梅花针叩刺联合康复训练治疗中风后手拘挛临床观察

Clinical observation on plum-blossom needle combined with rehabilitation training for hand spasm after stroke

目的:观察梅花针叩刺作为辅助方法联合康复训练与单纯康复训练治疗中风后手拘挛的临床疗效差异。方法:将61例中风后手拘挛患者随机分为综合治疗组(30例)和康复训练组(31例)。康复训练组采用单纯康复训练包括Bobath作业疗法、OT训练、手功能训练治疗,每天一次;综合治疗组在康复训练组治疗基础上配合梅花针叩刺手太阴肺经、手少阴心经、手厥阴心包经的手部循行部位,隔天1次,均3周为一疗程。治疗3个疗程后,进行临床疗效评价,并通过改良Ashworth量表评定治疗前后痉挛程度、Fugl-Meyer(FMA)运动功能评分。结果:两组治疗后Ashworth量表分级及FMA评分均优于治疗前(均P<0.05),且综合治疗组均优于康复训练组(均P<0.05);综合治疗组和康复训练组改善手运动功能总有效率分别为93.3%(28/30)和74.2%(23/31),综合治疗组优于康复训练组(P<0.05)。结论:梅花针叩刺作为辅助疗法联合康复训练治疗中风后手拘挛较单纯康复训练治疗疗效显著。

Objective To observe the effect difference between plum-blossom needle combined with rehabilitation training and conventional rehabilitation training for hand spasm after stroke. Methods A total of 61 patients were randomly divided into a comprehensive treatment group （30 cases） and a rehabilitation training group （31 cases）. In the rehahilitation training group, Bohath occupational therapy, OT training, and hand flmction training were adopted, onee every day; on the basis of treatment in the rehabilitation group, plum-blossom needle was applied at the lung meridian of hand-talyin, heart meridian of hand-shaoyin, pericardium meridian of hand-jueyin in the comprehensive treatment group. The treatment was given once every two days, three weeks as one course in the two gnoups. After 3 courses of treatment, clinical efficacy evaluation was performed, and the modified Ashworth scale and Fugl-Meyer （FMA） motor function scores were assessed before and after treatment. Results After treatment, the grade for Ashworth scale and FMA scores in the comprehensive treatment group and the rehabilitation trainning group were better than those before treatment （all P〈 0.05）, and the improvements in hand spasm and hand fuction in the comprehensive treatment group were superior apparently to those in the rehabilitation trainning group （both P〈 0.05） The total effective rate of hand function was 93.3% （28/30） in the comprehensive treatment group, which was better than 74.2% （23/31） in the rehabilitation training group （P〈 0.05）. Conclusion Plum-blossom needle combined with rehabilitation training are more effective than simple rehabilitation training for hand spasm after stroke.