针刺联合肌电生物反馈疗法治疗脑卒中偏瘫临床观察

Clinical Observation of Acupuncture plus Electromyographic Biofeedback Therapy for Cerebral Stroke Hemiplegia

目的观察针刺联合肌电生物反馈疗法对脑卒中患者神经功能、日常生活活动能力、生化指标及下肢功能的影响。方法收治脑卒中恢复期患者102例,依据随机数字表法随机分为观察组51例和对照组51例。两组患者均给予常规治疗,对照组同时给予肌电生物反馈疗法,观察组在上述基础上结合针刺治疗。两组疗程均为8星期。比较两组患者美国国立卫生院神经功能缺损评分(NIHSS)、日常生活活动能力(ADL)、内皮素-1(ET-1)、降钙素基因相关肽(CGRP)及Fugl-Meyer(FMA)评定下肢运动功能变化。结果两组患者治疗后NIHSS评分明显降低,ADL评分明显增加(P<0.05);观察组治疗后NIHSS评分低于对照组,ADL评分高于对照组(P<0.05);观察组治疗后血浆ET-1水平明显下降,CGRP水平明显增加(P<0.05);观察组治疗后血浆ET-1水平低于对照组,CGRP水平治疗后高于对照组(P<0.05);两组治疗后FMA评分明显增加(P<0.05);观察组治疗后FMA评分高于对照组(P<0.05)。结论在常规治疗基础上,针刺联合肌电生物反馈疗法可明显改善脑卒中患者神经功能,提高患者日常生活活动能力,促进下肢功能的康复,降低ET-1水平且升高CGRP水平。

Objective To observe the effect of acupuncture plus electromyographic biofeedback therapy（EMGBFT） on the nerve function,activities of daily life（ADL）,biochemical indexes,and lower-limb function in cerebral stroke patients.Method Totally 102 cerebral stroke patients in recovery stage were recruited and allocated to an observation group and a control group by using the random number table,51 cases in each group.The two groups were both given conventional treatment,based on which,the control group was given EMGBFT,while the observation group was given acupuncture plus EMGBFT.The treatment duration was 8 weeks in both groups.The changes of National Institute of Health Stroke Scale（NIHSS）,ADL,endothelin 1（ET-1）,calcitonin gene-related peptide（CGRP）,and Fugl-Meyer Assessment（FMA） of the lower-limb motor function were compared.Result The NIHSS scores dropped and ADL scores increased significantly in the two groups after the intervention（P〈0.05）;after the intervention,the NIHSS score of the observation group was lower than that of the control group and the ADL score was higher than that of the control group（P〈0.05）;in the observation group,the plasma ET-1 level decreased significantly and CGRP level increased significantly after the intervention（P〈0.05）;after the treatment,the plasma ET-1 level in the observation group was lower than that in the control group and the CGRP level was higher than that in the control group（P〈0.05）;the FMA scores increased markedly in both groups after the intervention（P〈0.05）;the FMA score of the observation group was higher than that of the control group after the treatment（P〈0.05）.Conclusion Acupuncture plus EMGBFT can significantly improve the nerve function and ADL,promote the recovery of lower-limb function,down-regulate the ET-1 level,and up-regulate the CGRP level in cerebral stroke patients.