以静态平衡为主评估针刺治疗缺血性中风恢复期临床疗效

Clinical Study on the Evaluation of Acupuncture in Treating Ischemic Stroke of Recovery Stage Mostly Based on Static Equilibrium

目的通过对针刺治疗前后缺血性中风恢复期患者经静态平衡仪检测的变化观察,研究针刺治疗缺血性中风的临床疗效。方法将60例缺血性中风恢复期患者随机分为两组,药物组30例用常规药物治疗,针药组30例在常规药物治疗基础上施以针刺治疗。治疗20 d后比较两组疗效、神经功能缺损评分、Barthel指数、血脂指标、FM-B平衡功能评分;并对58例患者进行静态平衡仪检测,比较治疗前后左右下肢负荷比例偏差,重心标准偏差,目标达成率,恢复平均时间。结果两组治疗后神经功能缺损评分改善明显(P<0.001),针药组较药物组改善更明显(P<0.05)。两组治疗前后Barthel指数均有显著性差异(P<0.001),针药组更显著(P<0.05)。针药组治疗前后血脂各指标无统计学差异(P>0.05)。静态平衡仪显示针药组治疗前后各指标均有显著性差异(P<0.05),而药物组治疗前后左右下肢负荷比例偏差、重心标准偏差、目标达成率有显著性差异(P<0.05),睁眼时的恢复平均时间有显著性差异(P<0.05),闭眼时的恢复平均时间无显著性差异(P>0.05)。两组组间比较双下肢负荷比例偏差与重心标准偏差均有显著性差异(P<0.05)。两组治疗后FM-B评分改善明显(P<0.001),针药组改善优于药物组(P<0.001)。静态平衡仪所观察各指标除了治疗前双下肢负荷比例偏差睁闭眼有显著性差异(P<0.05),余指标在睁眼与闭眼时无显著性差异(P>0.05)。结论针药组患者神经功能缺损评分、Barthel指数、FM-B评分的改善较药物组明显,针刺介入可显著降低中风患者的致残率,提高生活质量。针刺治疗可改善缺血性中风恢复期患者的平衡功能。

Objective By observing the ischemic stroke patients of recovery stage by the static equilibrium detector before and after acupuncture treatment, to study the clinical efficacy of acupuncture in treating ischemic stroke. Method Sixty ischemic stroke patients of recovery stage were randomized into two groups. Thirty subjects in the medication group were intervened by conventional medication, while the other 30 subjects in the acupuncture-medication group were by acupuncture in addition to the conventional medication. After 20-day treatment, the therapeutic efficacies, neurological deficit scores, Barthel Index（BI）, blood lipid index, balance subscale of the Fugl-Meyer test（FM-B） scores were compared; 58 subjects were undergone the test by the static equilibrium detector： the deviation of the loads of bilateral lower limbs, deviation of the center of gravity, achievement rate, and the recovery time were compared before and after treatment. Result The neurological deficit scores were improved significantly after treatment in both groups（P 0.001）, and the improvement in the acupuncture-medication group was better than that in the medication group（P0.05）. The BI scores were changed significantly after treatment in both groups（P0.001）, and the change was more remarkable in the acupuncture-medication group（P0.05）. The change of blood lipid index was insignificant in the acupuncture-medication group（P0.05）. By the static equilibrium detector, the parameters were changed significantly after treatment in the acupuncture- medication group（P0.05）; in the medication group, the deviation of the loads of bilateral lower limbs, deviation of the center of gravity, and achievement rate were changed significantly after treatment（P0.05）, and the mean recovery time of opening eyes was changed significantly（P0.05） but the recovery time of closing eyes was changed insignificant（P0.05）. The inter-group comparisons of the deviation of the loads of bilateral lower limbs and deviation of the center of gravity showed significant differences（P0.05）. The FM-B scores were changed significantly after treatment in both groups（P0.001）, and the improvement in the acupuncture-medication group was better than that in the medication group（P0.001）. There were significant differences in comparing the deviations of the loads of lower limbs of both opening eyes and closing eyes between the two groups（P0.05）, but the differences in the other parameters by the equilibrium detector were statistically insignificant between the two groups（P0.05）. Conclusion The improvements of the neurological deficit score, BI score, FM-B score in the acupuncture-medication group were more significant than those in the medication group. Acupuncture can significantly reduce the disability rate and enhance the quality of life of the stroke patients. Acupuncture can improve the balance function of the ischemic stroke patients of recovery stage.