功能针刺联合手持续被动运动对脑卒中后手功能障碍康复质量的影响

Effect of functional acupuncture combined with continuous passive hand movement on rehabilitation quality of hand dysfunction after stroke

目的分析脑卒中后手功能障碍病因病机,总结功能针刺与手持续被动运动治疗脑卒中后手功能障碍的效果,为临床治疗手功能障碍寻找最优的方法。方法选取2018年1月—2019年2月在衢州市第三医院治疗的脑卒中后手功能障碍患者70例,采用完全随机法将患者分为对照组与联合组,各35例。对照组给予手持续被动运动训练,联合组在对照组基础上给予联合功能针刺。统计Fugl-Meyer上肢部分、手功能、Barthel ADL等评分。结果联合组治疗8周、12周Fugl-Meyer评分[(55.64±3.47)分、(64.45±5.18)分]高于对照组[(40.25±2.32)分、(46.42±3.37)分,t=21.811、17.262,均P<0.001];手功能评分[(67.86±6.06)分、(85.14±7.46)分]高于对照组[(58.49±5.51)分、(70.18±6.89)分,t=6.768、8.715,均P<0.001];Barthel ADL评分[(62.03±10.86)分、(88.57±12.59)分]高于对照组[(49.08±8.54)分、(62.75±9.64)分,t=5.545、9.633,均P<0.001]。结论功能针刺联合手持续被动运动能改善脑卒中后手功能障碍,促进患者上肢、手等功能恢复。

Objective To analyze the etiology and mechanism of hand dysfunction after stroke,summarize the effect of functional acupuncture and hand continuous passive movement in the treatment of hand dysfunction after stroke,and find the best way for clinical treatment of hand dysfunction.Methods Total 70 patients with hand dysfunction after stroke were selected to be treated in our hospital from January 2018 to February 2019.The patients were divided into control group and combined group with 35 cases in each group.The control group was given continuous passive hand training,and the combined group was given combined functional acupuncture on the basis of the control group.The scores of Fugl-Meyer's upper extremity,hand function and Barthel ADL were counted.Results At 8 and 12 weeks,the scores of Fugl Meyer(55.64±3.47 and 64.45±5.18)in the combined group were higher than those in the control group(40.25±2.32 and 46.42±3.37),t=21.811,17.262,all P<0.001.The scores of hand function(67.86±6.06 and 85.14±7.46)were higher than those of control group(58.49±5.51 and 70.18±6.89),t=6.768,8.715,all P<0.001.Barthel ADL(62.03±10.86 and 88.57±12.59)was higher than that of the control group(49.08±8.54 and 62.75±9.64),t=5.545,9.633,all P<0.001.Conclusion Functional acupuncture combined with hand continuous passive movement can improve hand dysfunction after stroke,and promote the functional recovery of upper limbs and hands,which is worth popularizing.