针刺联合康复训练治疗脑卒中后偏瘫的回顾性研究

A Retrospective Study of Acupuncture Combined with Rehabilitation Training in the Treatment of Post-stroke Hemiplegia

【目的】分析针刺联合康复训练治疗脑卒中后偏瘫的临床疗效。【方法】采用回顾性研究方法,选取2021年1月至2023年1月在海口市人民医院中南大学湘雅海口医院就诊的121例脑卒中后偏瘫的患者,根据是否进行针刺治疗分为对照组和针刺组,对照组59例给予常规的康复训练方法治疗,针刺组62例在常规康复治疗的基础上增加针刺治疗,疗程均为1个月。观察2组患者治疗前后的中医证候积分的变化情况,以及脑血管阻力值包括颈动脉平均血流量(Qmean)、平均血流速度(Vmean)、脑血管床特性阻抗(Zc)、血管外周阻力(R)的情况,比较2组患者治疗前后卒中影响量表(SIS)、神经功能缺损程度量表(CSS)以及Fug-Meyer运动功能量表(FMA)评分的变化情况,并评价2组患者的临床疗效。【结果】(1)针刺组总有效率为93.55%(58/62),对照组为79.66%(47/59)。针刺组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的各项中医证候积分及总积分均明显改善(P<0.05),且针刺组在改善中医证候积分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的脑循环动力学参数均明显改善(P<0.05),且针刺组在改善脑循环动力学参数方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的SIS、CSS、FMA评分均明显改善(P<0.05),且针刺组在改善SIS、CSS、FMA评分方面明显优于对照组,差异均有统计学意义(P<0.05)。【结论】针刺治疗脑卒中后偏瘫疗效显著,其疗效优于单纯常规康复训练。

Objective To analyze the clinical efficacy of acupuncture combined with rehabilitation training in the treatment of post-stroke hemiplegia.Methods A retrospective study was conducted to select 121 cases of poststroke hemiplegia patients who attended Haikou People’s Hospital,Haikou Affiliated Hospital of Central South University Xiangya School of Medicine from January 2021 to January 2023,and were divided into the control group and the acupuncture group according to whether acupuncture treatment was performed or not;59 cases in the control group were given conventional rehabilitation training methods of treatment,and 62 cases in the acupuncture group were added with acupuncture treatment on the basis of the conventional rehabilitation treatment.The course of treatment was 1 month.The changes in the traditional Chinese medicine(TCM)syndrome scores of the patients in the two groups were observed before and after treatment,as well as the cerebrovascular resistance values,including carotid artery mean blood flow(Qmean),mean velocity(Vmean),cerebrovascular bed characteristic impedance(Zc),and peripheral vascular resistance(R),and the changes in the Stroke Impact Scale(SIS),China Stroke Scale(CSS),and Fugl-Meyer Assessment(FMA)in the patients in the two groups were observed before and after treatment,and the clinical efficacy of the two groups was evaluated.Results(1)The total effective rate was 93.55%(58/62)in the acupuncture group and 79.66%(47/59)in the control group.The efficacy of the acupuncture group was superior to that of the control group,and the difference was statistically significant(P<0.05).(2)After treatment,all TCM syndrome scores and total scores of patients in the two groups were significantly improved(P<0.05),and the acupuncture group was significantly superior to the control group in improving TCM syndrome scores,with statistically significant differences(P<0.05).(3)After treatment,the cerebral circulatory kinetic parameters of the patients in the two groups were significantly improved(P<0.05),and the acupuncture group was significantly superior to the control group in improving the cerebral circulatory kinetic parameters,with a statistically significant difference(P<0.05).(4)After treatment,the SIS,CSS,and FMA scores of patients in the two groups were significantly improved(P<0.05),and the acupuncture group was significantly superior to the control group in improving the SIS,CSS,and FMA scores,and the differences were all statistically significant(P<0.05).Conclusion The efficacy of acupuncture in the treatment of post-stroke hemiplegia is remarkable,and its efficacy is better than that of simple conventional rehabilitation training.