镜像视觉反馈疗法联合针刺对卒中后上肢功能重建的康复作用  

Rehabilitation effect of mirror visual feedback therapy combined with acupuncture on upper limb function reconstruction after stroke

作　　者：石珏 舒锦 金立 顾怡雯 SHI Jue;SHU Jin;JIN Li;GU Yiwen(Department of Geriatric Rehabilitation,Shibei Hospital of Jing'an District,Shanghai 200443;Longhua Clinical Medical College,Shanghai University of Traditional Chinese Medicine,Shanghai 200032)

机构地区：[1]上海市静安区市北医院老年康复科,上海200443 [2]上海中医药大学龙华临床医学院,上海200032

出　　处：《河北中医》2024年第10期1704-1707,1711,共5页Hebei Journal of Traditional Chinese Medicine

基　　金：上海市卫生健康委员会科研项目(编号:202140225);上海市静安区医学重点学科建设项目(编号:2021ZD03)。

摘　　要：目的观察镜像视觉反馈疗法联合针刺对卒中后上肢功能重建的作用研究。方法选取2022年1月至2024年12月120例进行康复治疗的卒中后上肢功能障碍患者采用随机数字法分为镜像视觉反馈(MVF)组、联合组、针刺组,每组40例,3组均予常规上肢康复训练,MVF组加MVF训练,联合组加MVF联合针刺疗法,针刺治疗组加针刺疗法。比较3组治疗后第4、8、12周Fugl-Meyer评定量表上肢部分(FMA-UE)、改良Barthel指数(BI)及手臂动作调查测试表(ARAT)评分变化。结果治疗后第4、8、12周,3组患者FMA-UE评分、改良BI评分、ARAT评分均较本组治疗前显著改善(P<0.05);治疗后第4周,联合组患者FMA-UE评分及改良BI评分改善情况均优于MVF组及针刺组(P<0.05);治疗后第8周,联合组患者FMA-UE评分、改良BI评分、ARAT评分改善情况均优于MVF组(P<0.05),联合组患者改良BI评分及ARAT评分改善情况均优于单纯针刺组(P<0.05);治疗后第12周,联合组患者改良BI评分改善情况均显著优于MVF组及针刺组(P<0.05)。结论镜像视觉反馈疗法联合针刺能有效改善卒中后上肢功能重建,提高临床疗效,在提升患者日常功能、改善上肢功能重建方面效果明显。Objective To investigate the effect of mirror visual feedback(MVF)therapy combined with acupuncture on upper limb function reconstruction after stroke.Methods A total of 120 patients with upper limb dysfunction from 1 to 6 months after stroke who received rehabilitation treatment in our hospital from January 2022 to December 2024 were enrolled.Based on upper-limb rehabilitation training,they were additionally receive MVF therapy(MVF group,n=40),acupuncture therapy(acupuncture group,n=40)or MVF+acupuncture therapy(combined group,n=40).The aim was to compare Fugl-Meyer assessment-upper extremity(FMA-UE),modified Barthel Index(MBI),Action Research Arm Test(ARAT)at weeks 4,8,12 of treatment among the three groups.Results The 4-week,8-week and 12-week improvements of FMA-UE,MBI and ARAT scores were significantly improved in the three groups compared with before treatment(P<0.05).The 4-week improvements of FMA-UE and MBI scores in combined group were significantly better than those of MVF group and acupuncture group(P<0.05).The 8-week improvements of FMA-UE,MBI and ARAT scores in combined group were more pronounced than those of MVF group(P<0.05).The improvements of MBI and ARAT scores in combined group were significantly better than those of acupuncture group(P<0.05).The 12-week improvements of MBI score in combined group were significantly better than those of MVF group and acupuncture group(P<0.001),which were significantly better in MVF group than in acupuncture group(P<0.001).Conclusion The combination of MVR therapy,acupuncture and upper-limb rehabilitation training can effectively improve daily function and upper limb motor functional reconstruction after stroke.It has obvious therapeutic effect and is worth popularizing.

关 键 词：卒中后并发症 康复治疗 针刺疗法 

分 类 号：R255.2[医药卫生—中医内科学]