拮抗肌运动点电员针治疗卒中后上肢痉挛临床研究

Clinical study of electric rounded needle treatment for post-stroke upper limb spasticity at muscular motor point of antagonistic muscle

目的观察拮抗肌运动点电员针治疗对卒中后上肢痉挛的临床疗效。方法回顾性分析2011年11月至2014年11月黑龙江省东宁市人民医院康复医学科收治的卒中后上肢痉挛患者90例。按照随机数字表法分为治疗组与对照组,每组45例,两组患者均进行基础治疗及康复训练,对照组采用拮抗肌运动点针刺疗法,治疗组采用拮抗肌运动点电员针疗法。采用χ~2检验比较两组患者治疗4周后临床疗效差异,采用Ridit分析比较两组患者改良Ashworth量表(MAS)分级差异,采用t检验比较两组患者改良Barthel指数(BI)评分和Fugl-Meyer运动功能评分(FMA)差异。结果治疗4周后,对照组和治疗组总有效率分别为64.44%(29/45)和86.67%(39/45),两组疗效比较,差异具有统计学意义(χ~2=6.016 0,P<0.05)。对照组治疗前后、治疗组治疗前后和治疗后两组MAS分级差异均有统计学意义(u=2.015 1、5.069 1、3.369 1,P均<0.05)。对照组治疗前后、治疗组治疗前后和治疗后两组BI指数评分差异均有统计学意义(t=2.44、5.19、2.54,P均<0.05)。对照组治疗前后、治疗组治疗前后和治疗后两组FMA评分差异均有统计学意义(t=2.51、5.64、2.80,P均<0.05)。结论拮抗肌运动点电员针疗法可有效改善卒中患者上肢痉挛程度,提高患者运动功能水平及日常生活活动能力,值得临床推广。

Objective To investigate the clinical curative effect of electric rounded needle treatment on muscular motor point of antagonistic muscle in patients with upper limb spastieity after stroke. Methods Ninety patients with upper limb spasm after cerebral apoplexy hospitalized in the department of rehabilitation medicine, Dongning city people＇s hospital from November 2011 to November 2014 were retrospectively analyzed in this study. According to random number table method patients were divided into the treatment group and control group, 45 cases in each group. Two groups of patients were given the basic treatment and rehabilitation training. Patients of the control group were given acupuncture therapy at muscular motor point of antagonistic muscle. Patients of the treatment group were given electric rounded needle treatment at muscular motor point of antagonistic muscle. The clinical curative effect was compared between two groups using X2 test. Results of the modified Ashworth scale （MAS） in two groups of patients were compared by Ridit analysis. Results of the modified Barthel index （BI） score and Fugl-Meyer movement function score （FMA） were compared between two groups of patients by t test. Results After four-week treatment, there were significant differences in the total effective rates between control group and treatment group [64.44% （29/45） and 86.67% （39/45）, X^2 = 6. 016 0, P 〈0.05）]. There were significant differences in MAS grades before and after treatment between two groups （u = 2. 015 1, 5. 069 1, 3. 369 1, all P 〈 0. 05）. There were significant differences in BI index scores before and after treatment between two groups （ t = 2.44, 5.19, 2.54, all P 〈0.05）. There were also significant differences in FMA scores before and after treatment between two groups （ t = 2. 51, 5.64, 2.80, all P 〈 0.05）. Conclusion The Dian Yuan Zhen treatment in muscular motor point of antagonistic muscle can effectively improve the degree of upper limb spasm in patients after stroke, which can improve the level of motor function and daily life of patients, and is worth clinical promotion.