巨刺联合经筋刺治疗脑卒中后痉挛性偏瘫随机平行对照研究

The Randomized Parallel Contrast Study of Post-Stroke Hemiplegic Spasticity Treating by Macro-needling Therapy Combined with Muscle Region Needling

[目的]观察巨刺联合经筋刺治疗脑卒中后痉挛性偏瘫疗效。[方法]使用随机平行对照方法,将50例住院及门诊患者按随机数字表法随机分两组。对照组25例常规针刺(上肢肩髃、合谷、曲池、手三里、外关,下肢取髀关、伏兔、足三里、丰隆、解溪等),快速进针后行提插捻转补法得气后留针,留针30min,1次/d,6次/周。治疗组25例巨刺联合经筋刺法(上肢取肩髃、曲池、外关、合谷,下肢取阳陵泉、悬钟、足临泣等),快速进针后行提插捻转补法得气后留针,并取患侧上肢肘关节、下肢膝关节附近的肌腱两侧找压痛点为穴进行针刺,快速进针后反复提插捻转,针感强度以患者能忍受、关节不发生阵挛为度后留针,留针30min,1次/d,6次/周。连续治疗1周为1疗程。观测临床症状、肌张力(痉挛程度)评定、痉挛指数评定、不良反应。连续治疗2周疗程,判定疗效。[结果]治疗组基本痊愈5例,显效7例,有效12例,无效1例,总有效率96.00%;对照组基本痊愈2例,显效0例,有效14例,无效9例,总有效率88.00%;治疗组疗效优于对照组(P<0.05)。肌张力(痉挛程度)评定、痉挛指数评定改善治疗组优于对照组(P<0.01)。[结论]巨刺联合经筋刺法治疗脑卒中后痉挛性偏瘫,疗效满意,无严重不良反应,值得推广。

[Objective] To observe the efficacy of Macro-needling Therapy combined with muscle region needling in treating post-stroke hemiplegic spasticity. [Methods] Fifty patients Hospital were randomly divided into two groups with method of parallel Contrast. A control group of 25 cases were acupunctured normally （Upper limbs take Jianyu, hegu, Quchi, shousanli, wai kuan, Lower limbs take Piguan, Futu, tsusanli, Fenglong, chieh hsi and so on）, retaining needle for 30rain after bringing about the desired sensation with high speed puncture by lifting and twisting techniques. A treatment group of 25 cases received macro-needling therapy combined with muscle region needling （Upper limbs take Jianyu, Quchi, wai kuan, hegu, Lower limbs take Yanglingquan, Xuanzhong, Zulinqi and so on）, inserting needle point was found in the tendons tenderness point of elbow and knee,retaining needle for 30min until patient can bear and clonus is not occurred in joint with high speed puncture by lifting and twisting techniques. Each group was given treatment 6 times per week and one time per day. [Results] In treatment group, there were 5 cases complete recovery, 7 cases significantly effective, 12 cases effective, 1 case invalid and the total effective rate reached 96.00%; In control group, there were 2 cases complete recovery, 0 case significantly effective, 14 cases effective, 9 cases invalid and the total effective rate reached 88.00%; the curative effect of treatment group is better than the control one （P〈0.05）. The muscular tension （degree of spasticity） and spasticity index of treatment group is better than the control one （P〈0.01）. [Conclusion] The curative effect of Macro-needling Therapy combined with muscle region needling for treating post-stroke hemiplegic spasticity is satisfied and there was no serious adverse reaction.