热敏灸联合体外冲击波穴位疗法治疗脑卒中后手痉挛临床研究  

Clinical Study on Heat-Sensitive Moxibustion Combined with Therapy of Extracorpo⁃real Shock Wave at Acupoints for Post-Stroke Hand Spasm

作　　者：曹梦霞 李瑞青[2] 宋宇锦 王慧灵[2] CAO Mengxia;LI Ruiqing;SONG Yujin;WANG Huiling(Department of Rehabilitation,Henan General Hospital,Zhengzhou Henan 450002,China;Department of Rehabilitation,the First Affiliated Hospital of Henan University of Chinese Medicine,Zhengzhou Henan 450007,China)

机构地区：[1]河南省职工医院康复科,河南郑州450002 [2]河南中医药大学第一附属医院康复科,河南郑州450007

出　　处：《新中医》2025年第4期67-72,共6页New Chinese Medicine

基　　金：河南省中药科学研究专项课题(2019JDZX2111,2021JDZY061);河南省自然科学基金(222301420066)。

摘　　要：目的:观察热敏灸联合体外冲击波穴位疗法治疗脑卒中后手痉挛的临床疗效。方法:选取2021年6月—2022年6月在河南中医药大学第一附属医院及河南省职工医院治疗的45例脑卒中后手痉挛患者,采用随机数字表法分为热敏组、冲击波组和联合组各15例。3组均给予常规手功能康复训练治疗,在此基础上,热敏灸组在八邪、上八邪穴附近选取热敏点施以热敏灸,冲击波组在八邪、上八邪穴处施以体外冲击波疗法,联合组在热敏灸治疗结束0.5 h后予体外冲击波穴位疗法治疗。3周为1个疗程,3组均治疗2个疗程。比较3组治疗前后改良Ashworth评定量表(MAS)分级,指浅屈肌、指伸肌均方根值(RMS),以及Fugl-Meyer运动功能评定量表中手腕部分(FMA-UE)、改良Lindmark评定量表、改良Barthel指数(MBI)评分。结果:治疗后,3组MAS分级均较治疗前改善,联合组MAS分级均优于热敏灸组和冲击波组,差异均有统计学意义(P<0.05)。3组指浅屈肌、指伸肌RMS均较治疗前降低,联合组指浅屈肌、指伸肌RMS均低于热敏灸组和冲击波组,差异均有统计学意义(P<0.05)。3组FMA-UE、改良Lindmark评定量表、MBI评分均较治疗前提高,联合组FMA-UE、改良Lindmark评定量表、MBI评分均高于热敏灸组和冲击波组,差异均有统计学意义(P<0.05)。结论:热敏灸联合体外冲击波穴位疗法能有效改善脑卒中后手痉挛状态,提高手腕运动功能和日常生活能力。Objective:To observe the clinical effect of heat-sensitive moxibustion combined with the extracorporeal shock wave therapy at acupoints on post-stroke hand spasm.Methods:A total of 45 patients with poststroke hand spasm treated in the First Affiliated Hospital of Henan University of Chinese Medicine and Henan General Hospital from June 2021 to June 2022 were selected and divided into the heat-sensitive group,the shock wave group and the combination group by random number table method,with 15 cases in each group.All the three groups were given routine training of hand function rehabilitation.On this basis,the heat-sensitive moxibustion group was treated with heat-sensitive moxibustion at selected heat-sensitive points near Baxie point and upper Baxie points;the shock wave group was treated with extracorporeal shock wave therapy at Baxie point and upper Baxie points;and the combination group was treated with extracorporeal shock wave therapy at acupoints half a hour after the treatment of heatsensitive moxibustion.Three weeks was a course of treatment,and all the three groups were treated for two courses.The scores of Modified Ashworth Scale(MAS)classification,the root mean square(RMS)of flexor and extensor muscle of fingers,Fugl-Meyer Assessment Scale-Upper Extremity(FMA-UE),modified Lindmark Scale,and modified Barthel Index(MBI)were compared among the three groups before and after treatment.Results:After treatment,the MAS classification of the three groups was improved when respectively compared with that before treatment,and the MAS classification of the combination group was better than that of the heat-sensitive moxibustion group and the shock wave group,differences being significant(P<0.05).The RMS of flexor and extensor muscle of fingers in the three groups were reduced when compared with those before treatment,and the RMS of flexor and extensor muscle of fingers in the combination group were lower than those in the heat-sensitive moxibustion group and the shock wave group,differences being significant(P<0.0

关 键 词：脑卒中 手痉挛 热敏灸 体外冲击波穴位疗法 表面肌电图 手腕运动功能 日常生活能力 

分 类 号：R743.3[医药卫生—神经病学与精神病学] R246.6[医药卫生—临床医学]