六步法中医导引术治疗偏瘫足下垂的临床研究

The mechanism and clinical effectiveness of six-step procedure of Daoyin on hemiplegic foot-drop

目的:改良古老中医导引术,简化其操作、提高其对偏瘫足下垂的治疗效果。方法:将以调神,调息为基本技术的按照传统中医导引术按照现代医学理论,改良为运动想象和模拟、精力调集、确定目标点、击发、坚持和放松六个步骤。选取脑卒中偏瘫足下垂患者60例,随机分为六步法组和对照组,治疗前后分别进行Fugl-Meyer评分(FMS)、Lovett徒手肌力检查(MMT)、主动关节活动度(AROM)和肌电信号强度(EMG)等功能评定,结果进行统计学分析。结果:两组各项指标间均有显著性差异(P<0.01),六步法组疗效明显优于对照组疗效训练后数据:MMT:六步法组:3.62±1.21,对照组:2.13±1.01;胫前肌EMG:六步法组:87.31±23.66μV,对照组:43.18±8.36μV;AROM:六步法组:18.43±2.68°,对照组:13.47±4.36°;胫前肌FMS:六步法组:1.7±0.47,对照组:0.7±0.47。结论:六步法中医导引术是康复卒中偏瘫足下垂的有效方法。

Objective：To modify the ancient Daoyin technique to improve its＇ effect on hemiplegic foot-drop and simplifying it＇s operation procedure. Method：Based on the ancient Daoyin technique, six-step procedure was developed including motion imagining and imitating, mental and breathing regulating, target point determining, motion percussing, persisting and relaxing. Sixty patients with hemiplegic foot-drop after stroke were divided into six-step group and control group randomly. The functional evaluations including Fugl-Meyer scores （FMS）, Lovett manual muycle test（MMT）, active range of motion（AROM） and electromyography（EMG） test were administered before and after treatment. Result：The differences between two groups were significant. The effectiveness in six-step group was significantly better than that in control group. The data after training were as follows： MMT：six-step group： 3.62±1.21, control group：2.13±1.01; EMG of anterior tibial muscle：six-step group：87.31±23.66μV, control group： 43.18±8.36μV; AROM：six-step group：18.43±2.68°, control group：13.47±4.36°; FMS： six-step group：1.7±0.47, control group：0.7±0.47. Conclusion：The six-step procedure of Daoyin （Chinese physical and breathing exercises） is an effective training technique for foot-drop in hemiplegic patient after stroke.