颞三针配合挛三针治疗中风后痉挛性偏瘫疗效观察

Efficacy observation on post-stroke spastic hemiplegia treated with temporal three-needle and spastic three-needle therapy

目的:观察颞三针配合挛三针、康复治疗以及联合应用对中风后痉挛性偏瘫疗效的影响。方法:将100例患者随机分为靳三针组(35例)、康复组(33例)、联合组(32例),在常规药物治疗基础上分别予颞三针合挛三针针刺治疗、康复训练以及针刺结合康复训练的联合治疗,分别在治疗前、治疗7天和治疗14天后采用功能综合评定量表(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)评分对患者痉挛程度、肢体功能进行评定。结果:在FCA、NDS、FMA量表评分方面,治疗7天后,除康复组外,其他两组均较治疗前改善(均P<0.05),靳三针组、联合组优于康复组(均P<0.05);治疗14天后,3组均较治疗前、治疗7天后改善(P<0.05,P<0.01),联合组优于其他两组(均P<0.05)。在CSI评分方面,治疗7天后,3组较治疗前均显著改善(P<0.05,P<0.01),且联合组优于其他两组(均P<0.05);治疗14天后,3组CSI评分进一步改善,但组间差异无统计学意义(均P>0.05)。结论:靳三针、康复训练及其联合应用均可缓解中风后痉挛性偏瘫症状,靳三针组和联合组在治疗7天后即显示出效果,优于康复组;对痉挛程度的改善,联合应用效果最优。

Objective To observe the impacts on post-stroke spastic hemiplegia treated with temporal three-needle therapy, spastic three-needle therapy, and rehabilitative therapy as well as combined application. Methods One hundred cases were randomized into a Jin;s three-needle group （35 cases）, a rehabilitation group （33 cases） and a combined therapy group （32 cases）. Beside the basic treatment, the acupuncture therapy of temporal three-needle and spastic three-needle techniques, rehabilitation training, and the combined therapy of acupuncture and rehabilitation were applied in the Jin;s three-needle group, the rehabilitation group and the combined therapy group, respectively. Before treatment, in 7 days and 14 days of treatment, the functional comprehensive assessment scale （FCA）, clinical neurological defect score （NDS）, four-limb simplified Fugl-Meyer assessment （FMA） and clinical spasm index （CSI） were adopted to assess the spastic degree and limb function, respectively. Results In terms of FCA, NDS and FMA, in 7 days of treatment, except the rehabilitation group, the results in the other two groups were all improved as compared with those before treatment （all P;0.05）. The results in the Jin＇s three-needle group and the combined therapy group were better than those in the rehabilitation group （all P;0.05）. In 14 days of treatment, the results in the three groups were improved as compared with those before treatment and in 7 days of treatment （P〈0.05, P〈0.01）. The results in the combined therapy group were better than those in the other two groups （all P〈0. 05）. Regarding CSI assessment, in 7 days of treatment, the re- suits of the three groups were all improved significantly as compared with those before treatment （P〈0.05, P〈0.01）, and the results in the combined therapy group were better than those in the other two groups （all P〈0.05）. In 14 days of treatment, CSI scores were further improved in the three groups, but the difference was not significant in comparison （all P;0.05）. Conclusion The Jin＇s three-needle therapy, rehabilitation therapy and the combined application all relieve the symptoms of post-stroke spastic hemiplegia. The effect in the Jin;s three-needle group and the combined therapy group is achieved in 7 days of treatment, which is better than that in the rehabilitation group. The combined therapy a- chieves the best effect on spasm in comparison with the single therapy.