经皮穴位电刺激对脑卒中患者偏瘫下肢运动功能的影响

Effect of transcutaneous accupoint electrical stimulation on motor function recovery of the lower extremity of stroke patients

目的探讨经皮穴位电刺激对脑卒中偏瘫患者下肢功能的影响。方法 41例脑卒中患者随机分为TAES组和安慰刺激组,分别为21例和20例。两组常规治疗相同。TAES组采用KD-2A型经皮神经电刺激治疗仪治疗,刺激部位选择患侧下肢的4个穴位(足三里ST 36、太冲LV 13、阳陵泉GB 34、昆仑BI 60),频率100 Hz,脉宽0.2 ms,强度为患者最大耐受强度为限;安慰刺激组接受治疗的部位时间和疗程与TAES组相同,但每次治疗时没有电流输出。治疗前、治疗2周、治疗3周分别用综合痉挛量表(CSS)评定踝关节痉挛,Fugl-Meyer运动评定量表中下肢部分(FMA)评定下肢运动功能,Berg平衡量表(BBS)评定平衡功能。结果组内比较:治疗2周和治疗3周后与治疗前比较两组CSS、FMA下肢部分、BBS评分差异有统计学意义(P<0.05);组间比较:治疗2周和3周后,TAES组CSS、FMA、BBS评分优于安慰刺激组,差异有统计学意义(P<0.05)。结论 TAES治疗能减轻脑卒中患者偏瘫下肢痉挛程度和提高平衡功能,改善下肢运动能力。

Objective To investigate the effect of transcutaneous accupoint electrical stimulation （TAES） in enhancing motor and functional recovery of the lower extremity in subjects with stroke. Methods 41 subjects with first stroke were randomly assigned into 2 groups： TAES group and placebo stimulation group. All subjects received the same standard rehabilitation. In the TAES group. Model KD-2A stimulator was applied with 0. 2 ms pulses, at 100 Hz within the subject＇s tolerance level on the 4 acupuncture points （ST 36, LV 3, GB 34, and B1 60） in the affected lower legs for 60 rain, 5 days a week tbr 3 weeks; The time and the course of treatment of the placebo stimulation group was as well as the TAES group＇s, but no c, urrent output for each treatment. All subjects in the 2 groups received standard rehabilitation program. Measurements including composite spastieity score （CSS） for the spastieity of the ankle planter flexors, Fugl-Meyer motor assessment （FMA） for the lower extremity, and Berg Balance Scale （BBS） for balance were recorded before treatment, after 2 and 3 weeks＇ treatment. Results After 2 and 3 weeks of treatment, the CSS score in the TAES group was significantly lower than the placebo stimulation group （ P 〈 0. 05 ） and the FMA score and BBS score in the TAES group was significantly higher than the placebo stimulation group （ P 〈 0. 05 ） . Conclusion Transcutaneous aceupoint electrical stimulation significantly decreased ankle plantar flexor spastieity and improve motor function of the affected lower extremity.