祛风通络方、针刺联合康复训练治疗中风后肌张力增高随机平行对照研究

Randomized Parallel Group Study of Decoction, Increased Muscle Tension Acupuncture Combined with Rehabilitation Therapy after Stroke

[目的]观察祛风通络方、针刺联合康复训练治疗中风后肌张力增高疗效。[方法]使用随机平行对照方法,将90例住院患者按掷骰子法简单随机分为两组。对照组35例康复训练:抑制上肢痉挛、手指屈曲痉挛、下肢痉挛及踝关节背屈训练,包括抗痉挛模式,站位,手膝四点训练;50min/次,1次/d。治疗组55例祛风通络方(白芍60g,木瓜250g,龟板7g,全蝎3g,白花蛇蜕1.5g,萆薢、丝瓜络各15g,川芎6g),1剂/d,水煎200m L,早晚口服。针刺,电体针搭配头针:头针取足远感区、运动区;体针取手少阳经穴位和足太阳经穴位,选阳池、承山、肩髃、外关、承扶、太溪、足三里、阳陵泉、十宣、昆仑、三阴交、委中;以患者耐受为度,留针30min/次,1次/d。康复训练同对照组。连续治疗6d为1疗程。观测临床症状、痉挛程度、不良反应。连续治疗4疗程,疗程间隔1d,判定疗效。[结果]肘关节痉挛程度疗效:治疗组显效10例,有效24例,无效21例,总有效率61.82%。对照组显效1例,有效8例,无效26例,总有效率25.71%。膝关节痉挛程度疗效:治疗组显效21例,有效8例,无效26例,总有效率60.00%。对照组显效2例,有效8例,无效25例,总有效率28.57%。治疗组疗效优于对照组(P<0.05)。相关指标两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]祛风通络方、针刺联合康复训练治疗中风后肌张力增高疗效满意,无副作用,值得推广。

[Objective] To observe the decoction, acupuncture combined with rehabilitation therapy after stroke increased muscle tone effect. [Methods] Randomized parallel-group method using the 90 cases of hospitalized patients were randomly divided into two groups craps method is simple. 35 cases in the control group rehabilitation： suppression of upper limb spasticity, finger flexion spasms, leg cramps and ankle dorsiflexion training, including anti-spasm mode, stations, four hands and knees training; 50 min / times, 1 times / d. Treated 55 cases of decoction（Baishao 60 g, Mugua250 g, Guiban 7g, Quanxie 3g, Baihuashetui 1.5g, Bixie 15 g, Sigualuo 15 g, Chuanxiong 6g）, daily oral administration of 2 times per 300 m L decoction 200 m L, sooner or later orally. Acupuncture, body acupuncture with electric Scalp： Scalp take away a sense of the foot area, sports area; body acupuncture points and take the hand Shaoyang full sun points, the election Yang Chi, Cheng-shan, shoulder Yu, foreign relations, Cheng Fu, Tai chi, the full three years, Yanglingquan, ten declared, Kunlun, Sanyinjiao, Venezuela; the degree of patient tolerance, the needle 30 min / times, 1 times / d. Rehabilitation with the control group. 6d continuous treatment for a course of treatment. Observation of clinical symptoms, spasticity, adverse reactions. 4 continuous treatment course of treatment interval 1d, to determine efficacy. [Results] elbow spasticity effect： treatment group 10 cases, effective 24 cases, 21 cases ineffective, the total efficiency of 61.82%. Group 1 cases markedly effective in 8 cases, 26 cases, the total efficiency of 25.71%. Knee spasticity efficacy： treatment group 21 cases, 8 cases, 26 cases ineffective, the total efficiency of 60.00%. Group 2 cases markedly effective in 8 cases, 25 cases, the total efficiency of 28.57%. Treatment group than in the control group（P〈0.05）. Symptom scores were improved in both groups（P〈0.01）, the treatment group than the control group improved（P〈0.01）. [Conclusion]Decoction, acupuncture combined with rehabilitation after stroke increased muscle tone results were satisfactory, no side effects, it is worth promoting.