手针联合电针治疗脑卒中手痉挛患者的临床疗效观察

Clinical observation of acupuncture plus electroacupuncture for hand spasm in stroke patients

目的:观察手针联合电针与单纯手针治疗脑卒中手痉挛患者的临床疗效差异。方法:将60例脑卒中手痉挛患者随机分为手针组和手针联合电针组,每组30例。手针组穴取患侧肩髃、臂臑、肩髎、曲池、手三里、外关、伏兔、梁丘、血海、足三里、上巨虚、下巨虚、阴陵泉、三阴交、太溪、太冲以及各掌骨骨间背侧肌中央;手针联合电针组在手针组的基础上于外关和第2、3掌骨骨间背侧肌中央接以断续波型的电针仪。两组均留针40 min,每天治疗1次,每周5次,4周为一疗程,共治疗3个疗程。观察两组患者治疗前后改良Ashworth分级(MAS)、Fugl-Meyer手指运动功能评定量表以及改良Barthel指数(BI)。结果:两组患者治疗后MAS较治疗前分级均下降(均P<0.05);治疗后,手针联合电针组患者MAS较手针组分级降低(P<0.05);两组患者治疗后Fugl-Meyer手指运动功能评分和BI均较治疗前提高(均P<0.05);治疗后,手针联合电针组Fugl-Meyer手指运动功能评分和BI均高于手针组(均P<0.05)。结论:手针联合电针治疗脑卒中手痉挛与单纯手针相比,更能够缓解脑卒中患者手的痉挛程度、促进手功能的恢复,提高患者生存质量。

ObjectiveTo observe the effect difference between acupuncture combined with electroacupuncture （EA） and simple acupuncture for hand spasm in stroke patients.Methods Sixty patients were randomly assigned into an acupuncture group and a combination group, 30 cases in each one. Patients in the two groups were treated with acupuncture at the affected Jianyu （LI 15）, Binao （LI 14）, Jianliao （TE 14）, Quchi （LI 11）, Shousanli （LI 10）, Waiguan （TE 5）, Futu （ST 32）, Liangqiu （ST 34）, Xuehai （SP 10）, Zusanli （ST 36）, Shangjuxu （ST 37）, Xiajuxu （ST 39）, Yinlingquan （SP 9）, Sanyinjiao （SP 6）, Taixi （KI 3）, Taichong （LR 3）, and the points at the middle of all the dorsal muscles between metacarpal bones. EA with discontinuous wave was used in the combination group at Waiguan （TE 5） and the middle point of the dorsal muscle between the second and thethird metacarpal bones. The treatment was given for 40 min, once a day for 3 courses, five treatment per week, 4 weeks as a course. The modified Ashworth scale （MAS）, the Fugl-Meyer finger motor function rating scale and the modified Barthel index （BI） were observed before and after treatment in the two group.ResultsThe MAS scores after treatment significantly decreased compared with those before treatment in the two groups （bothP〈0.05）, with lower score in the combination group （P〈0.05）. The Fugl-Meyer scores and BI scores after treatment increased in the two groups （allP〈0.05）, with higher scores in the combination group （bothP〈0.05）.ConclusionEA combined with acupuncture can more apparently alleviate hand spasm, promote the recovery of hand function, improve the quality of life for stroke patients than simple acupuncture.