头部围针、体针联合作业疗法对脑卒中后上肢痉挛性偏瘫患者认知、肌痉挛和患肢精细运动的影响  

Effects of Scalp Acupuncture and Body Acupuncture Combined with Occupational Therapy on Cognition,Muscular Spasticity,and Fine Motor of Affected Limbs in Patients with Spastic Hemiplegia of Upper Limbs After Stroke

作　　者：陆家卉 阴秀春 李元婧 LU Jiahui;YIN Xiuchun;LI Yuanjing(Elderly Intensive Rehabilitation Department,Ningbo Rehabilitation Hospital,Ningbo Zhejiang 315100,China)

机构地区：[1]宁波市康复医院老年重症康复科,浙江宁波315100

出　　处：《新中医》2025年第4期83-87,共5页New Chinese Medicine

基　　金：宁波市康复医院院级项目(2020FH18)。

摘　　要：目的:观察头部围针、体针联合作业疗法对脑卒中后上肢痉挛性偏瘫患者认知功能、肌痉挛及患肢精细运动的影响。方法:选取2023年3月—2024年3月宁波市康复医院收治的100例脑卒中伴上肢痉挛性偏瘫患者为研究对象,采用随机数字表法分为对照组和研究组各50例。对照组给予作业疗法进行康复治疗,研究组给予头部围针、体针联合作业疗法进行康复治疗。治疗2个月后,比较2组治疗前后神经功能[美国国立卫生研究院卒中量表(NIHSS)、神经功能缺损程度量表(NDS)]、认知功能[蒙特利尔认知评估量表(MoCA)]、肌痉挛评分[上肢改良Ashworth量表(MAS)]、上肢精细运动功能[简式Fugl-Meyer运动功能评定量表(FMA)、Carroll手功能评定(UEFT)]、日常生活活动能力[改良Barthel指数(MBI)、功能独立性评定量表(FIM)]的差异。结果:治疗后,2组NIHSS、NDS评分均较治疗前降低(P<0.05),且研究组NIHSS、NDS评分均低于对照组(P<0.05)。治疗后,2组MoCA评分均较治疗前升高(P<0.05),且研究组MoCA评分高于对照组(P<0.05)。治疗后,2组肌痉挛MAS评分均较治疗前降低(P<0.05),且研究组肌痉挛MAS评分低于对照组(P<0.05)。治疗后,2组FMA、UEFT评分均较治疗前升高(P<0.05),且研究组FMA、UEFT评分均高于对照组(P<0.05)。治疗后,2组MBI、FIM评分均较治疗前升高(P<0.05),且研究组MBI、FIM评分均高于对照组(P<0.05)。结论:头部围针、体针联合作业疗法康复治疗脑卒中后上肢痉挛性偏瘫具有良好疗效,能改善患者神经功能、认知功能及上肢肌肉痉挛,提高上肢精细运动功能及日常生活活动能力。Objective:To observe the effects of scalp acupuncture and body acupuncture combined with occupational therapy on cognition,muscular spasticity,and fine motor of affected limbs in patients with spastic hemiplegia of upper limbs after stroke.Methods:A total of 100 patients with stroke were treated in the Ningbo Rehabilitation Hospital from March 2023 to March 2024 were selected and divided into the control group and the study group according to the random number table method,with 50 cases in each group.The control group received occupational therapy for rehabilitation,and the study group received scalp acupuncture and body acupuncture combined with occupational therapy for rehabilitation.After two months of treatment,the differences in neurological function[National Institutes of Health Stroke Scale(NIHSS),Neurological Deficit Scale(NDS)],cognitive function[Montreal Cognitive Assessment(MoCA)],muscular spasticity[Modified Ashworth Scale(MAS)for upper limbs],fine motor function of the upper limbs[Simplified Fugl-Meyer Assessment(FMA),Carroll Upper Extremity Function Test(UEFT)],and activities of daily living[Modified Barthel Index(MBI),Functional Independence Measure(FIM)]were compared between the two groups before and after treatment.Results:After treatment,the scores of NIHSS and NDS in the two groups were decreased when compared with those before treatment(P<0.05),and the study group had lower scores of NIHSS and NDS compared to the control group(P<0.05).MoCA scores in thte two groups increased significantly after treatment(P<0.05),with the study group showing higher MoCA score than the control group(P<0.05).MAS scores for muscular spasticity in the two groups decreased significantly after treatment(P<0.05),with the study group showing lower MAS score than the control group(P<0.05).The scores of FMA and UEFT in the two groups increased significantly after treatment(P<0.05),with the study group showing higher scores of FMA and UEFT than the control group(P<0.05).The scores of MBI and FIM in the two groups increase

关 键 词：脑卒中 上肢痉挛性偏瘫 头部围针 体针 作业疗法 认知功能 肌痉挛 患肢精细运动 

分 类 号：R743.3[医药卫生—神经病学与精神病学]