Clinical observation on acupuncture plus motor therapy for postapoplectic spastic hemiplegia

针刺结合运动疗法治疗脑卒中后痉挛性瘫痪临床观察（英文）

Objective： To observe the clinical efficacy of acupuncture plus motor therapy for postapoplectic spastic hemiplegia and provide reference for rehabilitation care of patients with spastic hemiplegia after stroke. Methods： A total of 87 cases with postapoplectic spastic hemiplegia were randomly allocated into a treatment group and a control group. Patients in both groups received basic treatments to control blood pressure, blood sugar, blood fat and improve circulation. The 43 cases in the treatment group received acupuncture combined with motor therapy, whereas the 44 cases in the control group received motor therapy alone（same as the treatment group）. The treatment was conducted once a day, for a total of 3 sessions. One session consisted of 10 times and there was a 1-day interval between two sessions. Then the changes in modified Ashworth scale（MAS） score and Fugl-Meyer assessment scale（FMA） score and clinical efficacy were observed. Results： After treatment, the MAS scores were significantly decreased in both groups, showing intra-group statistical differences（P〈0.01）. The MAS score in the treatment group was significantly lower than that in the control group, showing a between-group statistical difference（P〈0.01）. The total effective rate was 69.8% in the treatment group, versus 45.5% in the control group, showing a between-group statistical difference（P〈0.05）. After treatment, the FMA scores were significantly increased in both groups, showing intra-group statistical differences（P〈0.01）; and the FMA score in the treatment group was significantly higher than that in the control group, showing a between-group statistical difference（P〈0.05）. Conclusion： Acupuncture combined with motor therapy is better than motor therapy alone in alleviating postapoplectic limb spasticity, improving the limb motor function and increasing the activities of daily living（ADL）.

目的:观察针刺结合运动疗法治疗脑卒中后痉挛性瘫痪的临床疗效,为脑卒中痉挛性瘫痪患者的康复治疗提供参考。方法:将87例脑卒中后痉挛性偏瘫的患者按就诊的先后顺序随机分为治疗组和对照组,所有患者均予以控制血压、调整血糖、降血脂、改善循环等基础治疗。治疗组43例,予以针刺结合运动疗法治疗,对照组44例,予以与治疗组相同的运动疗法治疗。两组均每日治疗1次,10次为1个疗程,疗程间休息1 d,共治疗3个疗程。观察两组改良Ashworth痉挛量表(MAS)、Fugl-Meyer量表(FMA)评分变化及临床疗效。结果:治疗后,两组MAS积分均较治疗前明显下降,组内差异有统计学意义(P<0.01);治疗组MAS积分明显低于对照组,组间差异具有统计学意义(P<0.05)。治疗组总有效率为69.8%,对照组总有效率为45.5%,组间差异具有统计学意义(P<0.05)。治疗后,两组FMA积分均较治疗前明显增加,组内差异有统计学意义(P<0.01);治疗组FMA积分明显高于对照组,组间差异具有统计学意义(P<0.05)。结论:针刺结合运动疗法能缓解脑卒中后肢体痉挛患者的痉挛状态,改善患者的肢体运动功能,提高患者的日常生活活动能力,其疗效优于运动疗法。