针刺解痉调气法治疗脑卒中痉挛期患者疗效观察

Clinical Efficacy of Spasmolytic Acupuncture Therapy for Patients in Convulsive Stage of Apoplectic Sequelae

目的观察改良的针刺疗法(针刺解痉调气法)治疗疗效。方法将98例脑卒中痉挛期患者随机分为两组。治疗组50人,取肩髃、肩髎、尺泽、天井、合谷、极泉、后溪、三阴交、血海、解溪、足三里、委中穴,头针患侧对应运动区;手法为行浅刺多捻,针前注重押手的作用,在施术部位切按重压,快速进针,深度约0.5～1.0寸,行小幅提插捻转,得气后留针30min。对照组48人,康复训练采用常规Bobath康复训练手法进行治疗;1次/d,40min/次。5次/周,15次为一疗程。完成2个疗程后做疗效评价。结果治疗组总有效率为70%,对照组总有效率为52.08%;两组患者治疗后均有明显改变(P<0.05),治疗组疗效明显优于对照组(P<0.05)。结论针灸解痉调气法能有效缓解脑卒中痉挛期症状,值得临床推广。

Objective To evaluate the clinical efficacy of spasmolytic acupuncture therapy for patients in convulsive stage of apoplectic sequelae.Methods 98 patients with post-stroke spasticity were randomly divided into 2 groups.Treatment group（50 cases）received prescription acupoints：Jianyu（LI15）,Jianliao（TE14）,Chize（LU5）,Tianjing（TE10）,Hegu（LI4）,Jiquan（HT1）,Houxi（SI3）,Sanyinjiao（SP6）,Xuehai（SP10）,Jiexi（ST41）,Zusanli（ST36）,Weizhong（BL39）;Scalp acupuncture ipsilateral side corresponds to motor zone.Manipulation：using horizontal and shallow insertion,paying attentions to the role of the pressing hand before insertion,giving hard press beside the operation area,insert the needles quickly with a depth of about 0.5-1 inches,following slight thrusting and lifting with rotation,retaining for 30 minutes after qi is obtained.Control group（48 cases）received rehabilitation training using conventional Bobath approach;once a day,40 minutes per time,5 times per week,15 times as a course of treatment.Results The total effective rate was 92.0% in the treatment group,and 87.5% in the control group;both groups were significantly improved after treatment（P〈0.05）,while the treatment group was significantly better than the control group（P〈0.05）.Conclusion Acupuncture relieving muscular spasm and regulating-qi technique can effectively ease the symptoms of the post-stroke spasticity,and worthy to be popularized in clinic.