针刺结合核心肌群训练对缺血性脑卒中偏瘫患者平衡功能的影响

Clinical observation of acupuncture combined core muscle training on early balance function of ischemic stroke patients with hemiplegia

目的探讨针刺结合核心肌群训练对缺血性脑卒中偏瘫患者平衡功能的影响及其作用机制。方法采用随机数字法将192例缺血性脑卒中偏瘫患者分为2组,每组96例。对照组给予核心肌群训练治疗,观察组在对照组的基础上结合针刺治疗。治疗后,比较2组躯干控制能力(PASS评分)、下肢运动功能(FMA评分)、平衡能力(BBS评分)、步行能力(Holden评分)、生活质量(SF-36健康问卷)及治疗前后双侧大脑中动脉搏动指数(PI)、阻力指数(RI)与平均血流速度(Vm)的变化。结果治疗后,2组PASS评分、FMA评分显著升高(P<0.05),且观察组明显高于对照组(P<0.05)。治疗后,2组BBS评分、Holden评分均明显升高(P<0.05),且观察组显著高于对照组(P<0.05)。治疗后,观察组在生理功能、生理职能、躯体疼痛、健康状况、精力、社会功能、情感职能与精神健康等方面的评分均低于对照组(P<0.05)。治疗后,2组RI、PI明显降低(P<0.05),且观察组低于对照组(P<0.05);2组Vm明显升高(P<0.05),且观察组高于对照组(P<0.05)。结论针刺结合核心肌群训练治疗可明显改善缺血性脑卒中偏瘫患者的平衡功能,提高日常生活质量,其作用机制可能与针刺结合核心肌群训练能有效改善缺血性脑卒中偏瘫患者脑血流动力学有关。

Objective To investigate the effect and mechanism of acupuncture combined core muscle training on early balance function of ischemic stroke patients with hemiplegia. Methods A total of 192 cases of ischemic stroke patients with hemiplegia were randomly divided into two groups, 96 cases in each group. The control group was given core muscle training, and the observation group was added Dialectical stage acupoints acupuncture based on control group. The trunk control ability （PASS score） , lower limbs function （FMA score） , balance ability （BBS score） , walking ability （Holden score） , life quality （SF-36 health questionnaire）, Middle cerebral artery pulsatility index （P1） , resistance index （RI） and mean blood flow velocity （Vm） of two groups were compared. Results After treatment, PASS score and FMA score of two groups were significantly increased （ P 〈 0.05 ） , and PASS score and FMA score of observation group was signifi- cantly higher than control group （ P 〈 0.05 ）. After treatment, BBS score and Holden score of two groups were signifi-cantly increased （ P 〈 O. 05 ）, and BBS score and Holden score of observation group were significantly higher than control group （ P 〈 0.05 ）. The physiological function, physiological functions, body pain, health status, energy, social lunch tions, emotional function, versus, mental health of observation group were lower than those of control group （ P 〈 0.05 ）. After treatment, the RI and PI of two groups were significantly reduced （P 〈 0.05） , and the RI and PI of observation group were lower than that of control group （ P 〈 0.05 ） ; the Vm of two groups were significantly increased （ P 〈 0.05 ）, and the Vm of observation group were higher than that of control group （ P 〈 0.05 ）. Conclusion Acupuncture combined core muscle training could significantly improve the balance function and life quality of patients with ischemic stroke, and its mechanism may be related to the improvement of cerebral hemodynamics by dialectical stage acupoints acupuncture combined core muscle training.