早期针灸联合现代康复在急性缺血性中风弛缓期瘫痪治疗中的临床疗效研究

Clinical study of early acupuncture combined with modern rehabilitation method in the treatment of flaccid paralysis of acute ischemic stroke

目的观察针灸联合现代康复治疗急性缺血性中风弛缓期瘫痪的疗效。方法将90例缺血性中风急性期7 d内弛缓期瘫痪的患者随机分为单纯现代康复治疗组(A组)30例,针灸治疗组(B组)30例,针灸联合现代康复治疗组(C组)30例,分别于发病后3个月和6个月对患者的运动功能与日常生活能力进行比较。结果各组运动功能评分治疗3个月、6个月后较治疗前均显著改善(P<0.01);治疗3个月后,相较于A组,B组(P<0.05)与C组(P<0.01)具有显著性改善,C组较B组具有显著改善(P<0.05);治疗6个月,C组较A、B2组具有极显著改善(P<0.01)。日常生活能力量表评分各组治疗3个月、6个月后较治疗前均显著改善(P<0.01);治疗3个月后,C组较A组具有显著改善(P<0.05);治疗6个月后,B、C2组较A组均具有显著改善(P<0.01)。结论针灸联合现代康复治疗在提高运动功能评分(FMA)和改善生活能力方面具有可行性、有效性和可重复性,针灸治疗在改善运动功能方面优势明显,可在一定程度上改善中风患者的临床预后及生活质量,为临床上急性缺血性中风弛缓期瘫痪患者中医康复方法的选择和干预时机提供了有益的依据。

Objective To investigate the effect of acupuncture combined with modern rehabilitation therapy on acute ischemic stroke patients. Methods 90 acute ischemic stroke patients within 7 days of flaccid period were randomly divided into three groups： modern rehabilitation therapy group （group A ） , acupuncture therapy group （group B ） and acupuncture combined with modern rehabilitation therapy group （group C）. The fugl-meyer assessment （FMA） and ability of daily living （ADL） were used for evalua- tion on 3 and 6 months after treatment. Results FMA were improved on both 3 and 6 month in three groups than before treatment （P 〈0.01 ）. After 3 months, group B （P 〈0.05） and C （P 〈0.01 ） were significant improved comparing to group A, as well as group C to B （P 〈 0.05 ）. After 6 months, group C was significant improved comparing to group A and B （P 〈0.01 ）. ADL were improved both on 3 and 6 month in three groups than before treatment （P 〈0.01 ）. After 3 months, group C was significant improved comparing to group A. After 6 months, group B and C were significant improved comparing to group A （P 〈 0.01 ）. Conclusion Acupuncture combined with modem rehabilitation therapy were found practicable, effective and repeatable in improving fugl-meyer assessment （FMA） and ADL. Especially acupuncture therapy could improve the clinical prognosis and quality of life of stroke patients, which provides a useful basis for acute ischemic stroke patients in the selection of traditional Chinese medicine rehabilitation methods and intervention time.