电针肱二头肌起止点对偏瘫痉挛肢体表面肌电变化的影响

Effect of Electroacupuncture at the Beginning and Ending Points of Bicipital Muscle on the Superficial Electromyography of the Spastic Limb in Hemiplegia

目的观察电针肱二头肌起止点对偏瘫痉挛肢体表面肌电变化的影响。方法将40例脑卒中后偏瘫痉挛患者,采用随机数字表法分为电针起止点组和电针拮抗肌组,前者取肱二头肌起止点处阿是穴,后者取上臂拮抗肌穴位(如天井、清冷渊等),直刺进针后留针30 min,拔针后检测患者在完全静息状态下肱二头肌表面肌电数据,分别于针刺前、针刺2星期、针刺4星期对痉挛的肱二头肌进行表面肌电检测,检测指标包括均方根值(RMS)、积分肌电值(IEMG)。结果两组患者针刺后肱二头肌RMS、IEMG值均较针刺前显著降低(P<0.05);组间比较发现,RMS、IEMG值在针刺不同时间段差异无统计学意义(P>0.05)。两组患者在针刺4星期后RMS、IEMG值总下降趋势相同。结论电针起止点或拮抗肌穴位均可降低偏瘫患者静态肌张力;表面肌电在评价偏瘫患者治疗后痉挛有一定的参考价值。

Objective To observe the effect of electroacupuncture at the beginning and ending points of bicipital muscle on the superficial electromyography （sEMG） of the spastic limb in hemiplegia.Method Forty patients with spastic hemiplegia after cerebral stroke were divided by the random number table into a group of electroacupuncture at the beginning and ending points （group A） and a group of electroacupuncture at antagonistic muscles （group B）. The former selected Ashi points at the beginning and ending points of bicipital muscle, while the latter selected points at the antagonistic muscles [Tianjing （TE10）, Qinglingyuan （TE11）, etc.], to receive perpendicular puncturing. The needles were retained for 30 min, and the sEMG of bicipital muscles in resting state was detected after the removal of the needles. The spastic bicipital muscle was examined by sEMG prior to the acupuncture treatment, and respectively after 2-week and 4-week acupuncture treatment, and the detected parameters included root mean square （RMS） and integrated electromyography （IEMG）.ResultThe EMG and IEMG declined gradually in the two groups after the acupuncture treatment; the intra-group comparisons of the RMS and IEMG values at three time points, e.g. prior to acupuncture treatment, after 2-week acupuncture treatment and after 4-weekacupuncture treatment, showed that the values changed significantly compared to those at the previous time point （P〈0.05）; the between-group comparisons showed that there were no significant differences in comparing the RMS and IEMG values regardless of different time points （P〉0.05）. The RMS and IEMG values presented same changing tendencies after 4-week acupuncture treatment in the two groups.ConclusionAcupuncture at the beginning and ending points and at the points on antagonistic muscles both can decrease the resting-state muscle tension in hemiplegia patients; sEMG is of certain significance in evaluating the treatment of hemiplegia.