针刺结合推拿治疗中风后痉挛性瘫痪的疗效观察

Curative Effect Observation of Acupuncture Combined with Massage Therapy for Spastic Paralysis after Stroke

目的:观察针刺结合推拿治疗中风后痉挛性瘫痪的临床效果,为改善患者预后提供依据。方法:将89例中风后痉挛性瘫痪患者(ASA分级Ⅰ~Ⅱ级)为研究对象,按照患者意愿分为两组。两组患者均给予药物治疗;在此基础上,对照组(43例)加用针灸治疗,观察组(46例)加用推拿手法治疗。治疗1个月后,采用改良的Ashworth量表(MAS)、Fugl-Meyer评分法(FMA)、改良Barthel指数比较两组治疗前后痉挛程度、运动功能及日常生活活动能力变化。比较两组临床效果。采用SF-36生活质量评价量表比较两组患者生活质量。结果:治疗前,两组MAS评分、FMA评分、改良Barthel指数及SF-36量表各亚项评分比较,差异均无统计学意义(P>0.05);治疗后,两组患者MAS评分、FMA评分及改良Barthel指数均显著改善,与治疗前比较,差异均有统计学意义(P<0.05),且观察组上下肢MAS评分显著低于对照组(P<0.05),上下肢FMA评分、改良Barthel指数及SF-36量表各亚项评分显著高于对照组(P<0.05)。观察组治疗总有效率为82.6%,对照组为62.8%,两组的治疗总有效率比较,差异具有显著性意义(P<0.05)。结论:针刺结合推拿用于中风后痉挛性瘫痪有助于缓解痉挛状态、改善患者运动功能及日常生活活动能力,提高其生存质量,值得在临床上推广应用。

Objective ： To observe the effect of acupuncture combined with massage for treatment of spastic paralysis after stroke to provide the basis for improving the prognosis of patients. Methods ： A tota of 89 patients with spastic paralysis after stroke （ ASA class I - I1 ） were as the research object and divided into 2 groups according to the patients＇ willing. Two groups were given drug treatment. On this basis, the control group （43 cases） was treated with acupuncture treatment and the observation group （46 cases） treated with massage. One month after treatment, the modified Ashworth scale （ MAS）, Fugl - Meyer scoring method （FMA） and modified Barthel index were compared the two groups＇ spasm degree,motor function and ability to change daily life activities. Compare two groups＇ clinical effect. The SF -36 life quality evaluation scale was used to compare two groups＇ quality of hfe. Results：Before treatment,two groups＇ MAS score, FMA score, modified Barthel index and SF -36 scale had no statistically significant difference （P 〉 0. 05 ）. After treatment, two groups＇ MAS score, FMA score and modified Barthel index were signifi- cantly improved. Compared with before treatment, the difference had statistical significance （ P 〈 0. 05 ）. The onset of MAS score was significantly lower than that of the control group and observation group （P 〈 0. 05）. The onset of FMA score, modified Barthel index and SF -36 scale each sub score were significantly higher than that of control group （P 〈 0. 05 ）. Observation group＇s total effective rate was 82.6% and the control group＇s was 62.8%. The comparsion of the total effective rate of two groups had signifi- cant difference significance （ P 〈0. 05）. Conclusion ： Acupuncture combined with massage for spastic paralysis after stroke would help to ease the movement function in patients with spasticity, improvement and daily life activities ability, improve their quality of life and is worthy of popularization and application in clinic.