颈腰夹脊刺配合温针灸治疗脑卒中后肌张力增高96例临床观察

Clinical Observation on Cervical and Lumbar Jiaji Point Acupuncture Combined with Warm Needling for 96 Cases of Musclar Hypertonia after Stroke

目的观察颈腰夹脊刺配合温针灸治疗脑卒中后肌张力增高的临床疗效。方法将192例脑卒中后肌张力增高患者随机分为治疗组和对照组各96例,均采用体针针刺治疗,治疗组加用颈腰夹脊刺配温针灸,两组均每日1次,14次为1个疗程,治疗2个疗程后采用改良Ashworth痉挛量表、Fugl-Meyer运动功能评分、Barthel评分以及经颅多普勒超声检测评定临床疗效。结果治疗组治疗后改良Ashworth痉挛量表评分、Fugl-Meyer运动功能评分、Barthel评分均明显优于对照组(P<0.05)。与对照组治疗后比较,治疗组左椎动脉舒张末期流速(EDV)、右椎动脉EDV、右基底动脉收缩期峰值流速、左椎动脉血管搏动指数(PI)、右椎动脉PI差异均有统计学意义(P<0.05)。结论颈腰夹脊刺配合温针灸治疗可改善瘫痪肢体的肌肉痉挛状态,改善椎-基底动脉系统供血,在降低中风后的致残率、提高患者的生活质量方面疗效可靠。

Objective To observe the therapeutic effect of cervical and lumbar Jiaji point acupuncture combined with warm needling on musclar hypertonia after stroke. Methods Totally 192 cases of muselar hypertonia after stroke were randomized into treatment group and control group with 96 in each. Both groups were given body needling. The treatment group was added cervical and lumbar Jiaji point acupuncture combined with warm needling. Both groups were treated once daily. One treatment course lasted for 14 days. After two treatment courses, the therapeutic effect was observed with Modified Ashworth Scale （MAS）, Fugl-Meyer Motor Scale （FM） , Barthel Index （BI） and Transcranial Doppler （TCD）. Results There were signifi- cant differences in MAS, FM and BI between groups （P〈0.05）. There were significant differences in end-diastolic velocity （EDV） of left vertebral artery （LVA） and right vertebral artery （RVA）, peak-systolic velocity （PSV） of right basilar artery （RBA） and pulsatility index （PI） of LVA and RVA between groups （P〈0.05）. Conclusion Cervical and lumbar Jiaji point acupuncture combined with warm needling for musclar hypertonia after stroke is effective in relieving musclar spasm of affected limbs, improving blood supply of vertebral basilar artery, reducing disability rate after stroke and improving quality of life.