调神火针治疗脑卒中后痉挛性肌张力障碍  

Treating Spasmodic Dystonias After Stroke with Tiaoshen Fire Needling

作　　者：李赛赛[1] 杨云涛[1] 岳岩岩 潘冉[1] 高杨[2] LI Saisai;YANG Yuntao;YUE Yanyan;PAN Ran;GAO Yang(The Third Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450008;The First Affiliated Hospital to Henan University of Chinese Medicine,Zhengzhou Henan China 450000)

机构地区：[1]河南中医药大学第三附属医院,河南郑州450008 [2]河南中医药大学第一附属医院,河南郑州450000

出　　处：《中医学报》2024年第5期1104-1108,共5页Acta Chinese Medicine

基　　金：国家中医药管理局资助项目{国中医药人教函〔2019〕62号};河南省中医药专项课题项目(20-21ZY2127);河南省中医药传承与创新人才工程中医药青苗人才第二批培养项目{豫卫中医函〔2021〕16号}。

摘　　要：目的:观察调神火针治疗脑卒中后痉挛性肌张力障碍的临床疗效。方法:90例脑卒中后痉挛性肌张力障碍患者按照随机数字表法分为观察组(调神火针治疗,45例)与对照组(普通针刺治疗,45例),两组均治疗4周。比较两组患者治疗前后肌张力[改良Ashworth痉挛量表(modified Ashworth scale,MAS)评分]、运动功能[Fugl-Meyer运动功能评定表(Fugl-Meyer assessment scale,FMA)评分]、痉挛情况[临床痉挛指数(clinic spasticity index,CSI)评分]及生活质量[日常生活活动功能量表(activity of daily living scale,ADL)评分]。结果:治疗后,两组MAS评分均降低,观察组MAS评分为(1.79±0.55)分,对照组MAS评分为(2.07±0.58)分,观察组MAS评分低于对照组,差异有统计学意义(P<0.05)。治疗后,两组上肢、下肢FMA评分均升高,观察组上肢FMA评分为(41.28±4.09)分,对照组上肢FMA评分为(36.22±3.81)分,观察组FMA评分高于对照组,差异有统计学意义(P<0.05);观察组下肢FMA评分为(22.07±2.31)分,对照组下肢FMA评分为(20.82±1.98)分,且两组下肢FMA评分比较,观察组FMA评分高于对照组,差异有统计学意义(P<0.05)。治疗后,两组CSI评分均降低,观察组CSI评分为(6.02±2.58)分,对照组CSI评分为(7.31±2.93)分,观察组CSI评分低于对照组,差异有统计学意义(P<0.05)。治疗后,两组ADL评分均增高,观察组ADL评分为(61.06±4.49)分,对照组ADL评分为(58.65±3.95)分,观察组ADL评分显著高于对照组,差异有统计学意义(P<0.05)。结论:调神火针可有效干预脑卒中患者痉挛性肌张力障碍,改善患者肌张力,缓解肌肉痉挛,提高运动功能及生活质量。Objective:To observe the clinical efficacy of Tiaoshen Fire needling in treatment of spastic dystonia after stroke.Methods:A total of 90 patients with post-stroke spastic dystonia were divided into observation group(45 cases of Tiaoshen Fire needling)and control group(45 cases of general needling treatment)according to the random number table method,and both groups were treated for 4 weeks.Muscle tone[modified Ashworth scale(MAS)score],motor function[Fugl-Meyer assessment scale(FMA)score],spasticity[clinical spasticity index(CSI)score],and quality of life[Activity of daily living scale(ADL)score].Results:After treatment,the MAS score of both groups decreased,the MAS score of the observation group was(1.79±0.55)points,and the MAS score of the control group was(2.07±0.58),and the MAS score of the observation group was lower than that of the control group,and the difference was statistically significant(P<0.05).After treatment,the FMA scores of upper limbs and lower limbs were increased in both groups,the FMA scores of upper limbs in the observation group were(41.28±4.09)points,and the FMA scores of upper limbs in the control group were(36.22±3.81),and the FMA scores of the observation group were higher than those of the control group,and the difference was statistically significant(P<0.05),and the FMA scores of the lower limbs in the observation group were(22.07±2.31)points,and the FMA scores of the control group were(20.82±1.98)points,and the FMA score of lower limb between the two groups was significantly higher in the observation group than in the control group(P<0.05).After treatment,the CSI scores of the two groups were reduced,and the CSI scores of the observation group were(6.02±2.58)points,and the CSI scores of the control group were(7.31±2.93),and the CSI scores of the observation group were lower than those of the control group,and the difference was statistically significant(P<0.05).After treatment,the ADL scores of the two groups were increased,and the ADL scores of the observation group were(61

关 键 词：痉挛性肌张力障碍 调神火针 脑卒中 肌张力 运动功能 生活质量 

分 类 号：R245.316[医药卫生—针灸推拿学]