通督调神针法结合巨刺治疗脑卒中后痉挛性瘫痪的临床研究

Clinical Research on Spastic Paralysis after Stroke Treated by Acupuncture Therapy of Dredging Governor Vessel for Regulating Mentality Combined with Needling Acupuncture

目的:观察通督调神针法结合巨刺治疗脑卒中后痉挛性瘫痪的临床疗效。方法:将60例患者随机分为观察组32例和对照组28例,两组均接受康复治疗。观察组予以通督调神针法结合巨刺治疗,取督脉穴百会、风府、水沟、大椎、至阳、腰阳关为主穴,配合健侧肢体穴位,每日针刺1次,每次40 min,每周6次,周日休息,连续治疗4周。对照组予以单纯巨刺治疗,肢体取穴、操作及疗程均与观察组平行。两组患者分别于治疗前、治疗4周时运用改良的Ashworth量表、Fugl-Meyer运动功能评定量表、Barthel量表进行评定,比较两组间的疗效差异。结果:观察组肢体痉挛改善总有效率达90.63%,优于对照组的78.57%,差异具有统计学意义(P<0.05);两组治疗后Fugl-Meyer评分、BI评分分别为观察组69.79±6.92(对照组50.09±6.67)、79.24±9.83(对照组59.79±10.12),两组均高于治疗前,且观察组均高于对照组,差异均具有统计学意义(均P<0.05)。结论:通督调神针法结合巨刺治疗能改善脑卒中后痉挛性瘫痪患者的肢体痉挛,提高生活质量。

Objective： To observe the clinical efficacy on spastic paralysis after stroke treated by acupuncture therapy of dredging governor vessel for regulating mentality combined with needling acupuncture. Methods： 60 patients were randomly divided into an observation group with 32 cases and a control group with 28 cases. Two groups received rehabilitative therapy. The observation group was treated by acupuncture therapy of dredging governor vessel for regulating mentality combined with needling acupuncture,mainly selecting governor meridians at Baihui,Fengfu,Shuigou,Dazhui,Zhiyang,Yaoyangguan,with the healthy side limb acupuncture point,retaining the needles for 40 minutes,once per day,six times per week,continuous treatment for four weeks. The control group was treated with simple needling acupuncture,and the acupoints,the operation and the treatment course were all parallel to the observation group. The two groups were assessed before treatment,4 weeks of treatment with modified Ashworth scale,Fugl- Meyer motor function assessment scale and Barthel index scale to compare the difference between two groups. Results： The total effective rate of the observation group was90. 63%,which was superior to that of the control group（ 78. 57%）,and the difference was statistically significant（ P〈0. 05）. After treatment the Fugl Meyer score,score of Barthel Index（ BI） in the observation group were 69. 79 ± 6. 92（ control group 50. 09 ± 6. 67）,79. 24 ± 9. 83（ control group 59. 79 ± 10. 12） and they were higher than those before treatment. In the observation group they were higher than those in the control group,and the difference was statistically significant（ P〈0. 05）. Conclusion： The acupuncture therapy of dredging governor vessel for regulating mentality combined with needling acupuncture can improve spastic paralysis with limb spasm after stroke,and can improve their quality of life.