头部电针结合屈伸肌交替经皮穴位电刺激治疗脑卒中偏瘫患者平衡及步行能力的临床研究  

Clinical Study of Scalp Electro-Acupuncture Combined with Alternating Flexor-Extensor Transcutaneous Electrical Stimulation of Acupoints for Improving Balance and Walking Ability in Patients with Post-Stroke Hemiplegia

作　　者：张译尹 张健[2] 王东岩[3] 董旭[3] 冯丽媛[3] 霍宏[3] 张虹岩 ZHANG Yiyin;ZHANG Jian;WANG Dongyan;DONG Xu;FENG Liyuan;HUO Hong;ZHANG Hongyan(Heilongjiang University of Chinese Medicine,Harbin 150040,China;The Third Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin 150060,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三医院,黑龙江哈尔滨150060 [3]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3期7-12,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:82374601;哈尔滨市科技计划自筹经费项目,编号:2022ZCZJNS062;黑龙江中医药大学科研基金,编号:201203。

摘　　要：目的:观察头部电针结合屈伸肌交替经皮穴位电刺激治疗脑卒中(CVA)偏瘫患者平衡及步行能力的临床疗效。方法:将60例符合纳入标准的CVA偏瘫患者作为本试验研究对象,运用随机数字表法将患者分为常规组与联合组。两组患者均给予CVA基础治疗;常规组额外给予患肢足三里、阳陵泉、阴陵泉、三阴交、丘墟及太冲进行电针治疗;联合组额外给予百会、病灶侧运动区和双侧平衡区进行电针治疗,同时给予患肢浮郄、殷门、血海及箕门进行屈伸肌交替经皮穴位电刺激治疗。治疗前后采用5次椅子坐立测试(5-TSST)、四阶段平衡测试(4-STB)、简明平衡评价系统测试(Brief-BESTest)、功能性步态评估(FGA)、脑卒中专用生存质量量表(SS-QOL)及表面肌电信号最大肌电幅值(MAX)对患者进行疗效评估。结果:两组患者5-TSST评分治疗后降低,4-STB评分、Brief-BESTest评分、FGA评分、SS-QOL评分及表面肌电信号MAX值治疗后均升高,治疗后两组患者各项评分组间比较差异有统计学意义(P<0.01)。结论:头部电针联合屈伸肌交替经皮穴位电刺激治疗能有效改善CVA偏瘫患者的平衡及步行能力,上下协同同步刺激疗效显著,值得临床推广。Objective:To observe the clinical efficacy of scalp electro-acupuncture combined with alternating flexor-extensor transcutaneous electrical stimulation of acupoints for improving balance and walking ability in hemiplegic patients with cerebrovascular accident(CVA).Methods:60 cases of hemiplegic CVA patients,who met the inclusion criteria,were randomly divided into the conventional group and the combined group.Both groups were given basic treatment for stroke;the conventional group was additionally treated with electro-needling Zusanli(ST36),Yanglingquan(GB34),Yinlingquan(SP9),Sanyinjiao(SP6),Qiuxu(GB40) and Taichong(LR3) on affected limb;the combined group was additionally treated with scalp electro-needling Baihui(DU20),the affected motor area and bilateral balance area;meanwhile alternating flexor-extensor transcutaneous electrical stimulation of acupoints was applied to Fuxi(BL38),Yinmen(BL37),Xuehai(SP10),and Jimen(SP11) on the affected limb.5-Times Sit to Stand Test(5-TSST),4-Stage Balance Test(4-STB),Brief-Balance Evaluation Systems Test(Brief-BESTest),Functional Gait Assessment(FGA),Stroke-Specific Quality of Life(SS-QOL),and Surface Electromyography MAX Amplitude(MAX) were used to evaluate treatment efficacy in the two groups.Results:The score of 5-TSST was decreased(P<0.01),the scores of 4-STB,Brief-BESTest,FGA and SS-QOL,as well as the value of MAX of surface electromyographic signals were increased after the treatment compared to those before the treatment in the two groups(P<0.01);of which the improvements were more significant in the combined group than those in the conventional group(P<0.01).Conclusion:Scalp electro-acupuncture combined with alternating flexor-extensor transcutaneous electrical stimulation of acupoints can effectively improve the balance and walking ability in hemiplegic patients with CVA,and the efficacy is remarkable by upper and lower synergistic and synchronized stimulation.The therapy is worthy to be promoted in clinical practice.

关 键 词：脑卒中 偏瘫 电针 屈伸肌交替经皮穴位电刺激 平衡及步行能力 

分 类 号：R246.6[医药卫生—针灸推拿学]