针刺结合运动再学习康复疗法对脑卒中后神经功能恢复的疗效观察  

Effect of Acupuncture Combined with Motor Relearning Rehabilitation Therapy on Neurological Function Recovery after Stroke

作　　者：宋华隆 牛博真 曹颖 SONG Hualong;NIU Bozhen;CAO Ying(First Teaching Hospital of Tianjin University of Traditional Chinese Medicine,Center for Preventive Health Management(National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion),Tianjin 300073,China;Department of Acupuncture and Moxibustion,First Teaching Hospital of Tianjin University of Traditional Chinese Medicine(National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion),Tianjin 300073,China;Department of Sores and Ulcers,Affiliated Hospital of Tianjin Academy of Traditional Chinese Medicine,Tianjin 300120,China)

机构地区：[1]天津中医药大学第一附属医院治未病健康管理中心(国家中医针灸临床医学研究中心),天津300073 [2]天津中医药大学第一附属医院针灸科(国家中医针灸临床医学研究中心),天津300073 [3]天津市中医药研究院附属医院疮疡科,天津300120

出　　处：《中华中医药学刊》2024年第1期78-81,共4页Chinese Archives of Traditional Chinese Medicine

基　　金：国家自然科学基金青年科学基金项目(81704136)。

摘　　要：目的观察针刺结合运动再学习康复疗法对脑卒中后患者神经功能恢复的疗效。方法根据纳入和排除标准选取2019年2月—2020年10月天津中医药大学第一附属医院康复科与针灸科收治的80例脑卒中患者,按照自愿原则将上述患者均分为两组,对照组40例,予以运动再学习康复疗法,观察组40例,在对照组基础上给予针刺治疗。比较两组患者的临床疗效和不良反应,以及干预前后的神经功能、肢体运动功能以及生活质量。结果对照组的总有效率为80.00%(32/40),观察组的总有效率95.00%(38/40),与对照组比较,观察组的总有效率明显升高(P<0.05)。两组患者干预完成后,观察组患者的国立卫生研究院卒中量表(National Institute of Healthstroke scale,NIHSS)和中国卒中神经功能评分量表(Chinese Stroke Neurological Function Scale,CSS)水平相较于对照组均明显下降(P<0.01)。与对照组比较,观察组病人的上肢运动功能评测(Fugl-Meyer,FMA评测法)水平和10 m最大步行速度均明显升高(P<0.01)。治疗前两组的脑卒中专用生活质量量表(Stroke Specific Quality Of Life scale,SS-QOL)、日常生活活动能力(Activities of Daily Living,ADL)评分无明显差异(P>0.05)。干预完成后,观察组病人的SS-QOL评分、ADL水平相较于对照组明显升高(P<0.01)。观察组血清血清环磷酸腺苷(cyclic adenosine monophosphate,cAMP)和环磷酸鸟苷(cyclic guanosine monophosphate,cGMP)水平明显升高(P<0.01)。结论针刺联合运动再学习康复疗法可改善脑卒中后偏瘫患者的肢体运动功能和神经功能,提高其日常生活能力和生活质量,适宜临床推广。Objective To observe the effect of acupuncture combined with motor relearning rehabilitation therapy on the recovery of neurological function in patients after stroke.Methods According to the inclusion and exclusion criteria,80 stroke patients admitted to the Rehabilitation Department and the Acupuncture and Moxibustion Department of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine from February 2019 to October 2020 were selected,and the above patients were divided into two groups on a voluntary basis.Forty patients in the control group were given exercise relearning rehabilitation therapy,and the other forty patients in the observation group were given the acupuncture treatment on the basis of the control group.The clinical efficacy and adverse reactions of the two groups as well as the neurological function,limb motor function and the quality of life before and after intervention were compared.Results The total effective rate of the control group was 80.00%(32/40),and that of the observation group was 95.00%(38/40).Compared with that of the control group,the total effective rate of the observation group was significantly increased(P<0.05).After the completion of the intervention,the National Institute of Health Stroke Scale(NIHSS)score and Chinese Stroke Neurological Function Rating Scale(CSS)score of the observation group were significantly lower than those of the control group(P<0.01).Compared with those of the control group,the level of Fugl-Meyer Motor Function Assessment Scale(FMA)score and the maximal walking speed of 10 m in the observation group were significantly increased(P<0.01).Before treatment,there was no significant difference in stroke specific quality of life scale(SS-QOL)score or daily living ability assessment scale(ADL)score between the two groups(P>0.05).After the completion of intervention,the SS-QOL score and ADL score of the observation group were significantly higher than those of the control group(P<0.01).The serum levels of cyclic adenosine monophosp

关 键 词：针刺 运动再学习康复 脑卒中 神经功能 临床疗效 

分 类 号：R245.31[医药卫生—针灸推拿学] R277.743.3[医药卫生—中医临床基础]