针刺配合体感音乐对脑卒中后上肢痉挛的效果

Effect of Acupuncture Combined with Vibroacoustic Therapy on Upper Limb Spasticity Post Stroke

目的观察针刺配合体感音乐对脑卒中后上肢痉挛的效果。方法 2014年11月~2015年11月,90例脑卒中后上肢痉挛患者分为治疗组（针刺＋体感音乐）、对照组1（体感音乐）和对照组2（针刺）,每组30例。三组患者均进行基础治疗及康复训练,并在治疗前及治疗4周后,分别采用改良Ashworth痉挛量表（MAS）、Fugl-Meyer上肢功能评分（FMA）,改良Barthel指数（MBI）对患者上肢肌张力、运动功能、日常生活活动能力进行评定。结果治疗后,各组患者MAS分级均较治疗前显著降低（Z〉3.067,P〈0.001）,FMA评分、MBI评分均较治疗前明显升高（t〉3.326,P〈0.01）。治疗后,治疗组MAS分级明显低于对照组1和对照组2（Z〉2.919,P〈0.01）,治疗组FMA评分、MBI评分高于对照组1和对照组2（P〈0.05）;对照组1与对照组2 MAS分级、FMA评分、BI评分比较无显著性差异（P〉0.05）。治疗组有效率为80%,对照组1为50%,对照组2为53%（χ~2=8.573,P=0.014）。结论针刺配合体感音乐可有效改善患者上肢痉挛程度,提高患者运动功能水平及日常生活活动能力。

Objective To observe the clinical effect of acupuncture combined with vibroacoustic therapy on upper limb spasticity post stroke.Methods From November,2014 to November,2015,90 patients with upper limb spasticity post stroke were randomized into treatment group（acupuncture combined with vibroacoustic therapy）,control 1 group（simple vibroacoustic therapy） and control 2 group（simple acupuncture） with 30 cases in each group.All the patients accepted routine fundamental treatment and rehabilitation training.The modified Ashworth Scale（MAS）,Fugl-Meyer Assessment（FMA） and modified Barthel Index（MBI） were used to assess the upper limb muscle tension,motor function and activities of daily living before and four weeks after treatment.Results After treatment,MAS score decreased in all groups（Z3.067,P〈0.001）,and FMA score and MBI score increased（t3.326,P〈0.01）.MAS score decreased more（Z2.919,P〈0.01）,and FMA score and MBI score increased more（P〈0.05） in the treatment group than in the control groups after treatment.However,there was no significant difference between the control groups（P〈0.05）.The total effective rate was 80% in the treatment group,50% in the control group 1 and 53% in the control group 2（χ2=8.573,P=0.014）,respectively.Conclusion Acupuncture combined with vibroacoustic therapy can alleviate the upper limb spasticity,and promote the recovery of motor function and activities of daily living.