针灸在中风偏瘫后足下垂患者中的应用及对表面肌电图的影响

Application of Acupuncture Therapy in Patients with Foot Drop after Apoplectic Hemiplegia and Effects on External Electromyography

目的:评价针灸在中风偏瘫后足下垂患者中的应用及对表面肌电图的影响。方法:选取2016年6月至2017年6月首都医科大学附属北京中医医院收治的中风足下垂患者70例,按照随机数字表法随机分对照组和观察组,每组35例。对照组给予西医康复疗法,观察组给予针灸联合西医康复疗法,记录并比较2组患者治疗后的临床疗效、临床症状评分、积分肌电值和三维步态空间参数指标。结果:治疗后,观察组的总有效率为89. 58%,对照组总有效率为72. 92%,组间比较,观察组显著高于对照组,差异有统计学意义(P <0. 05)。治疗后,2组患者的临床症状积分(Fugl-Meyer和Bathel积分)、积分肌电值(胫骨前肌、腓骨长肌、腓骨短肌、腓肠肌内侧、腓肠肌外侧)均高于治疗前,且观察组的临床症状积分和积分肌电值均高于对照组,2组比较,差异有统计学意义(P <0. 05)。治疗后,观察组和对照组患者的三维步态空间参数步幅、步速、步频均上升,步宽减少,且观察组三维步态空间参数改善较对照组显著,差异有统计学意义(P <0. 05)。结论:针灸可以有效提高中风偏瘫后足下垂患者的运动功能积分、日常生活功能积分和积分肌电值,显著协调和平衡患者步态,提高中风足下垂患者的临床治疗效果。

Objective ： To evaluate the application of acupuncture therapy in patients with foot drop after apoplectic hemiplegia and effects on external eleetromyography. Methods：A total of 70 patients with foot drop after apoplectic hemiplegia admitted to Beijing Hospital of Traditional Chinese Medicine, Capital Medical University from June 2016 to June 2017 were randomly divided into two groups, with 35 patients in each group. The control group was given western medicine rehabilitation treatment, and the observation group was given acupuncture combined with western medicine rehabilitation treatment. The clinical efficacy, symptom scores, in- tegrating eleetromyogram （iEMG） and three-dimensional gait spatial parameters were recorded and compared between the two groups. Results：The total effective rate in the observation group （89. 58 % ） was higher than that in the control group （72. 92% ）, and the difference was statistically significant （ P 〈 0. 05 ）. After treatment, the clinical symptom scores （ Fugl-meyer and Bathel scores） and the iEMG （tibialis anterior,peroneus longus, peroneus brevis,medial head of gastroenemius, and lateral head of gas- troenemius） in the observation group were higher than those in the control group （P 〈 0. 05）. The changes of three-dimensional gait spatial parameters in the observation group were more significant than those in the control group （P 〈 0. 05）. Conclusion：Ac- upuncture can effectively improve the scores of sports function,and daily life function and iEMG, significantly coordinate and bal- ance the gait, and increase the clinical treatment effect of patients with foot drop after apoplectic hemiplegia.