火针联合艾灸对脑卒中后痉挛性肌张力障碍中枢神经调控及表面肌电图的影响  

Effect of Fire Needling Combined with Moxibustion on Central Nervous Regulation and Surface Electromyography of Post-Stroke Spastic Dystonia

作　　者：史林 孙明明 郭丽娜 SHI Lin;SUN Mingming;GUO Li'na(Department of Rehabilitation Medicine,Zhoukou Central Hospital,Zhoukou Henan 466000,China)

机构地区：[1]周口市中心医院康复医学科,河南周口466000

出　　处：《新中医》2025年第1期156-161,共6页New Chinese Medicine

基　　金：河南省科学技术厅科技发展计划(222102310038)。

摘　　要：目的:观察火针联合艾灸通过Toll样受体4(TLR4)信号通路对脑卒中后痉挛性肌张力障碍中枢神经调控及表面肌电图的影响。方法:选择2020年1月—2023年5月周口市中心医院收治的98例脑卒中后痉挛性肌张力障碍患者,按随机数字表法分为艾灸组及联合组各49例。2组均给予现代医学治疗,艾灸组在现代医学治疗基础上给予艾灸治疗,联合组在艾灸组基础上给予火针治疗。比较2组临床疗效,比较2组治疗前后中医证候评分、临床痉挛指数(CSI)、改良Ashworth肌张力(MAS)、Fugl-Meyer运动功能量表(FMA)、躯干损伤量表(TIS)、临床神经功能缺损评分量表(CSS)评分、表面肌电图[肱二头肌表面肌电图积分肌电值(iEMG)、肌电信号值均方根(RMS)]、血清脂蛋白相关磷脂酶A2(Lp-PLA2)、TLR4、血清磷酸化α-突触核蛋白(α-syn)水平的变化。结果:联合组临床疗效总有效率优于艾灸组,差异有统计学意义(P<0.05)。治疗后,2组半身不遂、感觉减退、不语、口舌歪斜、自汗、面色㿠白、气短乏力中医证候评分均较治疗前下降(P<0.05),联合组上述7项中医证候评分均低于艾灸组(P<0.05)。治疗后,2组CSI、MAS评分均较治疗前下降,FMA评分均较治疗前上升,差异均有统计学意义(P<0.05);联合组CSI、MAS评分均低于艾灸组,FMA评分高于艾灸组,差异均有统计学意义(P<0.05)。治疗后,2组TIS评分均较治疗前升高,CSS评分均较治疗前下降,差异均有统计学意义(P<0.05);联合组TIS评分高于艾灸组,CSS评分低于艾灸组,差异均有统计学意义(P<0.05)。治疗后,2组肱二头肌RMS、iEMG均较治疗前下降(P<0.05),联合组肱二头肌RMS、iEMG均低于艾灸组(P<0.05)。治疗后,2组Lp-PLA2、TLR4、α-syn水平均较治疗前下降(P<0.05),联合组Lp-PLA2、TLR4、α-syn水平均低于艾灸组(P<0.05)。结论:火针联合艾灸治疗脑卒中后痉挛性肌张力障碍疗效较好,可通过TLR4信号通路调控中枢神经Objective:To observe the effect of fire needling combined with moxibustion on central nervous regulation and surface electromyography of post-stroke spastic dystonia through toll-like receptor 4(TLR4)signaling pathway.Methods:A total of 98 patients with post-stroke spastic dystonia treated in Zhoukou Central Hospital from January 2020 to May 2023 were selected and divided into the moxibustion group and the combination group according to random number table method,with 49 cases in each group.The two groups were given modern medical treatment;the moxibustion group was additionally given moxibustion,and the combination group was additionally given fire needling and moxibustion.The clinical effects in the two groups were compared.The changes in traditional Chinese medicine syndrome scores,Clinical Spasticity Index(CSI)and Modified Ashworth Scale(MAS),Fugl-Meyer Assessment(FMA),Trunk Impairment Scale(TIS),China Stroke Scale(CSS),surface electromyography[integrated electromyography(iEMG),root mean square of electromyography(RMS)],and levels of serum lipoprotein-associated phospholipase A2(Lp-PLA2),TLR4,and serum phosphorylatedα-synuclein(α-syn)were compared between the two groups before and after treatment.Results:The total effective rate in the combination group was better than that in the moxibustion group,the difference being significant(P<0.05).After treatment,the traditional Chinese medicine syndrome scores of hemiparalysis,hypoaesthesia,speechlessness,deviated tongue and mouth,spontaneous sweating,pale facial complexion,and shortness of breath and lack of strength in the two groups were all decreased when compared with those before treatment(P<0.05),and the above seven traditional Chinese medicine syndrome scores in the combination group were all lower than those in the moxibustion group(P<0.05).After treatment,the CSI and MAS scores in the two groups were decreased when compared with those before treatment,and the FMA scores were increased,differences being significant(P<0.05).The CSI and MAS scores in the com

关 键 词：脑卒中 痉挛性肌张力障碍 火针 艾灸 TLR4信号通路 表面肌电图 

分 类 号：R277.7[医药卫生—中医学]