等力测时法对肢体痉挛的评估与经筋刺法针灸治疗肢体痉挛(英文)

Evaluation with isodynamic time-measuring method and acupuncture tre atment with muscle-region needling for limb spasm

背景:针灸治疗偏瘫的痉挛状态疗效明显差于治疗弛缓状态,究其原因,主要忽视了对两种状态治疗差异的理解。目的:探讨有关肢体痉挛状态有效的针灸疗法及效果评定方法。设计:随机对照研究。单位:湖南中医学院针灸推拿系,湖南中医学院附属第一医院针灸科。对象:2002-01/2003-12湖南中医学院第一附属医院针灸科病房住院的肢体痉挛患者72例,分为治疗组40例,对照组32例。方法:治疗组:自拟经筋刺法治疗40例。对照组:独取阳明法治疗32例。采用康复医学SIAS法,Ashworth法及自拟等力测时法对痉挛状态的肢体进行功能康复评定。主要观察指标:①SIAS积分变化。②两组疗效比较。③两组痉挛状态Ashworth分析比较。④两组患者等力测时法量化评定痉挛状态比较。结果:根据康复评定的结果,其中SIAS积分治疗组治疗前后分别为(6.79±3.58),(11.68±3.24)分,对照组分别为(6.68±3.36),(8.97±3.48)分,差异有显著性意义P<0.01),治疗组痊愈、显效、有效、无(效的例数分别为10,23,5,2例,对照组则分别为4,8,16,4例,两组相比差异有显著性意义(P<0.01)。两组痉挛状态Ashworth分析及等力测时法量化评定痉挛状态比较也有统计学意义。结论:①研究证实了经筋刺法治疗肢体痉挛状态疗效确实。

BACKGROUND:Acupuncture treatment for hemiplegia spasticity is remarkably worse than that for flaccidity,which roots from the neglect of the recognition of dif ferences in treatments of two states. OBJECTIVE:To probe into relevant effective acupuncture therapy and evaluation method of therapeutic results for limb spasticity. DESIGN:A randomized and controlled trial. SETTING:Department of Acupuncture Moxibustion and Massage of Hunan College of Chinese Medicine and Department of Acupuncture Moxibustion of First Affiliated Hospital of Hunan College of Chinese Medicine. PARTICIPANTS:A total of 72 inpatients of limb spasm were collected from the wa rd of Department of Acupuncture Moxibustion of First Affiliated Hospital of Hun an College of Chinese Medicine from January 2002 to December 2003, which was div ided into treatment group(40 patients) and control group(32 patients). METHODS:In treatment group, 40 patients were treated by the self designed nee dling method on muscle region.In the control,32 patients were treated with the p oints only from Yangming meridians.Evaluation of functional rehabilitation for s pasticity of limbs was carried on with SIAS methods,Ashworth methods and self d esigned isodynamic time measuring methods. MAIN OUTCOME MEASURES:①Changes of stroke infarction assessment score(SIAS) in tegral;②Changes in therapeutic effects in two groups;③Comparison of spasticity with Ashworth analysis in two groups;④Comparison of quantitative evaluation on spasticity with isodynamic time measuring method in two groups. RESULTS:According to the results of rehabilitation evaluation, SIAS integrals were(6.79±3.58),(11.68±3.24) before and after treatment respectively in treatm ent group,were(6.68±3.36),(8.97±3.48) respectively in the control,indicating s ignificant difference(P< 0.01).Patients of curing, remarkable effect, being effe ctive and no effect in treatment group were 10,23,5 and 5 successively in treatm ent group,were 4,8,16 and 4 successively in the control,indicating significant d ifferences by the comparison of two groups(P< 0.01).The statistical significance also presented in the comparisons of Ashworth analysis and quantitative evaluat ion with isodynamic time measuring method on spasticity in two groups. CONCLUSION:①The research verified the definite therapeutic effects of needlin g method on muscle region on limb spasticity.②Relevant quantitative evaluation methods for spasticity were proposed forward,named as isodynamic time measuring method.