运动灸配合反射抑制模式治疗脑卒中后痉挛性瘫痪疗效评价

Therapeutic Evaluation of Moving Moxibustion plus Reflex-inhibiting Pattern for Post-stroke Spastic Paralysis

目的评价运动灸配合反射抑制模式对脑卒中后痉挛性瘫痪患者肌张力的改善作用。方法纳入合格受试者90例,采用随机数字表法,随机分成3组,试验组(A组,30例)采用运动灸配合反射抑制模式治疗;对照组(B组,30例)采用运动灸治疗;对照组(C组,30例)采用反射抑制模式治疗。观察指标为改良Ashworth评分、临床神经功能缺损评分(NDS)及日常生活能力量表(ADL)。结果 3组治疗结束后及随访期间,组间NDS评分、ADL评分比较差异均有统计学意义(P<0.05);3组治疗后各关节均有所改善,但是A组肘关节、膝关节改善均优于B组和C组。各组急性期总有效例数最高,其次为恢复期,后遗症期;A组急性期总有效例数远高于B组、C组,恢复期和后遗症期例数差别不大。结论运动灸配合反射抑制模式对改善脑卒中痉挛性瘫痪的神经功能缺损程度、日常生活能力方面均优于单一疗法,而且对急性期患者效果更为明显。

Objective To evaluate the effect of moving moxibustion plus reflex-inhibiting pattern （RIP） in improving the muscle tone of patients with post-stroke spastic paralysis.Method Ninety eligible subjects were randomized into 3 groups by the random number table：the experiment group （group A,30 cases） was intervened by using moving moxibustion plus RIP; the control group （group B,30 cases） was intervened by moving moxibustion; another control group （group C,30 cases） was by RIP.The adopted observation indexes were Modified Ashworth Scale,neurological defect score （NDS）,and Activities of Daily Living （ADL）.Result After intervention and during the follow-up study,the inter-group comparisons of NDS and ADL showed significant differences among the three groups （P＜0.05）; the joints＇ functions were improved in all three groups after intervention,while the improvements of elbow and knee functions in group A were more significant than those in group B and C.The acute stage ranked top in comparing the number of effective case,followed by recovery stage and sequelae stage; in comparing the effective case number of acute stage,group A was higher than group B and C,while there were no big differences in comparing the effective case numbers of recovery stage and sequelae stage.Conclusion Combining use of moving moxibustion and RIP is better than use of these two methods independently in improving neurological defect degree and ADL,and has a more significant efficacy for patients of acute stage.