醒脑开窍针法联合针刺夹脊穴治疗卒中后痉挛性瘫痪临床研究

Efficacy of Xingnao-Kaiqiao combined with Jiaji acupuncture therapy in treatment of spastic paralysis of cerebral apoplexy

目的 观察醒脑开窍针法联合针刺夹脊穴治疗卒中后痉挛性瘫痪的疗效.方法 将符合入选标准的76例卒中后痉挛性偏瘫患者,按随机数字表法分为2组,每组38例.观察组给予醒脑开窍针联合针刺夹脊穴及康复训练治疗,对照组采用普通针刺疗法结合康复训练治疗.2组分别于治疗前及治疗后4、8、12周时采用Fugl Meyer量表及Barthel指数量表评估患者肢体运动功能及日常生活能力,评价临床疗效.结果 观察组Fugl Meyer评分治疗后4周[（66.9±11.7）分比（63.6±11.3）分,t=2.247]、8周[（73.2±11.2）分比（67.4±10.7）分,t=2.896]、12周[（79.6±12.4）分比（71.3±11.6）分,t=3.283]及Barthel指数评分治疗后4周[（52.3±9.2）分比（48.3±8.7）分,t=2.438]、8周[（62.5±9.4）分比（55.6±8.8）分,t=3.196]、12周[（68.9±10.5）分比（60.4±9.7）分,t=4.395]均高于对照组（P〈0.05）.观察组总有效率为92.1%（35/38）、对照组为71.1%（27/38）,2组比较差异有统计学意义（χ2=4.290,P=0.038）.结论 醒脑开窍针刺法联合针刺夹脊穴可明显缓解卒中后痉挛性瘫痪患者肌肉痉挛程度,提高肢体运动功能和日常生活能力.

Objective To observe clinical effect of Xingnao-Kaiqiao and Jiaji acupuncture therapy combined with rehabilitation training in treatment of spastic paralysis of cerebral apoplexy.Methods A total of 76 patients were randomly divided into the observation group （n=38） withXingnao-Kaiqiao＆Jiaji acupuncture therapy combined with rehabilitation training therapy and control group （n=38） with the common needling therapy combined with rehabilitation training therapy according to the random number table method.The Meyer Fugl score, Barthel index score after 4, 8 and 12weeks of treatment and clinical effect of two groups of patients were observed and compared.Results The Meyer Fugl scores after 4 weeks （66.9 ± 11.7vs. 63.6 ± 11.3,t=2.247）, 8 weeks （73.2 ± 11.2vs.67.4 ± 10.7,t=2.896） and 12 weeks （79.6 ± 12.4 vs.71.3 ± 11.6, t=3.283） in the observation group were significantly higher than those in the control group （P〈0.05）. The Barthel index scores after 4 weeks （52.3 ± 9.2 vs.48.3 ± 8.7,t=2.438）, 8 weeks （62.5 ± 9.4 vs.55.6 ± 8.8,t=3.196） and 12 weeks （68.9 ± 10.5 vs.60.4 ± 9.7,t=4.395） in the observation group were significantly higher than those in the control group （P〈0.05）. The total effect rate 92.1% of the observation group was 71.1% of the control group （χ2=4.290,P〈0.05）.Conlusions The Xingnao-Kaiqiao and Jiaji acupuncture therapy combined with rehabilitation training could significantly ease the muscle spasm degree of patients, improve the motor function and daily life ability.