恢刺温灸分经解痉法联合神经松动术治疗卒中后上肢痉挛性瘫痪:随机对照研究  

The Use of Huici Wenjiu Fengjie Method Combined with Neural Mobilization in Upper Limbs After Stroke:Random Control Research

作　　者：李成晨 黄源鹏 黄益清 曾钿 黄徐睿 张倩[5,6] LI Chengchen;HUANG Yuanpeng;HUANG Yiqing;ZENG Dian;HUANG Xurui;ZHANG Qian(Beijing University of Chinese Medicine Third Affiliated Hospital,Beijing 100029,China;Xiamen Hospital of Beijing University of Chinese Medicine,Xiamen Fujian 361009,China;College of Basic Medical Sciences,Shanxi University of Chinese Medicine,Jinzhong Shanxi 030619,China;Fujian University of Chinese Medicine,Fuzhou Fujian 350122,China;The Second Affiliated Hospital of Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040,China;Heilongjiang University of Chinese Medicine,Harbin Heilongjiang 150040,China)

机构地区：[1]北京中医药大学第三附属医院,北京100029 [2]北京中医药大学厦门医院,福建厦门361009 [3]山西中医药大学基础医学院,山西晋中030619 [4]福建中医药大学,福建福州350122 [5]黑龙江中医药大学附属第二医院,黑龙江哈尔滨150040 [6]黑龙江中医药大学,黑龙江哈尔滨150040

出　　处：《中医药导报》2025年第1期86-89,119,共5页Guiding Journal of Traditional Chinese Medicine and Pharmacy

基　　金：黑龙江省中医药管理局科研项目(ZHY2020-137,ZHY18-084)。

摘　　要：目的:观察恢刺温灸分经解痉法联合神经松动术治疗卒中后上肢痉挛性瘫痪的疗效。方法:将60例卒中后上肢痉挛性瘫痪患者随机分为观察组和对照组,每组30例,观察组予恢刺温灸分经解痉法联合神经松动术治疗,对照组予以神经松动术治疗。分析两组患者治疗前后上肢改良Ashworth痉挛量表(modified Ashworth scale,MAS)分级、Fugl-Meyer量表(Fugl-Meyer assessment,FMA)评分、最大伸直位时掌指关节及肘关节的关节活动度、脑卒中专门化生活质量表(SS-QOL)评分的变化情况,并比较临床疗效。结果:最终纳入观察组29例(1例剔除)、对照组27例(2例剔除、1例脱落)。治疗后,观察组总有效率(89.66%,26/29)优于对照组(70.37%,19/27),差异有统计学意义(P<0.05)。治疗后两组患者上肢痉挛程度(MAS分级)均较治疗前减轻(P<0.05),且观察组MAS分级低于对照组(P<0.05)。两组患者上肢运动功能(FMA评分)均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,两组患者上肢最大伸直位时掌指关节、肘关节活动度均较治疗前增大(P<0.05),且观察组大于对照组(P<0.05)。治疗后,两组患者生活质量(SS-QOL评分)均较治疗前升高(P<0.05),且观察组高于对照组(P<0.05)。结论:恢刺温灸分经解痉法联合神经松动术治疗卒中后上肢痉挛性瘫痪有效,可改善患者痉挛程度,促进其运动功能恢复,并提升其生活质量。Objective:To observe the clinical effect of treating spasmodic paralysis of upper limbs after apoplexy by Huici Wenjiu Fengjie Method combined with neural mobilization.Methods:A total of 60 patients with spasmodic paralysis of upper limbs after stroke were separated into observation group and control group(30 cases in each group).The patients in the observation group was treated with Huici Wenjiu Fengjie Method combined with neural mobilization,while the control group only received neural mobilization.The modified Ashworth spasticity Scale (MAS) grade and Fugl-Meyer Scale (Fugl-Meyerassessment) scores of the upper limbs of the 2 groups before and after treatment were analyzed. Joint motion of metacarpal and elbow joints at maximum extension, and stroke specialized Quality of Life scale (SS-QOL), and clinical efficacy were compared. Results: A total of 29 cases were included in the observation group (1 case was excluded) and 27 cases in the control group (2 cases were excluded and 1 case was dropped). After treatment, the total effective rate of the observation group (89.66%, 26/29) was better than that of the control group (70.37%, 19/27), the diffrence was significant (P<0.05). After treatment, the degree of upper limb spasm (MAS grade) in the two groups was lower than that before treatment (P<0.05), and the MAS grade in the observation group was lower than that in the control group (P<0.05). The upper limb motor function (FMA score) of the two groups was higher than that before treatment (P<0.05), and the observation group was higher than the control group (P<0.05). After treatment, the range of motion of the metacarpophalangeal joint and elbow joint in the maximum extension position of the upper limbs of the two groups were increased when compared with those before treatment (P<0.05), and the observation group was greater than the control group (P<0.05). After treatment, the quality of life (SS-QOL score) of the two groups was higher than that before treatment (P<0.05), and the observation group was higher tha

关 键 词：卒中 上肢痉挛性瘫痪 恢刺温灸分经解痉法 神经松动术 

分 类 号：R246.6[医药卫生—针灸推拿学]