不同电针参数对脑卒中后足内翻影响临床观察  

Clinical Observation of the Effect of Different Electroacupuncture Parameters on Post-Stroke Strephenopodia

作　　者：黄雯芳 郭伟 阙秀琴 沈东炜[2] 魏健良 张鹏 赖建恭 吴小平 Huang Wenfang;Guo Wei;Que Xiuqin;Sheng Dongwei;Wei Jianliang;Zhang Peng;Lai Jiangong;Wu Xiaoping(Department of Rehabilitation,Longyan Hospital of TCM,Longyan 364000,China;Longyan First Hospital Affiliated to Fujian Medical University,Longyan 364000,China)

机构地区：[1]龙岩市中医院康复科,福建龙岩364000 [2]福建医科大学附属龙岩市第一医院,福建龙岩364000

出　　处：《亚太传统医药》2024年第10期59-64,共6页Asia-Pacific Traditional Medicine

基　　金：龙岩市科技创新联合资金卫生项目面上项目(2021LYF17064)。

摘　　要：目的:比较针刺足少阳经不同电针参数对脑卒中后足内翻(PSS)的影响。方法:将120例PSS患者随机分为对照组、连续波治疗组和疏密波治疗组,每组40例,其中,对照组脱落1例,疏密波治疗组脱落2例。对照组采用常规针刺配合康复训练治疗;连续波治疗组在对照组基础上予电针阳陵泉、悬钟(连续波,频率2 Hz)治疗;疏密波治疗组在对照组基础上予电针阳陵泉、悬钟(疏密波,频率2/50 Hz)治疗,30 min/d, 1次/d,连续治疗6 d,休息1 d,治疗4周。比较治疗前后足内翻角度、改良Ashworth痉挛量表(MAS)、Fugl-Meyer下肢运动功能评分(FMA-LE)、静息状态下腓骨长、短肌厚度。结果:治疗后,3组患者足内翻角度、MAS分级、FMA-LE评分均较治疗前改善(P<0.05),进一步两两比较,连续波治疗组与疏密波治疗组均优于对照组,疏密波治疗组优于连续波治疗组,差异有统计学意义(P<0.05);治疗后,3组患者静息状态下腓骨长、短肌厚度差异无统计学意义(P>0.05)。结论:电针阳陵泉、悬钟联合常规康复训练可改善PSS患者足内翻程度、提高患者下肢运动功能,临床疗效优于单纯针刺联合康复训练,2/50 Hz疏密波是治疗该病较优的方案。Objective:To compare the clinical efficacy of post-stroke strephenopodia(PSS)treated with electroacupuncture under different parameters.Methods:A total of 120 patients with PSS were randomly divided into three groups,40 cases in each group,among them,1 case dropped off in the control group and 2 cases dropped off in the disperse-dense wave treatment group.The control group was treated with conventional acupuncture combined with rehabilitation therapy;In the continuous wave treatment group and the disperse-dense wave treatment group,besides the treatment as the control group,the electric stimulation was attached to the points of Yanglingquan(GB 34)and Xuanzhong(GB 39),with 2 Hz continuous wave,and 2 Hz/50 Hz disperse-dense wave,respectively.The treatment was given once daily,30 min/day,continuous treatment for 6 days,rest for 1 day,for 4 weeks consecutively.The analysis of foot varus angle,FMA and MAS,and the thickness of long and short muscles of the fibula in resting state were evaluated before and after the treatment.Results:Compared with before treatment,the scores of MAS and FMA,the varus angle were increased(P<0.05)in each group,and those in the continuous wave treatment group and the disperse-dense wave treatment group were better than the control group(P<0.05);when compared with continuous wave treatment group,those scores of disperse-dense wave treatment group were improved(P<0.05);After treatment,there was no significant difference in the thickness of the long and short muscles of the fibula in the three groups(P>0.05).Conclusion:Electroacupuncture at Yanglingquan(GB 34)and Xuanzhong(GB 39)combined with routine rehabilitation training can improve the degree of strephenopodia and improve the motor function of lower limbs in patients with PSS.The clinical effect is better than that of conventional acupuncture alone.A 2/50 Hz density wave is a better scheme for the treatment of this disease.

关 键 词：脑卒中后足内翻 阳陵泉 悬钟 电针参数 肌骨超声 肌肉厚度 

分 类 号：R255.2[医药卫生—中医内科学]