电针联合运动疗法在痉挛性偏瘫患者神经功能恢复中的应用

Application of Electroacupuncture plus Movement Therapy in Recovering Neurologic Function of Patients with Spastic Hemiplegia

目的观察电针联合强制性运动(constraint-induced movement therapy,CIMT)对痉挛性偏瘫患者神经功能恢复的临床疗效。方法选取脑卒中痉挛性偏瘫患者60例,随机分为电针组、强制性运动组(运动组)和电针联合强制性运动组(联合组)各20例,3组均在常规康复治疗基础上行相应治疗,分别于治疗前与治疗4星期后对3组患者改良Ashworth分级、临床神经功能缺损评分、简化Fugl-Meyer运动量表(FMA)、Berg平衡量表(BBS)评定变化进行对比分析。结果治疗4星期后3组改良Ashworth评定和神经功能缺损评分均较治疗前明显下降(P<0.01),且运动组低于电针组(P<0.05),联合组更低于其他两组(P<0.05);3组患者FMA及BBS的评分均较治疗前明显提高(P<0.01),且运动组高于电针组(P<0.05),联合组高于其他两组(P<0.05)。结论电针联合强制性运动能够减轻痉挛性偏瘫患者患侧肢体的肌张力,有效改善痉挛性偏瘫患者神经功能及运动功能,从而提高患者的生活质量。

Objective To observe the clinical efficacy of electroacupuncture plus constraint-induced movement therapy（CIMT） in recovering neurologic function of patients with spastic hemiplegia. Method Sixty patients with post-stroke spastic hemiplegia were randomized into an electroacupuncture group, a CIMT group, and an electroacupuncture ＋ CIMT（integrated） group to receive corresponding intervention in addition to the ordinary rehabilitation treatment, 20 cases in each group. Before treatment and after 4-week treatment, the modified Ashworth Scale, Clinical Neurologic Deficit Scale, Short-form Fugl-Meyer Assessment Scale（FMA）, and Berg Balance Scale（BBS） were adopted for evaluation and comparison. Result After 4-week treatment, the Ashworth score and neurologic deficit score were significantly reduced in the three groups（P〈0.01）, and the scores in CIMT group were significantly lower than that in the electroacupuncture group（P〈0.05）, and the scores in the integrated group were markedly lower than that in the other two groups（P〈0.05）; the FMA and BBS scores were significantly increased after intervention in the three groups（P〈0.01）, and the scores in CIMT group were higher than that in the elctroacupuncture group（P〈0.05）, and the scores in the integrated group were higher than that in the other two groups（P〈0.05）. Conclusion Electroacupuncture plus CIMT can reduce the muscular tension of the affected limb in patients with spastic hemiplegia, and improve the neurologic function, motor function, and the quality of life of the patients.