刺络拔罐辅助治疗脑卒中恢复期上肢痉挛疗效观察

Blood-letting and cupping therapy for upper limb spasticity in recovery phase of stroke

目的:观察刺络拔罐联合常规基础治疗与单纯常规基础治疗脑卒中恢复期上肢痉挛的疗效差异。方法:将60例脑卒中恢复期上肢痉挛患者随机分为观察组和对照组,每组30例。对照组采用常规基础治疗,包括常规内科治疗、针灸及康复训练,每日1次,每周6次,共治疗2周。观察组在常规治疗基础上配合刺络拔罐,于患肢肱二头肌肌腹痉挛最明显处行刺络拔罐及井穴放血,每次选取3个井穴,隔日1次,每周3次,共治疗2周。比较两组患者治疗前后上肢痉挛评分、上肢被动牵拉力值、上肢运动功能评分,并评价临床疗效。结果:治疗后,两组患者上肢痉挛评分及上肢被动牵拉力值均较治疗前明显减少(均P<0.01),且观察组均低于对照组(P<0.05,P<0.01),观察组治疗前后差值均优于对照组(P<0.05,P<0.01)。治疗后,两组患者上肢运动功能评分均较治疗前明显增加(均P<0.01),且观察组高于对照组(P<0.05),观察组治疗前后差值优于对照组(P<0.05)。观察组总有效率为90.0%(27/30),高于对照组的76.7%(23/30,P<0.05)。结论:在常规治疗基础上,采用刺络拔罐治疗脑卒中恢复期上肢痉挛疗效显著。

Objective To observe the effect difference between blood-letting and cupping therapy combined with basic treatment and simple basic treatment for upper limb spasticity in the recovery phase of stroke. Methods Sixty patients of upper limb spasticity in the recovery phase of stroke were randomly assigned into an observation group and a control group, 30 cases in each group. In the control group, the basic treatment, including the internal treatment, acupuncture and rehabilitation, was used for 2 weeks, 6 times a week, once a day. Based on the basic treatment, blood-letting, at 3 jing-well points each time, and cupping therapy were used at the most obvious spasm point in the belly of biceps muscle in the observation group for 2 weeks, 3 time a week, once every other day. The spasm score, passive traction value, and moter function score of upper limb were assessed in the two groups before and after treatment. The effects were compared between the two groups. Results After treatment, the spasm scores and passive traction values were lower than those before treatment in the two groups （all P0.01）, with better score and value as well as different values before and after treatment in the observation group （P0.05, P0.01）. After treatment, the motor function scores were higher than those before treatment in the two groups （both P0.01）, with better score and different value before and after treatment in the observation group （both P0.05）. The total effective rate was 90.0% （27/30） in the observation group, which was better than 76.7%（23/30） in the control group （P0.05）. Conclusion Based on the basic treatment, blood-letting combined with cupping therapy are effective for upper limb spasticity in the recovery phase of stroke.