腕踝针联合肺康复训练对缺血性脑卒中偏瘫患者的影响  

Effects of Wrist-Ankle Acupuncture Combined with Pulmonary Rehabilitation Training on Patients with Hemiplegic after Cerebral Ischemic Stroke

作　　者：郑美 赖文芳[3] 周小炫 黄建峰 陈开珍 ZHENG Mei;LAI Wenfang;ZHOU Xiaoxuan;HUANG Jianfeng;CHEN Kaizhen(Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350003,China;Fujian Institute of Rehabilitation Industry,Fuzhou,Fujian 350122,China;School of Pharmacy,Fujian University of Traditional Chinese Medicine,Fuzhou,Fujian 350122,China)

机构地区：[1]福建中医药大学附属康复医院,福建福州350003 [2]福建省康复产业研究院,福建福州350122 [3]福建中医药大学药学院,福建福州350122

出　　处：《康复学报》2025年第2期130-137,共8页Rehabilitation Medicine

基　　金：国家自然科学基金面上项目(82174001);福建省科技厅引导性项目(2020Y0052)。

摘　　要：目的观察腕踝针联合肺康复训练对缺血性脑卒中(CIS)偏瘫患者呼吸功能、躯干控制能力和运动功能的影响。方法选择2021年11月—2023年10月在福建中医药大学附属康复医院住院治疗的CIS偏瘫患者100例,采用SPSS 25.0软件生成随机数字表分为对照组和观察组,每组50例,因各种原因对照组、观察组分别中止/脱落6、4例,最终对照组、观察组分别纳入44、46例。2组均接受西医基础治疗和常规康复训练,同时对照组接受常规肺功能训练,包括体外膈肌起搏治疗(30 min/次)和腹式呼吸训练(15 min/次),1次/d,5 d/周,持续治疗4周。观察组在对照组基础上接受带针腕踝针针刺,1次/d,45 min/次,5次/周,连续治疗4周。分别于治疗前和治疗后使用高级运动心/肺功能测试仪检测患者肺通气功能[用力肺活量(FVC)、第1秒用力呼气容积(FEV_(1))、最大呼气峰流速(PEF)、最大分钟通气量(MVV)];采用智能呼吸耐力训练仪检测患者呼吸肌力量[最大吸气压(MIP)、最大呼气压(MEP)];采用躯干损伤评定量表(TIS)评价患者躯干控制能力(动态坐位平衡、静态坐位平衡、协调能力);采用Fugl-Meyer运动功能评分量表(FMA)评价运动功能;观察治疗期间的不良事件(局部疼痛、血肿、轻微出血、胶布过敏等)。结果与治疗前比较,2组治疗后FVC、FEV_(1)、PEF、MVV、MIP、MEP,动态坐位平衡、静态坐位平衡、协调能力评分,TIS总分和FMA评分均明显提高,差异均具有统计学意义(P<0.05)。与对照组比较,观察组治疗后FVC、FEV_(1)、PEF、MVV、MIP、MEP,动态坐位平衡、静态坐位平衡、协调能力评分、TIS总分和FMA评分均明显提高,差异具有统计学意义(P<0.05)。2组治疗过程中均未发生严重不良事件。结论腕踝针联合肺康复训练可改善CIS偏瘫患者肺通气功能、呼吸肌肌力与耐力、躯干控制能力及运动功能,值得临床推广应用。Objective To observe the effects of wrist-ankle acupuncture combined with pulmonary rehabilitation training on respiratory function,trunk control and motor function of hemiplegic patients after cerebral ischemic stroke(CIS).Methods A total of 100 hemiplegic patients after CIS who were hospitalized in the Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine from November 2021 to October 2023 were recruited and divided into control group and observation group according to the random number table generated by the SPSS 25.0 software,with 50 cases in each group.During the course of the treatment,six cases in the control group and four cases in the observation group discontinued or dropped out for various reasons,and finally 44 cases and 46 cases were included in the control group and the observation group,respectively.Both groups received basic treatment of western medicine and routine rehabilitation treatment.The control group received conventional pulmonary function training,including external diaphragmatic pacing treatment(30 minutes a time),abdominal breathing training(15 minutes a time),once a day,five days a week for four weeks.The observation group additionally received wrist-ankle acupuncture with the needles retained,once a day,45 minutes a time,five times a week for four weeks.Before and after treatment,an advanced exercise cardiopulmonary function tester was used to detect the pulmonary ventilation function[forced vital capacity(FVC),forced expiratory volume in the first second(FEV1),maximum peak expiratory flow rate(PEF),maximum minute ventilation volume(MVV)];an intelligent respiratory endurance training device was used to detect the respiratory muscle strength[maximum inspiratory pressure(MIP),maximum expiratory pressure(MEP)];the Trunk Impairment Scale(TIS)was used to evaluate the trunk control ability(dynamic sitting balance,static sitting balance,coordination ability);the Fugl-Meyer Assessment(FMA)was used to evaluate motor function;and adverse events(local pain,hema

关 键 词：缺血性脑卒中 偏瘫 腕踝针 肺康复训练 呼吸功能 运动功能 

分 类 号：R743.3[医药卫生—神经病学与精神病学]