热敏灸治疗脑卒中后痉挛性偏瘫患者的热敏化穴位分布情况及疗效观察  

Distribution of Heat-sensitive Acupoints in Patients with Post-stroke Spastic Hemiplegia and Clinical Efficacy of Heat-sensitive Moxibustion

作　　者：刘奕蕾[1] 王颖[1] 谢宗亮[1] 曹奕[1] LIU Yilei;WANG Ying;XIE Zongliang;CAO Yi(The Second Affiliated Hospital of Anhui University of Chinese Medicine,Anhui Hefei 230061,China)

机构地区：[1]安徽中医药大学第二附属医院,安徽合肥230061

出　　处：《安徽中医药大学学报》2024年第5期34-39,共6页Journal of Anhui University of Chinese Medicine

基　　金：安徽省第十三批“115”产业创新团队项目(皖人才办〔2020〕4号);安徽中医药大学科研基金项目(2021zjzx02);安徽省王颖名中医工作室(中发展〔2022〕5号)。

摘　　要：目的探查热敏灸治疗脑卒中后痉挛性偏瘫患者热敏化穴位的分布情况,观察热敏灸治疗痉挛性偏瘫患者的临床疗效。方法将70例脑卒中后痉挛性偏瘫患者随机分为对照组和热敏灸组,每组35例;对照组采用常规康复治疗和针刺治疗,热敏灸组在对照组治疗基础上采用热敏灸治疗;观察热敏灸组患者热敏化穴位分布情况,比较两组患者治疗前后美国国立卫生研究院卒中量表(National Institute of Health stroke scale,NIHSS)评分和改良Rankin量表(modified Rankin scale,MRS)评分、徒手肌力检查(manual muscle testing,MMT)评分、Fugl-Meyer评估(Fugl-Meyer assessment,FMA)量表评分、Wolf运动功能测试(Wolf motor function test,WMFT)量表评分、日常生活活动能力(activity of daily living,ADL)量表评分、世界卫生组织生活质量简表(World Health Organization quality of life brief,WHOQOL-BREF)评分以及临床疗效。结果共有35例患者出现热敏化穴位现象,共出现119个热敏化穴位;热敏化穴位中出现频率最高的5个穴位依次为足三里、曲池、悬钟、外关和阳陵泉。热敏灸组NIHSS评分、MRS评分均显著低于对照组(P<0.05),MMT评分、FMA量表评分、WMFT量表评分、ADL量表评分、WHOQOL-BREF各维度评分均显著高于对照组(P<0.05)。热敏灸组临床疗效显著优于对照组(P<0.05)。结论热敏灸联合常规针刺和康复治疗脑卒中后痉挛性偏瘫,能够显著改善患者肢体功能障碍,提高生活质量,疗效确切;应用热敏灸治疗该病时可优先选择足三里、曲池、悬钟、外关、阳陵泉穴进行治疗。Objective To investigate the distribution of heat-sensitive acupoints in patients with post-stroke spastic hemiplegia undergoing heat-sensitive moxibustion,as well as the clinical efficacy of heat-sensitive moxibustion in the treatment of spastic hemiplegia.Methods A total of 70 patients with post-stroke spastic hemiplegia were randomly divided into control group and heat-sensitive moxibustion group,with 35 patients in each group.The patients in the control group received conventional rehabilitation treatment and acupuncture,and those in the heat-sensitive moxibustion group received heat-sensitive moxibustion in addition to the treatment in the control group.The distribution of heat-sensitive acupoints was observed,and the two groups were compared in terms of National Institute of Health Stroke Scale(NIHSS)score,modified Rankin Scale(MRS)score,manual muscle testing(MMT)score,Fugl-Meyer Assessment(FMA)score,Wolf Motor Function Test(WMFT)score,Activity of Daily Living(ADL)score,WHO Quality of Life-BREF(WHOQOL-BREF)score,and clinical outcome.Results Heat-sensitive acupoints were observed in 35 patients,with 119 heat-sensitive acupoints in total,among which the top five acupoints in terms of frequency were Zusanli,Quchi,Xuanzhong,Waiguan,and Yanglingquan.Compared with the control group,the heat-sensitive moxibustion group had significantly lower scores of NIHSS and MRS(P<0.05)and significantly higher scores of each dimension of MMT,FMA,WMFT,ALD,and WHOQOL-BREF scales(P<0.05).The heat-sensitive moxibustion group had a significantly better clinical outcome than the control group(P<0.05).Conclusion In the treatment of post-stroke spastic hemiplegia,heat-sensitive moxibustion combined with conventional acupuncture and rehabilitation treatment can significantly improve limb dysfunction and quality of life,with a marked clinical effect,and the acupoints of Zusanli,Quchi,Xuanzhong,Waiguan,and Yanglingquan can be selected for heat-sensitive moxibustion.

关 键 词：脑卒中 中风 痉挛性偏瘫 热敏灸 热敏化穴位 

分 类 号：R255.2[医药卫生—中医内科学] R743.3[医药卫生—中医学]