“靳三针”联合康复训练治疗中风后痉挛性偏瘫患者40例临床观察

A Clinical Observation on Jin’s Three-Needle Therapy Combined with Rehabilitation for 40 Cases of Post-Stroke Spastic Hemiplegia

目的观察"靳三针"联合康复训练治疗中风后痉挛性偏瘫的临床效果。方法将120例患者随机分为"靳三针"组、康复组、联合组各40例,在基础治疗之外分别施加"靳三针"治疗、康复训练和联合康复训练治疗,"靳三针"治疗和康复训练每次30min,每日1次;联合组在针刺30min后再行康复训练30min,每日1次。于治疗前、治疗后第7天、第14天记录功能综合评定量表评分(FCA)、临床神经功能缺损程度评分(NDS)、四肢简化Fugl-Meyer评分(FMA)、临床痉挛指数(CSI)评分。治疗结束后评价临床疗效。结果联合组总有效率为90.00%,"靳三针"组为87.50%,康复组为82.50%,"靳三针"组、联合组总有效率均优于康复组(P<0.05)。治疗7天后,"靳三针"组和联合组患者FCA、NDS、FMA评分均较治疗前明显改善(P<0.05);各组患者CSI量表评分均较治疗前明显改善(P<0.05或P<0.01);联合组各项指标改善明显优于"靳三针"组和康复组(P<0.05或P<0.01);"靳三针"组各项指标改善明显优于康复组(P<0.05)。治疗14天后,各组患者各项指标均较治疗前和治疗7天后明显改善(P<0.05或P<0.01),联合组各项指标改善明显优于"靳三针"组和康复组(P<0.01),"靳三针"组各项指标改善明显优于康复组(P<0.05)。结论 "靳三针"联合康复训练治疗中风后痉挛性偏瘫能改善患者痉挛指数及神经缺损症状,疗效优于单纯康复训练。

Objective To observe the therapeutic effect of Jin’s three-needle therapy combined with rehabilitation for post-stroke spastic hemiplegia. Methods Totally 120 patients were randomized into the Jin’s three-needle therapy group, rehabilitation group and combo therapy group, with 40 in each. The Jin’s three-needle therapy group and rehabilitation group was given 30 minutes of Jin’s three-needle therapy or rehabilitation once daily. The combo therapy group was given 30-minute rehabilitation after 30-minute needling once daily. The functional comprehensive assessment （FCA）, neurological deficit score （NDS）, Fugl-Meyer assessment （FMA） and clinical spasms index （CSI） were recorded before and after 7-day and 14-day treatment. The comprehensive efficacy was evaluated after treatment. Results The total effective rate of the combo therapy group, Jin’s three-needle therapy group and rehabilitation group was 90.00%, 87.50% and 82.50% respectively, with no significant difference between the combo therapy group and Jin’s three-needle therapy group （P〈0.05）. There was no significant difference between groups in all indicators （P〈0.05）. The scores of FCA, NDS and FMA were significantly improved in the Jin’s three-needle therapy group and combo therapy group after 7-day treatment （P〈0.05）. The CSI scores were significantly improved in all groups after treatment （P〈0.05 or P〈0.01）. The improvement of all indicators in the combo therapy group was superior to that in other two groups （P〈0.05 or P〈0.01）. The improvement of all indicators in the Jin’s three-needle therapy group was superior to that in the rehabilitation group （P〈0.05）. Comparing with before and after 7-day treatment, the indicators in all groups were significantly improved after 14-day treatment （P〈0.01 or P〈0.05）, especially in the combo therapy group （P〈0.01） and Jin’s three-needle therapy group （P〈0.05）. Conclusion Jin’s three-needle therapy combined with rehabilitation is effective for post-stroke spastic hemiplegia and can relieve the spasm and neurological deficits.