头针联合三维步态分析训练系统治疗脑梗死患者下肢运动功能障碍疗效观察  

Therapeutic effect of scalp acupuncture combined with 3D gait analysis training system on lower limb motor dysfunction in patients with cerebral infarction

作　　者：杨影 汪富 贺飞[1,2] 丁彬 周伟[1,2] 孙珊 蒋志明 张辽[1,2] YANG Ying;WANG Fu;HE Fei;DING Bin;ZHOU Wei;SUN Shan;JIANG Zhiming;ZHANG Liao(Wanbei Coal-Electricity Group General Hospital,Shuzhou 234000,Anhui,China;Rehabilitation Branch of Wanbei Coal-Electricity Group General Hospital,Shuzhou 234000,Anhui,China)

机构地区：[1]皖北煤电集团总医院,安徽宿州234000 [2]皖北煤电集团总医院康复分院,安徽宿州234000

出　　处：《现代中西医结合杂志》2024年第12期1666-1670,1735,共6页Modern Journal of Integrated Traditional Chinese and Western Medicine

基　　金：安徽省宿州市科技计划项目(SZZCZJ202213)。

摘　　要：目的 探讨头针联合三维步态分析训练系统治疗脑梗死患者下肢运动功能障碍的临床疗效。方法 选择2022年6月—2023年6月皖北煤电集团总医院收治的脑梗死后下肢运动功能障碍患者60例,随机分成对照组和观察组各30例。对照组给予常规康复训练+三维步态训练治疗,观察组在对照组治疗基础上联合头针治疗,2组均治疗4周。观察比较2组患者治疗前后步态分析参数、改良Asworth肌张力量表评分、徒手肌力评定量表(MMT)评分、改良Barthel指数(MBI)评分、运动学参数、脑血流动力学参数,评估2组临床疗效。结果 2组患者治疗后步速、步频、跨步长、步长、步宽及MMT评分、MBI评分均明显增高,最大髋关节屈曲角度、最大膝关节屈曲角度、最大踝关节背屈和跖屈角度均明显增大,双侧大脑中动脉最大峰值流速(Vs)、平均流速(Vm)均明显加快,且观察组上述各指标较对照组改善更明显,差异均有统计学意义(P均<0.05);2组患者治疗后步态周期、双支撑时间、Asworth评分、血管阻力指数(RI)均明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05);观察组总有效率明显高于对照组[93.3%(28/30)比70.0%(21/30),P<0.05]。结论 头针联合三维步态分析训练系统能够明显提高脑梗死后下肢运动功能障碍患者下肢肌张力、肌力及生活能力,并能明显改善脑血流动力学,从而促进患者运动功能恢复。Objective It is to explore the therapeutic effect of scalp acupuncture combined with 3D gait analysis training system in the treatment of lower limb motor dysfunction in patients with cerebral infarction.Methods Sixty patients with lower limb motor dysfunction after cerebral infarction treated in Wanbei Coal-Electricity Group General Hospital from June 2022 to June 2023 were selected and randomly divided into control group and observation group,with 30 cases in each group.The control group was treated with conventional rehabilitation training+3D gait training,and the observation group was treated with scalp acupuncture on the basis of treatment of the control group.After 4 weeks of treatment,the parameters of gait analysis,scores of modified Asworth muscle tension scale,manual muscle test(MMT),modified Barthel index(MBI),kinematic parameters,cerebral hemodynamic parameters of the patients in the two groups before and after treatment were observed and compared,and the clinical efficacies of the two groups were assessed.Results The gait speed,giat frequency,stride length,step length,step width and MMT scores,MBI scores of the patients in the two groups were all significantly higher,while their maximum hip flexion angle,maximum knee flexion angle,maximum ankle dorsiflexion and plantarflexion angles were all significantly larger,and their maximum peak flow velocity(Vs)and the average flow velocity(Vm)of the bilateral middle cerebral arteries were all significantly faster than those before treatment,moreover,all of the above indexes were improved more significantly in the observation group than those in the control group,and the differences were all statistically significant(all P<0.05);the gait cycle,double support time,Asworth scores,and vascular resistance index(RI)of the patients in the two groups were all significantly lower after treatment than those before treatment(all P<0.05),and these indexes in the observation group were significantly lower than those in the control group(all P<0.05);the total effective rat

关 键 词：脑梗死 下肢运动功能障碍 头针 三维步态分析训练系统 下肢肌张力 脑血流动力学 

分 类 号：R743.33[医药卫生—神经病学与精神病学]