正中神经理论下不同电针参数刺激极泉穴对脑卒中软瘫期的疗效  

Effect of Different Electro-acupuncture Parameters Stimulating Jiquan Point under Median Nerve Theory on Flaccid Paralysis of Stroke

作　　者：马丽娜 夏晓曼 章子骏 胡燕 余浩 郑俊俊 MA Lina;XIA Xiaoman;ZHANG Zijun;HU Yan;YU Hao;ZHENG Junjun(Department of Neurology,Shangrao People's Hospital,Shangrao 334000,China;不详)

机构地区：[1]上饶市人民医院神经内科,江西上饶334000 [2]上饶市人民医院中医科,江西上饶334000

出　　处：《中国医学创新》2024年第25期1-5,共5页Medical Innovation of China

基　　金：江西省中医药管理局科技计划项目(2022B550)。

摘　　要：目的:观察基于正中神经理论不同电针参数刺激极泉穴对脑卒中软瘫期患者上肢功能的影响。方法:本研究选取病例来源于2022年7月—2023年10月就诊于上饶市人民医院神经内科的脑卒中软瘫期上肢运动功能障碍患者,共计120例。按照随机数字表法将患者分为基础治疗组(给予基础内科治疗+基础康复治疗+常规针刺治疗)、电针组1(给予基础治疗+2 Hz连续波电针)、电针组2(给予基础治疗+2 Hz断续波电针)、电针组3(给予基础治疗+2 Hz/10 Hz疏密波电针),每组30例。观察记录两组治疗前后Fugl-Meyer评估表(FMA)中上肢运动功能评分、肌力(英国医师学会肌力评估标准)、改良Barthel指数(MBI)及肌电图指标[复合肌肉动作电位(CMAP)波幅、远端运动潜伏期(DML)及运动神经传导速度(MCV)],并比较各组疗效。结果:治疗前各组FMA评分、肌力分级、MBI分级及肌电图指标比较,差异均无统计学意义(P>0.05);治疗后,电针组3的FMA评分、CMAP波幅、MCV均明显优于基础治疗组、电针组1、电针组2(P<0.05);治疗后电针组3的MBI较治疗前有改善,电针组3的MBI优于基础治疗组、电针组1(P<0.05);各组总有效率比较,差异有统计学意义(P<0.05);电针组3的总有效率明显高于基础治疗组、电针组2(P<0.05)。结论:不同电针参数刺激极泉穴对脑卒中软瘫期上肢运动功能障碍患者均有效果,但基础治疗+2 Hz/10 Hz疏密波电针方案在改善上肢运动功能、日常生活活动能力上优势更明显,效果更佳。Objective:To observe the effect of different electro-acupuncture parameters based on median nerve theory on upper limb function of stroke patients with flaccid paralysis.Method:A total of 120 patients with upper limb motor dysfunction in flaccid paralysis of stroke were selected from Department of Neurology,Shangrao People's Hospital from July 2022 to October 2023 in this study.The patients were divided into basic treatment group(basic medical treatment+basic rehabilitation treatment+conventional acupuncture treatment),electroacupuncture group 1(basic treatment+2 Hz continuous wave electro-acupuncture),electro-acupuncture group 2(basic treatment+2 Hz discontinuous wave electro-acupuncture),and electro-acupuncture group 3(basic treatment+2 Hz/10 Hz degree of closing electro-acupuncture)according to the random number table method,with 30 cases in each group.The upper limb motor function score in the Fugl-Meyer assessment(FMA),muscle strength(British medical research council muscle strength assessment standard),modified Barthel index(MBI)and electromyographic indexes[compound muscle action potential(CMAP)amplitude,distal motor latency(DML)and motor nerve conduction velocity(MCV)]were observed and recorded before and after treatment,and the efficacy of each group was compared.Result:Before treatment,there were no significant differences in FMA scores,muscle strength grades,MBI grades and electromyographic indexes among all groups(P>0.05).After treatment,FMA score,CMAP amplitude and MCV in electro-acupuncture group 3 were significantly better than those in basic treatment group,electro-acupuncture group 1 and electro-acupuncture group 2(P<0.05).After treatment,MBI in electroacupuncture group 3 was better than that before treatment,and MBI in electro-acupuncture group 3 was better than that in basic treatment group and electro-acupuncture group 1(P<0.05).The total effective rate of all groups was compared,the difference was statistically significant(P<0.05).The total effective rate of electro-acupuncture group 3 was si

关 键 词：正中神经理论 电针 刺激参数 极泉穴 脑卒中 软瘫期 上肢功能 

分 类 号：R246.6[医药卫生—针灸推拿学]