缪刺健侧合谷-血海联合肢体活动治疗脑卒中偏瘫44例临床观察

The Contralateral Hegu Needling Acupuncture combined with Blood-limbs in Treating Stroke Hemiplegia Clinical Observation of 44 Cases

[目的]观察缪刺健侧合谷-血海联合肢体活动治疗脑卒中偏瘫疗效。[方法]使用前瞻性设计方法,44例住院患者缪刺,嘱患者放松,直刺健侧合谷、血海（左上肢瘫痪-取右下血海,左下肢瘫痪-取右上合谷）,均进针0.5~1寸,平泻,得气后根据患者性格特点,以命令（或鼓励、或暗示）语气指导患者运动：针合谷同时辅助患者抬起右下肢,针血海同时辅助抬起右上肢,活动改善后,令活动偏瘫侧各关节,上肢重点锻炼关节背伸,下肢锻炼屈曲,反复10次,针刺时让家属协助偏瘫肢缓慢屈伸活动;酌情增加其他穴位并留针,偏瘫侧曲池、足三里、偏瘫穴（健侧率谷）酌选二三,泻法,得气后留针15~20min,加电针;退出其他针,留健侧合谷、血海,按上述手法操作,使患肢如此活动,3次左右即可;直接退针,以棉签按摩健侧合谷及血海,活动患侧,做康复锻炼,以病情需要及不疲劳为度,可不定时、定量。1次/d,或隔日1次。连续治疗3次为1疗程。观测临床症状、肌力、疗效指数、不良反应。连续治疗2疗程,判定疗效。[结果]首次针刺基本恢复率100%,合作良好及意志坚强者首次疗效及预后相对更好。1次治疗,效果满意出院13例;肌力提高1级2例,提高2级11例,提高3级16例,提高4级2例。1次针刺后肌力维持在改善后水平28例。脑出血患者药物治疗36d,已行常规针刺及肌电治疗,左侧上下肢肌力仍0级,1次治疗即提高至3级,再巩固2次,4-级肌力出院,1例。[结论]缪刺健侧合谷-血海联合肢体活动治疗脑卒中偏瘫,疗效满意,无严重不良反应,值得推广。

[Objective]To observe the contralateral Hegu needling acupuncture combined with bloodlimbs in treating stroke hemiplegia curative effect.[Method]Using a prospective design methods,44 cases of hospitalized patients Needling,the patient is asked to relax,piercing contralateral Hoku,a sea of blood（paralysis of limbs left-take the right lower sea of blood,limbs paralyzed left-take the upper right gu）,are 0.5 to 1 inch needle,reducing,according to the patient after the gas character,the command（or encouragement,or implied） tone to guide patients sport：needle gu while supporting the patient to lift the right leg,while the auxiliary lift the right needle sea of blood after the upper limbs,activity improved,so that the activities of the joint hemiplegic side,upper Key training dorsiflexion,lower limb flexion exercise,so repeated activity about 10 times to assist the families of hemiplegic limb range of motion when slow acupuncture;and,where appropriate,to add other points the needle,hemiplegic side Qu pool,full three years,hemiplegia points（contralateral rate Valley） discretion to choose two or three,reducing method,after the gas needle 15~20min,can add EA;quit the other needle,leaving the contralateral gu,sea of blood points,according to the above technique operation,so such activities limb,about 3 times;needle directly back to swab massage contralateral gu and a sea of blood,activity ipsilateral to do rehabilitation exercises to condition and do not need for the degree of fatigue,may Timing quantitative.The 1 /d,or 1 every other day.Continuous treatment for 3 times for 1 courses.Observation of clinical symptoms,muscle strength,adverse reactions.Continuous treatment of 2 courses,determine the efficacy.[Result]The first acupuncture basic recovery rate 100%,the first curative effect and prognosis of good cooperation and strong will is relatively better.1 cases were treated with 1 times of treatment,13 cases were improved,2 cases were improved,2 caseswere improved,11 cases were improved,16 cases were improved and 2 cases were improved by 4 grade.After 1 times of acupuncture,muscle strength can be maintained after improvement of 28 cases.Patients with cerebral hemorrhage were treated with 36 d,which was treated with routine acupuncture and EMG.The left upper limb muscle strength was still 0,and the 1 treatment was improved to grade 3,and 2 times,1 cases were treated with 4-grade.[Conclusion]Health side Hegu Xuehai Miao thorn acupuncture combined with physical activity in patients with hemiplegia after stroke,and the results were satisfactory.No serious adverse reactions,worthy of promotion.