针刺灵骨、大白穴治疗中风后下肢痉挛性偏瘫疗效观察  

Efficacy of acupuncture at acupoints Linggu and Dabai on spastic hemiplegia of lower limbs after stroke

作　　者：肖观伟 曾科学[3] XIAO Guanwei;ZENG Kexue(Guangzhou University of Chinese Medicine,Guangzhou 510006,Guangdong,China;Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine,Guangzhou 510800,Guangdong,China;Guangdong Second Traditional Chinese Medicine Hospital,Guangzhou 510095,Guangdong,China)

机构地区：[1]广州中医药大学,广东广州510006 [2]广州市中西医结合医院,广东广州510800 [3]广东省第二中医院,广东广州510095

出　　处：《现代中西医结合杂志》2024年第9期1219-1224,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：2022年度广东省针灸学会科研课题项目(GDZJ2022006)。

摘　　要：目的观察常规针刺基础上加刺灵骨、大白穴治疗中风后下肢痉挛性偏瘫的临床疗效。方法选择2023年1—8月广州市中西医结合医院收治的84例中风后下肢痉挛性偏瘫患者,按照随机数字表法将患者分为对照组和观察组,每组42例。对照组采用“中风病康复分期针刺疗法”痉挛期的针刺选穴治疗,观察组在对照组治疗基础上增加针刺灵骨穴、大白穴治疗,1次/d,30 min/次,6次/周,12次为1个疗程,连续治疗2个疗程。观察比较2组患者治疗前后下肢痉挛程度[改良Ashworth痉挛评定量表(MAS)评分]、步行能力(10 m步行测试速度)、平衡能力[Berg平衡量表(BBS)评分]、下肢运动功能[Fugl-Meyer运动功能评估量表(FMA)评分]、日常生活能力[改良Barthel指数量表(BI)评分]、生活质量[健康状况调查简表(SF-36)评分]及血清神经功能相关指标[神经元特异性烯醇化酶(NSE)、甘氨酸(Gly)]水平,评价2组康复治疗效果。结果治疗1个疗程和治疗2个疗程后2组MAS评分均明显低于治疗前(P均<0.05),且观察组MAS评分均明显低于同期对照组(P均<0.05);治疗2个疗程后2组患者的10 m步行测试速度均明显快于治疗前(P均<0.05),BBS评分、FMA评分、BI评分均明显高于治疗前(P均<0.05),且观察组10 m步行测试速度明显快于对照组(P<0.05),BBS评分、FMA评分、BI评分均明显高于对照组(P均<0.05)。治疗1个疗程后2组SF-36评分与治疗前比较及组间比较差异均无统计学意义(P均>0.05);治疗2个疗程后2组SF-36评分均明显高于治疗前(P均<0.05),且观察组明显高于对照组(P<0.05)。治疗2个疗程后,2组患者血清NSE水平均明显低于治疗前(P均<0.05),血清Gly水平均明显高于治疗前(P均<0.05);治疗后观察组血清NSE水平明显低于对照组(P<0.05),血清Gly水平明显高于对照组(P<0.05)。治疗2个疗程后,观察组的总有效率为90.48%(38/42),对照组为73.81%(31/42),观察组明显高于对照组(P<0.05)�Objective It is to observe the clinical efficacy of acupuncture at acupoints Linggu and Dabai based on conventional acupuncture in the treatment of spastic hemiplegia of lower limbs after stroke.Methods Eighty-four patients with spastic hemiplegia of lower limbs after stroke treated in Guangzhou Hospital of Integrated Traditional Chinese and Western Medicine from January to August in 2023 were selected,and were divided into a control group and an observation group according to random number table method,with 42 cases in each group.The control group was treated with acupuncture at acupoints for the spasm stage of“staged acupuncture therapy of stroke rehabilitation”,while the observation group was additionally treated with acupuncture at acupoints Linggu and Dabai on the basis of the control group,once daily,30 min per time,6 times per week,12 times as 1 course of treatment,both were continuously treated for 2 courses of treatment.The degree of lower limb spasticity[Modified Ashworth Scale(MAS)score],walking ability(10 m walking test speed),balance ability[Berg Balance Scale(BBS)score],and lower limb motor function[Fugl-Meyer Assessment Scale(FMA)score],ability of daily living[Modified Barthel Index(BI)score],quality of life[Short Form-36(SF-36)score],and serum indexes of neurological function[neuron-specific enolase(NSE),glycine(Gly)]before and after treatment were observed and compared between the two groups,and the effects of rehabilitation treatment in the two groups were evaluated.Results After 1 course and 2 courses of treatment,the MAS scores of the two groups were significantly lower than those before treatment(all P<0.05),and the MAS scores of the observation group were significantly lower than those of the control group at the same period(all P<0.05);after 2 courses of treatment,the 10 m walking test speeds of the two groups were significantly faster than those before treatment(all P<0.05),the BBS score,FMA score and BI score were all significantly higher than those before treatment(all P<0.05),the 10

关 键 词：下肢痉挛性偏瘫 中风 灵骨穴 大白穴 

分 类 号：R743.3[医药卫生—神经病学与精神病学]