张力平衡针法联合挛三针治疗中风后痉挛性偏瘫43例

Zhangli Pingheng Needling Combined with Luansanzhen Needle in Treating For Post-Stroke Spastice Hemiplegia with 43 Cases

目的:观察张力平衡针法联合挛三针治疗中风后痉挛性偏瘫气虚血瘀证的临床疗效,以及对患者生存质量的影响。方法:将86例患者按随机数字表法分为对照组和观察组,每组43例。两组患者均参见《中国脑卒中康复治疗指南》行常规干预。对照组给予Bobath技术为主的康复疗法。观察组在对照组治疗基础上给予张力平衡针法联合挛三针疗法治疗。两组患者疗程均为4周。比较两组患者肢体运动功能、上下肢肌力、临床痉挛指数(clinic spastcity index,CSI)评分及临床疗效。运用报告结局评价(report end evaluation,PRO)量表评价两组患者的生存质量。结果:治疗后,观察组患者傅格-梅尔氏运动量表(Fugl-Meyer movement scale,FMMS)评分高于对照组,上下肢肌力评分显著低于对照组,差异均有统计学意义(P<0.01)。治疗后2周和4周,观察组CSI评分均显著低于对照组,差异均有统计学意义(P<0.01)。观察组患者的有效率为93.02%,显著高于对照组的74.42%,差异有统计学意义(P<0.05)。治疗后4周和6周,观察组PRO评分均明显低于对照组,差异均有统计学意义(P<0.01)。结论:张力平衡针法联合挛三针治疗中风后痉挛性偏瘫气虚血瘀证可改善上下肢运动功能和肌张力,提高临床疗效和生存质量。

Objective：To investigate the clinical efficacy of Zhangli Pingheng needling combined with Luansanzhen needling in trea- ting for post-stroke spastice hemlplegia and the influence on patients＇ life quality. Method：Eighty-six patients were randomly divid- ed into control group （43 cases） and observation group （43 cases）. Both groups were treated with conventional treatment by refer- ring to Chinese Stroke Rehabilitation Therapy Guide. The control group received rehabilitation therapy mainly including the treat- ment of Bobath technology. In addition to that of control group, the observation group was treated with Zhangli Pingheng needling combined with Luansanzhen needling. Both groups wer observed for4 weeks in both groups. Scores of motor ability, muscle strength,clinical spasm index （CSI） and efficacy of two groups were compared. Patient-reported outcome （PRO） was used to e- valuate patients＇ life quality in two groups. Results：After treatment, scores of FMMS were remarkably higher while the upper and lower muscle strength was lower than control group （P 〈 0.01 ）. Two and 4 weeks after treatment, CS1 score of observation group was obviously less than that of the control group （P 〈 0.01 ）. The total effective rate of observation group was 93.02% ,which was evidently higher than that （74.42%） of the control group （ P 〈0.05）. Four and 6 weeks after treatment the PRO score of obser- vation group were remarkably less than that of the control group （P 〈 0.01 ）. Conclusion： Zhangli Pingheng needling combined with Luansanzhen needling in treating for pastice post-stroke hemiplegia can improve patients＇ limbs motor function and muscular tension as well as increasing the clinical efficacy and patients＇ life quality.