Observation of the effects of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism  

观察俞募配穴针刺对中风后患者平衡和步行功能的影响及其作用机制

作　　者：LIU Yajie LI Liping ZHONG Congcong LOU Yajie 刘亚杰;李丽萍;钟聪聪;楼雅洁(Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310002,China;Xiaoshan Hospital of Traditional Chinese Medicine,Zhejiang Province,Hangzhou 311201,China)

机构地区：[1]Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University,Hangzhou 310002,China [2]Xiaoshan Hospital of Traditional Chinese Medicine,Zhejiang Province,Hangzhou 311201,China

出　　处：《Journal of Acupuncture and Tuina Science》2024年第6期462-469,共8页针灸推拿医学（英文版）

基　　金：浙江省中医药科研基金计划,No.2021ZB197.

摘　　要：Objective:To observe the clinical efficacy of back-Shu and front-Mu points combination needling on balance and walking function in patients after stroke and its mechanism.Methods:A total of 79 patients with post-stroke balance and walking dysfunction were randomly divided into a control group and an observation group.Both groups received conventional treatments such as dietary guidance and oral medications as well as rehabilitation training.On this basis,the control group was treated with additional conventional acupuncture,and the observation group was treated with additional back-Shu and front-Mu points combination needling.Both groups were treated for 4 consecutive weeks.The thickness of abdominal muscle group(transverse abdominal muscle,rectus abdominis,obliquus internus abdominis,and obliquus externus abdominis),the scores of Berg balance scale(BBS),Fugl-Meyer assessment(FMA),and functional ambulation categories(FAC),and walking velocity and stride were compared between the two groups.Results:During the trial,there was 1 dropout case in the control group and 4 dropout cases in the observation group.Before treatment,there were no statistical differences in the abdominal muscle group thickness,scores of BBS,FMA,and FAC,and walking velocity and stride between the two groups(P>0.05).After 4 weeks of treatment,the thickness of abdominal muscle groups,scores of BBS,FMA,and FAC,and walking velocity and stride in both groups were improved(P<0.01),and the observation group was superior to the control group(P<0.05).Conclusion:Both conventional acupuncture and back-Shu and front-Mu points combination needling are conducive to the improvement of balance and walking function in patients after stroke.The back-Shu and front-Mu points combination needling method has better curative efficacy.Strengthening the core muscle group strength may be one of the mechanisms of back-Shu and front-Mu points combination needling treatment.目的:观察俞募配穴针刺治疗中风后平衡及步行功能障碍患者的临床疗效及作用机制。方法:将79例中风后平衡和步行功能障碍的患者随机分为对照组及观察组。两组均接受饮食指导、口服药物等常规治疗及康复训练。在此基础上,对照组加用常规针刺治疗,观察组加用俞募配穴针刺治疗。两组均连续治疗4周。比较两组患者腹部肌群(腹横肌、腹直肌、腹内斜肌及腹外斜肌)的厚度、Berg平衡量表(BBS)、Fugl-Meyer评定(FMA)、功能性步行分级(FAC)评分以及步速和步幅。结果:研究过程中,对照组脱落1例,观察组脱落4例。治疗前,两组患者的腹部肌群厚度,BBS、FMA及FAC评分,步速和步幅差异无统计学意义(P>0.05)。治疗4周后,两组腹部肌群厚度,BBS、FMA和FAC评分,步速及步幅均较治疗前改善(P<0.01),且观察组优于对照组(P<0.05)。结论:常规针刺与俞募配穴针刺均有助于改善中风后患者的平衡及步行功能,俞募配穴针刺治疗效果更佳;增强核心肌群的力量可能是俞募配穴针刺治疗的作用机制之一。

关 键 词：Acupuncture Therapy Back-Shu and Front-Mu Points Combination Poststroke Syndrome Postural Balance WALKING Muscle Strength Randomized Controlled Trial 

分 类 号：R246.6[医药卫生—针灸推拿学]