脑卒中痉挛性瘫痪中西医康复策略及临床应用专家共识  

Expert consensus on traditional Chinese and Western medicine rehabilitation strategy andclinical application for spastic paralysis after stroke

作　　者：脑卒中中西医康复专家共识编写组 李飞 汪美霞 徐磊 Writing Group of Expert Consensus on traditional Chinese and Western medicine rehabilitation for Stroke

机构地区：[1]不详 [2]安徽中医药大学第二附属医院 [3]安徽中医药大学第一附属医院 [4]蚌埠医科大学第一附属医院

出　　处：《中华全科医学》2025年第2期179-185,共7页Chinese Journal of General Practice

基　　金：国家青年岐黄学者项目(国中医药人教函[2022]256);国家中医药管理局课题(YGZXKT2024174);安徽省自然科学基金面上项目(2308085MH297);安徽高校自然科学重大研究项目(2023AH040099);安徽省临床医学研究转化专项项目(202304295107020085)。

摘　　要：脑卒中为“四高”疾病,即发病率高、致死率高、致残率高、复发率高。脑卒中后痉挛性瘫痪的发生率达到50%,如果误治或失治,会使痉挛状态被永久地固定下来,不但会引起患侧肢体的疼痛、僵硬,而且会造成肌肉萎缩、关节挛缩变形和活动度受限,最终造成残疾(致残率高达75%)。解除痉挛是脑卒中偏瘫康复的重点和难点,其可直接影响中风偏瘫康复的疗效。为解决这一重点和难点,脑卒中中西医康复专家共识编写组基于临床实际,通过整体论治与个体化康复相结合,制定了本项专家共识。脑卒中后肢体痉挛性瘫痪应以中西医结合康复为核心,联合康复医学科、针灸科等多学科团队,从诊断、西医治疗、中药治疗、针灸治疗、推拿治疗、康复治疗、评价指标、预防调摄等方面予以综合管理,充分借鉴国内外临床实践经验,发挥中医药特色和优势,临床疗效确切、发展潜力巨大。Stroke is known as a"four-high"disease,characterized by a high incidence,high mortality,high disability rate,and high recurrence rate.The incidence of spastic paralysis after stroke reaches 50%.If improperly treated or left untreated,the spastic state may become permanently fixed.This not only leads to pain and stiffness in the affected limbs but also results in muscle atrophy,joint contractures,deformities,and limited range of motion,ultimately causing disability(with a disability rate as high as 75%).Relieving spasticity is the key and difficult point in the rehabilitation of stroke-induced hemiplegia,and it directly influences the effectiveness of recovery outcomes.In order to address this key and difficult point,the Writing Group of Expert Consensus on traditional Chinese and Western medicine rehabilitation for stroke formulated this expert consensus based on clinical practice,combining holistic treatment with individualized rehabilitation.The rehabilitation of spastic paralysis of limbs after stroke should be centered on integrated traditional Chinese and Western medicine,combined with multidisciplinary teams such as rehabilitation department and acupuncture and moxibustion department,and comprehensively managed from diagnosis,western medical treatment,traditional Chinese medicine treatment,acupuncture therapy,massage therapy,rehabilitation therapy,evaluation indicators,and prevention and regulation,fully drawing on both domestic and international clinical practice experience to leverage the distinctive features and advantages of traditional Chinese medicine,which has demonstrated clear clinical efficacy and holds significant potential for further development.

关 键 词：脑卒中 痉挛性瘫痪 中西医康复 临床应用 专家共识 

分 类 号：R2-031[医药卫生—中西医结合] R743.3[医药卫生—中医学]