针刺疗法结合推拿治疗中风后痉挛性偏瘫临床研究

Clinical Study on Needling Therapy Combined with Tuina for Spastic Hemiplegia After Stroke

目的:观察针刺疗法结合推拿对中风后痉挛性偏瘫患者临床症状、肢肌张力及生活质量的影响。方法:选取中风后痉挛性偏瘫患者80例,按随机数字分表法分为对照组与观察组各40例。2组均予以常规康复训练,对照组联合推拿疗法治疗,观察组在对照组的基础上加用针刺治疗。2组疗程均为1个月,比较2组治疗前后中医症状积分、肢肌张力改善情况(Ashworth评分)、肢体运动功能改善情况(Fugl-Meyer评分)、神经功能恢复(改良RANKIN量表)及生活质量(Barthel指数评定量表)情况。结果:治疗后,2组中医症状积分均较治疗前下降(P<0.05),且观察组中医症状积分低于对照组(P<0.05)。治疗后,2组上、下肢肌张力Ashworth评分分级均较治疗前改善(P<0.05),且观察组Ashworth评分分级改善优于对照组(P<0.05)。治疗后,2组Fugl-Meyer运动功能评分均较治疗前升高(P<0.05),且观察组Fugl-Meyer运动功能评分高于对照组(P<0.05)。治疗后,2组RANKIN量表评分较治疗前降低(P<0.05),且观察组RANKIN量表评分低于对照组(P<0.05)。治疗后,2组Barthel指数评定量表评分较治疗前升高(P<0.05),且观察组Barthel指数评定量表评分高于对照组(P<0.05)。结论:针刺疗法结合推拿可有效改善中风后痉挛性偏瘫患者的临床症状,改善肢体肌张力与运动功能,提高患者神经功能与生活质量。

Objective:To observe the effect of needling therapy combined with tuina on clinical symptoms,muscular tension of limbs,and quality of life in patients with spastic hemiplegia after stroke.Methods:A total of 80 cases of patientswith spastic hemiplegia after stroke were selected and divided into the control group and the observation group according to the random number table method,40 cases in each group.Both groups were given routine rehabilitation training;the control group was additionally given tuina therapy,and the observation group was additionally given needling based on the treatment of the control group.Both groups were treated for one month.Before and after treatment,Chinese medicine symptom scores,the improvement of muscular tension of limbs evaluated by score of Modified Ashworth Scale,the improvement of motor function evaluated by score of Fugl-Meyer Assessment,recovery of the nerve function evaluated by Modified Rankin Scale,and level of quality of life evaluated by Barthel Index Scoring Scale were compared between the two groups.Results:After treatment,Chinese medicine symptom scores in the two groups were decreased when compared with those before treatment(P<0.05),and the scores in the observation group were lower than those in the control group(P<0.05).After treatment,the scores of Modified Ashworth Scale for evaluating muscular tension of limbs in the two groups were decreased when compared with those before treatment(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).After treatment,the scores of Fugl-Meyer Assessment for evaluating motor function in the two groups were increased when compared with those before treatment(P<0.05),and the score in the observation group was higher than that in the control group(P<0.05).After treatment,the scores of Modified Rankin Scale in the two groups were decreased when compared with those before treatment(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).After treatment,the scores of Barthel Index Scoring Scale in the two groups were increased when compared with those before treatment(P<0.05),and the score in the observation group was higher than that in the control group(P<0.05).Conclusion:For patients with spastic hemiplegia after stroke,the application of needling therapy combined with tuina can effectively relieve their clinical symptoms,improve muscular tension of limbs and motor function,enhance their nerve function,and improve quality of life.