MEP定位下头针联合经颅磁刺激对缺血性脑卒中偏瘫患者肢体运动能力的影响  

Effect of MEP-oriented scalp acupuncture combined with transcranial magnetic stimulation on limb motor ability in patients with ischemic stroke hemiplegia

作　　者：武士勇 张建斌 张费 朱子龙 傅博勋 WU Shiyong;ZHANG Jianbin;ZHANG Fei;ZHU Zilong;FU Boxun(Department of Rehabilitation,Suqian Hospital of Integrated Traditional Chinese and Western Medicine,Suqian 223800,Jiangsu Province,China;Department of Acupuncture and Moxibustion,Second Affiliated Hospital of Nanjing University of Chinese Medicine,Second TCM Hospital of Jiangsu Province)

机构地区：[1]宿迁市中西医结合医院康复科,江苏宿迁223800 [2]南京中医药大学第二附属医院/江苏省第二中医院针灸科

出　　处：《中国针灸》2024年第3期251-254,共4页Chinese Acupuncture & Moxibustion

基　　金：宿迁市科技计划资助项目:S202104。

摘　　要：目的:观察运动诱发电位(MEP)定位下头针联合经颅磁刺激对缺血性脑卒中偏瘫患者肢体运动能力的影响。方法:将60例缺血性脑卒中偏瘫患者随机分为观察组和对照组,各30例。两组均予内科药物治疗及偏瘫肢体综合训练。在此基础上,观察组患者接受MEP定位下取穴的头针联合经颅磁刺激治疗;对照组患者接受常规头针(双侧顶颞前斜线)联合经颅磁刺激治疗。两组治疗均每天1次,每周5 d,共4周。分别于治疗前后观察两组患者Fugl-Meyer运动功能评定量表(FMA)、改良Ashworth量表(MAS)及改良Barthel指数(MBI)评分。结果:治疗后,两组患者FMA、MBI评分均较治疗前升高(P<0.001),且观察组高于对照组(P<0.05);观察组患者上肢及下肢MAS评分较治疗前降低(P<0.01,P<0.001),对照组患者下肢MAS评分较治疗前降低(P<0.05)。结论:MEP定位下头针联合经颅磁刺激可有效改善缺血性脑卒中偏瘫患者肢体运动能力,提高其日常生活能力,减轻肢体痉挛。Objective To observe the effect of motor evoked potential(MEP)-oriented scalp acupuncture combined with transcranial magnetic stimulation(TMS)on limb motor ability in patients with ischemic stroke hemiplegia.Methods A total of 60 patients with ischemic stroke hemiplegia were randomized into an observation group and a control group,30 cases in each one.In addition to the medication treatment of internal medicine and comprehensive training of hemiplegic limbs,MEPoriented scalp acupuncture combined with TMS was applied in the observation group,conventional scalp acupuncture at bilateral anterior oblique line of parietal and temporal regions combined with TMS was applied in the control group.The treatment was given once a day,5 days a week for 4 weeks totally in the two groups.Before and after treatment,the scores of Fugl-Meyer assessment(FMA),modified Ashworth scale(MAS)and modified Barthel index(MBI)were observed in the two groups.Results After treatment,the FMA and MBI scores were increased compared with those before treatment in the two groups(P<0.001),and the FMA and MBI scores in the observation group were higher than those in the control group(P<0.05).After treatment,the MAS scores of upper and lower limbs in the observation group were decreased compared with those before treatment(P<0.01,P<0.001),the MAS score of lower limb in the control group was decreased compared with that before treatment(P<0.05).Conclusion MEP-oriented scalp acupuncture combined with TMS can effectively improve the limb motor ability,daily living ability and limb spasticity in patients with ischemic stroke hemiplegia.

关 键 词：缺血性脑卒中 偏瘫 头针 经颅磁刺激 运动诱发电位 运动功能障碍 随机对照试验 

分 类 号：R246.6[医药卫生—针灸推拿学]