手指点穴对脑卒中患者上肢痉挛及功能恢复的疗效观察

Finger-pressing therapy in the treatment of upper extremity spasticity

目的 观察手指点穴结合常规康复治疗对脑卒患者上肢痉挛及功能恢复的疗效.方法 将60例脑卒中患者按随机数字表法分为实验组和对照组,每组30例.2组患者均给予常规药物对症治疗,且未给予抗痉挛的药物;在此基础上,实验组给予常规康复治疗结合手指点穴治疗,对照组仅给予单纯常规康复治疗.实验组在第1次手指点穴结束后,采用Fugl-Meyer运动功能上肢部分（FMA）评分及肱二头肌、桡侧腕屈肌表面肌电的平均积分肌电值（iEMG）测试,观察手指点穴的即刻效应.且在治疗1个月后,2组再分别进行上述指标的测试,观察手指点穴的持续疗效.结果 第1次手指点穴后,实验组FMA评分（12.63±4.64）高于组内治疗前（12.13±4.88）（P＜0.05）,肱二头肌iEMG（41.64±9.22）、桡侧腕屈肌iEMG（37.06±7.02）均低于组内治疗前（43.67±9.56）、（39.17±7.56）（P＜0.01）.治疗1个月后,两组间比较,实验组FMA评分（25.17±5.93）、肱二头肌iEMG（34.42±7.55）、桡侧腕屈肌iEMG（30.63±5.54）改善程度大于对照组（P＜0.01）.结论 手指点穴改善脑卒中患者上肢痉挛的即刻效应较好;手指点穴结合常规康复治疗可有效降低脑卒中患者上肢痉挛,明显改善患者上肢运动功能,效果要优于单纯的常规康复治疗.

Objective To observe the effect of finger-pressing combined with conventional rehabilitation therapy on the recovery of upper limb function after stroke.Methods A total of 60 cerebral stroke patients were randomly divided into an experimental group （n =30） and a control group （n =30）.All patients were treated with conventional anti-symptomatic drugs but no anti-spasticity ones.The experimental group was given conventional rehabilitation and finger-pressing therapy,while the control group was given conventional rehabilitation only.Both groups were measured the motor function,using the upper-extremity portion of the Fugl-Meyer Scale,and the mean integrated electromyography （iEMG） output of biceps and flexor carpi radialis after the first finger-pressing treatment and 1 month later,so as to observe the immediate and continuous effects of finger-pressing therapy respectively.Results After the first session of finger-pressing therapy,the average Fugl-Meyer score（FMA） （12.63 ± 4.64） of the experimental group was significantly higher than in a pretest （12.13 ± 4.88） （P 〈 0.05）,while the iEMG of biceps （41.64 ± 9.22） and flexor carpi radialis （37.06 ± 7.02） were lower than before （P 〈 0.01）.One month after the treatment,compared with the control group,the average FMA （25.17 ± 5.93） and iEMG of biceps（34.42 ± 7.55） and flexor carpi radialis sEMG（30.63 ± 5.54） in the experimental group were significantly improved （P 〈 0.01）.Conclusions Finger-pressing therapy has significant and immediate effects in improving the upper extremity spasticity of stroke survivors.Combined with conventional rehabilitation therapy it can effectively reduce the upper extremity spasticity in stroke patients and significantly improve the upper extremity function.The combination is superior to conventional rehabilitation alone.