六字诀与抗痉挛手法对比作用于脑卒中偏瘫患者上肢屈肌痉挛的临床疗效研究  

Clinical effect research of Liuzijue and antispasmodic techniques on upper limb flexor spasm in stroke patients with hemiplegia

作　　者：单园菲 陈碧华 周鹏 唐征泳 卫静怡 崔蓉 张颖[2] SHAN Yuanfei;CHEN Bihua;ZHOU Peng;TANG Zhengyong;WEI Jingyi;CUI Rong;ZHANG Ying(Rehabilitation Department of Fenglin Community Health Service Center,Shanghai 200305,China;Rehabilitation Department of Xuhui Central Hospital,Shanghai 200030,China)

机构地区：[1]上海市枫林街道社区卫生服务中心康复科,上海200305 [2]上海市徐汇区中心医院康复科,上海200030

出　　处：《上海医药》2024年第12期33-36,42,共5页Shanghai Medical & Pharmaceutical Journal

基　　金：2020年度上海市徐汇区卫健委医学科研项目(SHXH202027)。

摘　　要：目的:评价健身功法“六字诀”应用于中风偏瘫患者上肢屈肌痉挛的临床有效性,综合评价对患者整体功能的受益程度。方法:选取2020年1月至2021年1月收治的脑卒中偏瘫患者40例,采用随机数字表法分为对照组和治疗组各20例。两组都进行常规康复训练,治疗组同时采用六字诀,对照组用常规抗痉挛技术。两组疗程均为4周,5次/周,1次/d,40 min/次。研究以反应痉挛的改良Tardieu量表(modifiled Tardieu scale,MTS)作为主要观察指标;以改良Ashworth评价法(modified Ashworth scale,MAS)、上肢运动功能Fugl-Meyer评分(Fugl-Meyer assessment,FMA)、Berg平衡量表(Berg balance scale,BBS)、躯干损伤量表(Trunk impairment scale,TIS)、日常生活活动能力Barthel指数量表(The barthel index,BI)作为次要指标。入组0 d、4周进行主要和次要指标评估。结果:两组患者MTS的R1角度值(快速)和R2角度值(慢速)及BBS评分均较干预前明显改善(P<0.05),且治疗后治疗组的MTS的R1角度值(快速)及BBS评分改善情况亦显著优于对照组水平(P<0.05)。结论:六字诀可以更好地改善偏瘫患者上肢屈肌痉挛,并改善平衡能力,值得临床推广应用。Objective:To evaluate the clinical effectiveness of fitness method Liuzijue applied to upper limb flexor spasm in stroke patients with hemiplegia,and comprehensively evaluate the degree of benefit to the overall function of the patients.Methods:A total of 40 stroke patients with hemiplegia from January 2020 to January 2021 were selected and divided into a control group and a treatment group with 20 patients in each group by random number table method.Both groups were treated with the basic routine rehabilitation training,the treatment group used Liuzijue and the control group used conventional antispasmodic technique.The treatment course of two group was 4 weeks,5 times per week,1 time per day,40 minutes per session.The modified Tardieu scale(MTS)was used as the main observation index;modified Ashworth scale(MAS),upper limb motor function Fugue-Meyer score(FMA),Berg balance scale(BBS),trunk impairment scale(TIS),and the Barthel index(BI)of activities of daily living were the secondary indicators.The primary and secondary indexes were evaluated at 0 day and 4 weeks.Results:The R1 angle value(rapid),R2 angle value(slow)and BBS score of MTS in 2 groups were significantly improved compared with those before intervention(P<0.05),and the improvement of R1 angle value(rapid)and BBS score of MTS in the treatment group were also significantly better than those in the control group after treatment(P<0.05).Conclusion:Liuzijue can better improve upper limb flexor spasm of the patients with hemiplegia,and improve balance ability,which is worthy of clinical application.

关 键 词：六字诀 脑卒中 上肢屈肌痉挛 抗痉挛手法 常规康复训练 

分 类 号：R743.3[医药卫生—神经病学与精神病学]