经皮穴位电刺激联合足底压力反馈训练治疗脑卒中后偏瘫临床研究  

Clinical Study on Transcutaneous Electrical Acupoint Stimulation Combined with Plantar Pressure-Based Feedback Training for Post-Stroke Hemiplegia

作　　者：陈文煜 毛显禹 刘海飞[1] 周阳阳 胡杰[1] CHEN Wenyu;MAO Xianyu;LIU Haifei;ZHOU Yangyang;HU Jie(Wenzhou TCM Hospital of Zhejiang Chinese Medical University,Wenzhou Zhejiang 325000,China)

机构地区：[1]浙江中医药大学附属温州市中医院,浙江温州325000

出　　处：《新中医》2025年第1期137-142,共6页New Chinese Medicine

基　　金：温州市科技计划项目(Y20211127)。

摘　　要：目的:观察经皮穴位电刺激联合足底压力反馈训练治疗脑卒中后偏瘫临床疗效及对平衡功能、下肢表面肌电信号的影响。方法:选取2022年1月—2023年1月在浙江中医药大学附属温州市中医院治疗的脑卒中后偏瘫患者90例,采用随机数字表法分为对照组、试验组各45例。2组均服用阿司匹林肠溶片,对照组予足底压力反馈训练,试验组予经皮穴位电刺激联合足底压力反馈训练。2组均治疗4周。治疗后,比较2组临床疗效。治疗前后,比较2组的平衡功能[Berg平衡量表(BBS)评分、5次坐立试验(FTSST)]、下肢表面肌电信号[患侧胫前肌、股直肌、腓肠肌的表面肌电信号平均均方根(RMS)值]、下肢运动功能[Fugl-Meyer运动功能量表下肢部分(FMA-LE)评分]、步行能力(步长差、步行速度)、日常生活活动能力[功能独立性评定量表(FIM)评分]。结果:治疗后,试验组总有效率93.02%(40/43),高于对照组76.74%(33/43)。2组BBS评分均较治疗前升高,试验组BBS评分高于对照组(P<0.05)。2组FTSST时间均较治疗前缩短,试验组FTSST时间短于对照组(P<0.05)。2组患侧胫前肌、股直肌、腓肠肌RMS均较治疗前升高,试验组患侧胫前肌、股直肌、腓肠肌RMS高于对照组(P<0.05)。2组FMA-LE评分、FIM评分均较治疗前升高,试验组FMA-LE评分、FIM评分均高于对照组(P<0.05)。2组步长差均较治疗前缩短,试验组步长差短于对照组(P<0.05);2组步行速度均较治疗前加快,试验组步行速度快于对照组(P<0.05)。结论:经皮穴位电刺激配合足底压力反馈训练治疗脑卒中后偏瘫,能有效促进平衡功能、下肢表面肌电信号改善,增强下肢运动功能,提高步行能力及日常生活活动能力。Objective:To observe the clinical effect of transcutaneous electrical acupoint stimulation combined with plantar pressure-based feedback training in the treatment of post-stroke hemiplegia and its effects on balance function and lower extremity surface electromyography signals.Methods:A total of 90 cases of patients with poststroke hemiplegia admitted to Wenzhou TCM Hospital of Zhejiang Chinese Medical University from January 2022 to January 2023 were divided into the control group and the trial group using a random number table method,with 45 patients in each group.Both groups took Aspirin Enteric-Coated Tablets.The control group received plantar pressure-based feedback training,and the trial group received transcutaneous electrical acupoint stimulation combined with plantar pressure-based feedback training.Both groups were treated for four weeks.After treatment,the clinical efficacy of the two groups was compared.Before and after treatment,the two groups were compared in terms of balance function[the Berg Balance Function Scale(BBS)and the Five Times Sit-to-Stand TEST(FTSST)],lower extremity surface electromyography signals[root mean square(RMS)of surface electromyography signals of the tibialis anterior muscle,rectus femoris muscle,and gastrocnemius muscle on the affected side],and lower extremity motor function[Fugl-Meyer Assessment Scale-Lower Extremity(FMA-LE)],walking ability(step size difference and walking speed),and activities of daily living[Functional Independence Measure(FIM)scores].Results:After treatment,the total effective rate in the trial group was 93.02%(40/43),which was higher than the control group's 76.74%(33/43).Both groups showed an increase in BBS scores compared to that before treatment,with the trial group having a higher BBS score than the control group(P<0.05).The FTSST time in the two groups was shortened when compared with that before treatment,with the trial group having a shorter FTSST time than the control group(P<0.05).The RMS of the tibialis anterior muscle,rectus femoris muscl

关 键 词：脑卒中 偏瘫 经皮穴位电刺激 足底压力反馈训练 表面肌电信号 

分 类 号：R259[医药卫生—中西医结合]