针刺拮抗肌穴位治疗脑卒中后下肢痉挛临床观察

Clinical observation of needling antagonistic muscle acupoints against spasm of lower limbs after cerebral apoplexy

目的观察针刺拮抗肌穴位联合康复训练等治疗脑卒中后下肢痉挛的临床疗效。方法将80例脑卒中后下肢痉挛患者随机分成治疗组和对照组,每组40例。两组均予神经内科常规西药、头针及康复训练,对照组加用传统针刺治疗,治疗组加用针刺拮抗肌穴位治疗。两组疗程均为34天,观察临床疗效,并比较改良Ashworth痉挛等级(MAS)、下肢功能积分(FMA)及日常活动能力指数(Barthel)的变化情况。结果 1治疗组、对照组临床总有效率分别为82.50%和70.00%;组间临床疗效比较,差异有统计学意义(P<0.05)。2治疗前后组内比较,两组MAS等级、FMA积分及Barthel指数差异均有统计学意义(P<0.05);组间治疗后比较,MAS等级、FMA积分及Barthel指数差异有统计学意义(P<0.05)。结论针刺拮抗肌穴位联合康复训练等治疗脑卒中后下肢痉挛可明显缓解患者下肢痉挛,增强下肢活动能力。

Objective To observe the clinical efficacy of needling the antagonistic muscle acupoints and joint rehabilitation training for spasm of lower limbs after cerebral apoplexy. Methods Eighty cases with lower limbs spasm after cerebral apoplexy were randomly divided into treatment group and control group,with 40 cases in each group. Both groups were treated with conventional western medicine,scalp acupuncture and rehabilitation training. Control group was added with traditional acupuncture,and treatment group was added with needling the antagonistic muscle acupoints therapy,with the course of 34 days. The clinical efficacy was observed and spasm of modified Ashworth rating（ MAS）,FMA and Barthel index were compared. Results 1 The overall effective rate was 82. 50% in the treatment group and 70. 00% in the control group,with a difference between the two groups（ P 〈 0. 05）. 2 In each group,there were significant differences in MAS,FMA and Barthel index between before and after treatment（ P 〈 0. 05）; after treatment,there were significant differences in MAS,FMA and Barthel index between the two groups（ P 〈 0. 05）. Conclusion Combined needling antagonistic muscle acupoints and rehabilitation training can relieve spasm of lower limbs and enhance the mobility in patients with lower limbs spasm after cerebral apoplexy.