电针大腿前后肌群穴位配合等速训练治疗中风后下肢功能障碍的临床研究

Clinical Study of Electroacupuncture on Acupoints Located Along Anterior and Posterior Thigh Muscles Plus Isokinetic Muscle Strength Training in Treating Poststroke Lower Limb Dysfunction

【目的】观察电针大腿前后肌群穴位配合等速训练治疗中风后下肢功能障碍的临床疗效。【方法】将52例符合纳入标准的轻度偏瘫患者随机分为对照A组17例、对照B组17例和试验组18例。对照A组给予常规康复训练治疗,对照B组在常规康复训练中增加带有视觉反馈和任务导向的膝关节力量和协调性等速训练,试验组在常规康复训练及等速运动训练基础上加用电针大腿前后肌群穴位。3组患者均每天治疗1次,每周5 d,共治疗3周。评估3组患者治疗前后下肢活动能力、膝关节屈伸肌群峰力矩(peak torque,PT)、步速和步态对称性的变化。【结果】治疗3周后,3组下肢活动能力、PT及步态对称性等均得到显著改善(P<0.05);组间比较,除试验组与对照B组的步速、下肢肌张力比较差异无统计学意义(P>0.05)外,对照B组的各项指标改善均优于对照A组,试验组的各项指标改善均优于对照A组和对照B组(P<0.05)。【结论】电针大腿前后肌群穴位配合等速训练治疗中风后下肢功能障碍比普通的等速训练更能有效地提高下肢功能。

Objective To observe the therapeutic effect of electroacupuncture（EA） on acupoints located along anterior and posterior thigh muscles plus isokinetic muscle strength training for poststroke lower limb dysfunction.Methods Fifty-two qualified mild hemiplegia cases were randomized into control group A（N =17）, control group B（N=17）, and observation group（N=18）. Control group A was given conventional rehabilitation training,control group B was given conventional rehabilitation training and task-targeting knee strength-coordination isokinetic muscle strength training based on visual feedback, and observation group was given EA on acupoints located along anterior and posterior thigh muscles plus the treatment for control group B. The treatment for the three groups was performed once a day, five days a week, lasting 3 weeks. Before and after treatment, the lower limb motor function, peak torque（PT） of knee flexion and extension muscles, and gait speed and gait symmetry were monitored. Results After treatment for 3 weeks, the lower limb motor function, PT and gait symmetry were much improved in the three groups（P〈0.05 compared with those before treatment）. Except that the gait speed and lower limb muscle tension of observation group did not differ from those of control group B（P〉0.05）, the improvement of observation indexes of control group B was superior to that of control group A,and the improvement of observation indexes of observation group was more obvious than that of the two control groups（P〈0.05）. Conclusion EA on acupoints located along anterior and posterior thigh muscles plus isokinetic muscle strength training is more effective for improving lower limb motor function of poststroke lower limb dysfunction patients than conventional isokinetic training.