 ZHANG Jinpeng;ZHAO Bin;CHEN Huijie;LI Ji;GUAN Ying;ZHU Luwen;LI Baolong;WANG Yanan(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150001,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

出　　处：《针灸临床杂志》2024年第1期17-21,共5页Journal of Clinical Acupuncture and Moxibustion

基　　金：国家自然科学基金青年项目,编号:82004439;黑龙江省应用技术研究与开放计划,编号:GA19C110;黑龙江省中医药经典普及化专项课题,编号:ZYW2022-029,ZYW2022-028;孙申田青年人才基金,编号:2021KY-10。

摘　　要：目的:观察芒针透刺联合针康法治疗中风后上肢痉挛性瘫痪的疗效。方法:76例中风后上肢痉挛性瘫痪患者随机分为治疗组(38例,脱落1例)和对照组(38例,脱落1例)。两组患者均给予常规药物治疗,对照组给予针康法治疗,治疗组采用针康法联合芒针透刺治疗,1次/d,疗程均为4周。观察并比较两组患者治疗前后改良Ashworth量表(MAS)评分、上肢简式Fugl-Meyer评定量表(FMA)评分、改良Barthel指数(MBI)评分与脑卒中专门化生活质量量表(SS-QOL)评分变化情况,检测两组治疗前后血清中γ-氨基丁酸(GABA)的含量,并评估临床疗效。结果:治疗前两组各项评分及GABA水平比较,差异无统计学意义(P>0.05)。治疗后两组MAS评分较治疗前显著降低;FMA评分、MBI评分、SS-QOL评分及GABA含量较治疗前明显升高;且治疗组对各项评分及血清学指标的改善程度明显优于对照组(P<0.05);观察组临床治疗愈显率为75.68%(28/37)、总有效率为97.30%(36/37),明显优于对照组愈显率45.95%(17/37)及总有效率86.49%(32/37),差异有统计学意义(P<0.05)。结论:芒针透刺联合针康法能有效降低中风后上肢痉挛性瘫痪患者肌张力,改善上肢运动功能,提升日常生活活动能力及生活质量,有效调节神经递质水平,临床疗效显著。Objective:To observe the clinical curative effect of elongated needle penetrating acupuncture combined with acupuncture-rehabilitation therapy in treatment of spastic paralysis of upper limb after stroke.Methods:76 patients with upper limb spastic paralysis after stroke were randomly divided into the treatment group(n=38,1 case dropped out)and the control group(n=38,1 case dropped out).Both groups were given conventional medication,the control group was treated with acupuncture-rehabilitation therapy;on which basis,the treatment group was also treated with penetrating acupuncture with elongated needle.The treatment was once a day,and the course of treatment was 4 weeks.The scores of modified Ashworth scale(MAS),upper extremity simplified Fugl-Meyer scale(FMA),modified Barthel index(MBI)and stroke-specific quality of life scale(SS-QOL)were observed and compared between before and after the treatment in the two groups;the serum content ofγ-aminobutyric acid(GABA)were detected before and after the treatment in the two groups;the clinical efficacy was evaluated and compared between the two groups.Results:There were no statistical differences in the scores and the GABA level between the two groups before the treatment(P>0.05).After the treatment,the MAS scores were significantly lower,the FMA scores,the MBI scores,the SS-QOL scores,and GABA content were significantly higher after the treatment than those before the treatment in the two groups(P<0.05);of which the improvements in the treatment group were more significant than those in the control group(P<0.05).The remarkable clinical curative rate was 75.68%(28/37),and the total effective rate was 97.30%(36/37)in the treatment group,which were significantly higher than 45.95%(17/37)and 86.49%(32/37)respectively in the control group(P<0.05).Conclusion:Penetrating needling with elongated needle combined with acupuncture-rehabilitation therapy can effectively reduce the muscle tension of patients with upper limb spastic paralysis after stroke,it can improve the motor fun

关 键 词：芒针 针康法 中风 痉挛性瘫痪 肌张力 

分 类 号：R246.6[医药卫生—针灸推拿学]