拮抗针法联合改良强制性运动疗法在急性脑梗死后上肢痉挛中的效果观察

Observation on the effect of antagonistic acupuncture combined with modified constraint-induced movement therapy in upper limb spasticity after acute cerebral infarction

目的探讨拮抗针法结合改良强制性运动疗法在急性脑梗死后上肢痉挛中的疗效。方法选取陕西省宝鸡市中医医院康复科2014年3月~2015年5月收治的120例急性脑梗死后伴有上肢痉挛患者,采用随机数字表法将其分为观察组和对照组,各60例。观察组给予拮抗针法联合改良强制性运动疗法治疗,对照组给予单纯改良强制性运动疗法治疗,采用简式Fugl-Meyer运动功能评定法(FMA)和改良Ashworth肌张力分级法进行疗效评定,判断两种治疗方法对急性脑梗死后上肢痉挛状态的改善情况。结果治疗后,观察组改良Ashworth肌张力分级疗效总有效率明显高于对照组,差异有统计学意义(P<0.05)。两组治疗后FMA评分均较治疗前显著升高(P<0.05),且观察组治疗后FMA评分明显高于对照组,差异有统计学意义(P<0.05)。结论拮抗针法结合改良强制性运动疗法能明显改善急性脑梗死后上肢痉挛状态,较单纯使用改良强制性运动疗法治疗效果佳,且患者容易操作,值得临床推广使用。

Objective To investigate the effect of antagonistic acupuncture combined with modified constraint-induced movement therapy in upper limb spasticity after acute cerebral infarction. Methods One hundred and twenty patients with upper limb spasticity after acute cerebral infarction admitted to Department of Rehabilitation, Baoji Hospital of Traditional Chinese Medicine from March 2014 to May 2015 were selected and divided into observation group and control group by random number table method, with 60 cases in each group. The observation group was given antagonistic acupuncture combined with modified constraint-induced movement therapy, the control group was given single modified constraint-induced movement therapy. The efficacy was evaluated by simple Fugl-Meyer assessment（FMA） and modified Ashworth muscular tension grading, the improvement of this two methods for the upper limb spasticity state after acute cerebral infarction. Results After treatment, the total effective rate of modified Ashworth muscular tension grading efficacy in observation group was higher than that of control group, the difference was statistically significant（P〈0.05）. The FMA scores of the two groups after treatment were higher than those before treatment（P〈0.05）, and the FMA scores of observation group after treatment were higher than those of control group, the differences were statistically significant（P〈0.05）. Conclusion Antagonistic acupuncture combined with modified constraint-induced movement therapy can significantly improve the state of upper limb spasticity after acute cerebral infarction, which is better than single use of modified constraint-induced movement therapy, and it is easy to operate for patients and worthy of clinical promotion and application.