针刺健侧下肢治疗中风后上肢软瘫的临床研究  

Clinical study on treatment of upper limb soft paralysis after stroke by acupuncture on healthy lower limb

作　　者：王凡[1] 李朝阳 蒋腾 王山[1] 刘熠 WANG Fan;LI Chao-yang;JIANG Teng;WANG Shan;LIU Yi(Nanyang Central Hospital,Nanyang,Henan 473000,China;Nanyang Zhangzhongjing Hospital,Nanyang,Henan 473000,China)

机构地区：[1]南阳市中心医院,河南南阳473000 [2]南阳张仲景医院,河南南阳473000

出　　处：《医药论坛杂志》2024年第24期2677-2680,共4页Journal of Medical Forum

基　　金：河南省中医药科学研究专项课题(20-21ZY3031)。

摘　　要：目的 探讨针刺健侧下肢治疗中风后上肢软瘫的临床效果。方法收集2021年8月至2023年2月就诊于南阳市中心医院接受中医康复治疗的中风后上肢软瘫患者共200例,随机分为健侧组与患侧组各100例,健侧组针刺健侧下肢穴位联合康复训练,患侧组针刺患侧上肢穴位联合康复训练,治疗前与治疗6周后分别采用lovett分级评分、简易Fugl-Meyer评定量表、改良Barthel指数评估患者肌力、患肢运动功能与日常生活能力。结果治疗后健侧组、患侧组lovett评分分别为(3.28±0.74)、(3.07±0.79),高于治疗前的(1.02±0.67)、(1.21±0.78)(P<0.05);但组间差异无统计学意义(P>0.05);治疗后健侧组Fugl-Meyer评定量表上肢近端肢体、腕、手、整体协调能力评分分别为(29.58±4.22)、(7.45±1.24)、(11.47±2.34)、(5.13±0.88),均高于治疗前的(15.28±2.42)、(5.38±1.12)、(7.38±1.22)、(3.24±0.63);治疗后患侧组上肢近端肢体、腕、手、整体协调能力评分分别为(27.74±3.94)、(6.88±1.39)、(10.35±2.45)、(4.81±0.64),均高于治疗前的(15.53±2.35)、(5.63±1.25)、(7.73±1.42)、(3.44±0.87);治疗后健侧组FMA-Meyer量表评分优于患侧组(P<0.05);治疗后健侧组、患侧组Barthel指数分别为(78.74±8.73)、(76.16±10.31),高于治疗前的(68.74±8.32)、(67.46±9.63)(P<0.05);但组间差异无统计学意义(P>0.05)。结论针刺健侧下肢及针刺患侧上肢联合康复训练均可改善中风后上肢软瘫患者的上肢肌力和运动功能,针刺健侧下肢在改善患肢运动功能方面优于针刺患侧上肢。Objective To explore the clinical effect of acupuncture on upper limb paralysis after stroke.Methods Totally 200 patients with upper limb soft paralysis after stroke who received traditional Chinese medicine rehabilitation treatment in Nanyang Central Hospital from August 2021 to February 2023 were randomly divided into the healthy group and the affected group with 100 cases each.The healthy group combined rehabilitation training with acupuncture on the lower extremity points on the healthy side,and the affected group combined rehabilitation training with acupuncture on the upper extremity points on the affected side.lovett grading score,simple Fugl-Meyer Rating Scale and modified Barthel index were used to evaluate muscle strength,motor function and daily living ability before and after 6 weeks of treatment,respectively.Results lovett scores in the healthy group and the affected group were(3.28±0.74)and(3.07±0.79),respectively,higher than those before treatment(1.02±0.67)and(1.21±0.78)(P<0.05).There was no significant difference between groups(P>0.05).The scores of proximal limb,wrist,hand and overall coordination in the healthy side group were(29.58±4.22),(7.45±1.24),(11.47±2.34)and(5.13±0.88),respectively.They were higher than those before treatment(15.28±2.42),(5.38±1.12),(7.38±1.22),(3.24±0.63).After treatment,the scores of proximal limb,wrist,hand and overall coordination in the affected group were(27.74±3.94),(6.88±1.39),(10.35±2.45)and(4.81±0.64),respectively.They were higher than those before treatment(15.53±2.35),(5.63±1.25),(7.73±1.42),(3.44±0.87).After treatment,the FMA-Meyer scale score of healthy side group was better than that of sick side group(P<0.05).After treatment,the Barthel index of the healthy side group and the affected side group were(78.74±8.73)and(76.16±10.31),which were higher than those before treatment(68.74±8.32)and(67.46±9.63),respectively(P<0.05).There was no significant difference between the two groups(P>0.05).Conclusion Acupuncture on the healthy lower l

关 键 词：针刺 中风 瘫痪 运动障碍 运动功能 

分 类 号：R246.6[医药卫生—针灸推拿学]