基于壮医毒虚致病理论探讨壮医药熨联合针刺治疗脑卒中患者痉挛性偏瘫的研究  

Zhuang Medicine Ironing Therapy Combined with Acupuncture in Treatment of Spastic Hemiparesis in Post-Stroke Patients Based on the Theory of"Toxic Deficiency Causing Disease"in Zhuang Medicine

作　　者：王文卢 唐菀羚 黄永 陈莹 WANG Wenlu;TANG Wanling;HUANG Yong;CHEN Ying(Guangxi International Zhuang Medical Hospital(Affiliated International Zhuang Medical Hospital of Guangxi University of Traditional Chinese Medicine),Nanning,Guangxi 530000)

机构地区：[1]广西国际壮医医院(广西中医药大学附属国际壮医医院),广西南宁530000

出　　处：《中医康复》2025年第4期24-28,共5页Traditional Chinese Medicine Rehabilitation

基　　金：广西自然科学基金面上项目(2023GXNSFAA026105);广西中医药适宜技术开发与推广项目(GZSY22-45);广西中医药管理局自筹课题(GXZYA20220135);广西国际壮医医院院级课题(GZ2021039);广西国际壮医医院特色学科(院字[2021]33号)。

摘　　要：目的:基于壮医毒虚致病理论探讨壮医药熨疗法联合针刺治疗脑卒中痉挛性偏瘫的临床疗效。方法:选取2023年1月~2024年6月本院就诊的80例脑卒中痉挛性偏瘫患者,以随机数字表法分为治疗组和对照组各40例。两组均给予脑卒中二级预防用药如控制血压、血糖、血脂等基础治疗,对照组在此基础上给予普通针刺,治疗组在对照组基础上采用壮医药熨疗法。比较两组治疗前后改良Ashworth量表(MAS)分级评分、Fugl-Meyer(FMA)运动功能评分、日常生活能力(Barthel指数)评分、肱二头肌及股四头肌的表面肌电图积分肌电值(iEMG)。结果:治疗后,两组患者FMA评分、Barthel指数均较治疗前提高(P<0.05),MAS评分较治疗前降低(P<0.05),且治疗组治疗后FMA评分、Barthel指数显著高于对照组(P<0.05),MAS评分低于对照组(P<0.05)。治疗后,两组肱二头肌、股四头肌iEMG积分值均有显著提高(P<0.05),且治疗组肱二头肌、股四头肌iEMG积分值高于对照组(P<0.05)。结论:壮医药熨联合针刺治疗脑卒中患者痉挛性偏瘫是一种较为行之有效的方法,可以减轻肢体痉挛,改善运动功能,提高日常生活自理能力。Objective:To discuss the efficacy of Zhuang medicine ironing therapy combined with acupuncture in the treatment of spastic hemiplegia in post-stroke patients based on the theory of"Toxic Deficiency Causing Disease"in Zhuang medicine.Methods:Eighty patients with spastic hemiplegia in post-stroke who visited the clinic from January 2023 to June 2024 were selected and divided into treatment group(n=40)and control group(n=40).Both groups were given basic treatment with secondary stroke prevention drugs such as controlling blood pressure,blood sugar and blood lipids,on which the control group was given ordinary acupuncture,and the treatment group was treated with Zhuang medicine ironing therapy on the basis of the control group.The modified Ashworth scale(MAS)grading scores,Fugl-Meyer motor function(FMA)scores,ability to perform activities of daily living(Barthel Index)scores,and surface electromyographic integral electromyographic values(iEMG)of the biceps brachii muscle and quadriceps femoris muscle were compared between the two groups before and after treatment.Results:After treatment,the FMA score and Barthel index of both groups were higher than those before treatment(P<0.05),and the MAS score was lower than that before treatment(P<0.05),and the FMA score and Barthel index of the treatment group were significantly higher than those of control group(P<0.05),and the MAS score was lower than that of control group(P<0.05).After treatment,the biceps and quadriceps iEMG integral values of both groups were increased significantly(P<0.05),and the biceps and quadriceps iEMG integral values of the treatment group were higher than those of control group(P<0.05).Conclusion:Zhuang medicine ironing therapy combined with acupuncture is a relatively effective method for treating spastic hemiplegia in post-stroke patients,which can reduce limb spasms,improve motor function,and enhance daily self-care ability.

关 键 词：脑卒中 痉挛性偏瘫 毒虚致病 壮医药熨疗法 表面肌电图 积分肌电值(iEMG) 

分 类 号：R29[医药卫生—民族医学]