火针改善中风痉挛性偏瘫患者生存质量临床研究

Life quality improvement of spastic hemiplegia of stroke treated with fire-needle:a randomized controlled trial

目的:观察火针疗法对中风痉挛性偏瘫患者生存质量的疗效。方法:将60例患者随机分为火针组及康复组,每组各30例。两组均给予神经内科常规治疗并加强肢体功能康复训练。火针组取肩髃、臂臑、曲池、阳陵泉、血海、三阴交等穴行火针治疗,每2天1次,连续治疗30天,共15次;康复组采用常规康复锻炼,一周5次,共4周、20次。在治疗前、治疗结束时及治疗结束后1个月运用Ashworth量表、临床痉挛指数(clinic spastcity index,CSI)量表分别评定上下肢痉挛指数,Fugl-Meyer(FM)量表评定肢体运动功能,患者报告结局评价(patient-reported outcome,PRO)量表评定生存质量。并比较两组的临床疗效。结果:1Ashworth量表评定,两组治疗结束时及治疗后1个月的结果均优于治疗前(P<0.05,P<0.01),且火针组在同期比较中均优于康复组(均P<0.05);2CSI量表评定,火针组治疗结束时及治疗后1个月均优于治疗前(均P<0.01),康复组治疗结束时及治疗后1个月与治疗前相当(均P>0.05),火针组在同期比较中均优于康复组(P<0.05,P<0.01);3FM量表评定,除康复组下肢治疗结束时的结果与治疗前相当(P>0.05)外,两组上下肢治疗结束时及治疗后1个月均优于治疗前(均P<0.01),火针组在同期比较中均优于康复组(P<0.05,P<0.01);4PRO量表评定,两组治疗结束时及治疗后1个月均优于治疗前(均P<0.01),火针组在同期比较中均优于康复组(P<0.05,P<0.01)。结论:火针疗法可有效减轻中风患者痉挛性偏瘫状态,改善肢体运动功能,提高患者生存质量,较常规康复疗法为佳。

Objective To observe the life quality improvement of spastic hemiplegia of stroke treated with fireneedle.Methods Sixty patients were randomly divided into a fire-needle group and a rehabilitation group,30 cases in each one.In the two groups,the conventional treatment of neurology and rehabilitation strengthening limbs function were applied.In the fire-needle group,fire-needle was used at Jianyu（LI 15）,Binao（LI 14）,Quchi（LI 11）,Yanglingquan（GB 34）,Xuehai（SP 10）and Sanyinjiao（SP 6）,etc.,once two days and continuously for 30days（15times）.In the rehabilitation group,conventional rehabilitation exercises were given five times a week for 4weeks（20times）.Before treatment,at the end of treating program and one month later after treatment,spasticity of upper and lower limbs was assessed by Ashworth scale and clinic spasticity index（CSI）;limbs function was evaluated by Fugl-Meyer（FM）scale;life quality was estimated by patient-reported outcome（PRO）.Clinical effects were compared between the two groups.Results 1At the end of treating and one month later after treatment,the Ashworth scales were better than those before treatment in the two groups（P0.05,P0.01）,and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group（both P0.05）.2At the end of treating and one month later after treatment,the CSIs were better than those before treatment in the fire-needle group（both P0.01）,but not changed apparently in the rehabilitation group（both P0.05）.And the indices of the fire-needle group were superior to those at the same time of the rehabilitation group（P0.05,P0.01）.3The FM scales of upper and lower limbs at the end of treating and one monthlater after treatment were better than those before treatment in the two groups（all P0.01）,except the lower limbs at the end of treating in the rehabilitation group（P0.05）.The FM scales of the fire-needle group were superior to those at the same time of the rehabilitation group（P0.05,P0.01）.4At the end of treating and one month later after treatment,the PRO scales were better than those before treatment in the two groups（all P0.01）,and the scales of the fire-needle group were superior to those at the same time of the rehabilitation group（P0.05,P0.01）.Conclusion Fire-needle can effectively relieve spastic hemiplegia of stroke,and improve limbs motor function and life quality.It is better than rehabilitation.