针刺结合意向性运动疗法治疗脑卒中Pusher综合征的临床研究

Clinical Effect of Acupuncture Combined with Willed-movement Therapy in Treatment of Stroke and Pusher Syndrome

目的探讨针刺结合意向性运动疗法(willed movement,WM)对脑卒中Pusher综合征(倾斜综合征)患者运动功能、平衡功能及日常生活活动能力所产生的影响。方法脑卒中Pusher综合征患者61例,采用随机区组设计将患者分为治疗组(针刺+WM)31例、对照组(针刺)30例,两组均治疗6周。分别采用临床倾倒量表(SCP)、患侧Fugl-Meyer下肢运动功能(FMA)、Berg平衡量表(BBS)、日常生活活动能力Barthel指数(BI)评定。结果 (1)经治疗6周后,两个试验组FMA、BI及BBS评分,较治疗前均提高(P<0.05),治疗组在FMA、BI及BBS评分明显优于对照组(P<0.05);(2)两个试验组的SCP评分,较治疗前均下降(P<0.05),且治疗组的SCP明显优于对照组(P<0.05)。结论针刺疗法结合WM疗法能明显改善Pusher综合征患者的身体倾斜症状,对恢复身体中线方面有较好疗效,并且可以显著提高患者的运动功能、平衡功能,使其尽早恢复直立位,加快康复进程,提高日常生活自理能力。

Objective To investigate the effect of acupuncture combined with willed-movement(WM)therapy on motor function,balance function,and activities of daily living in patients with stroke and pusher syndrome.Methods A total of 61 patients with stroke and pusher syndrome were randomly divided into treatment group(acupuncture+WM)with 31 patients and control group(acupuncture alone)with 30 patients.The course of treatment was 6 weeks for both groups.The Scale for Contraversive Pushing(SCP),Fugl-Meyer Assessment(FMA),Berg Balance Scale(BBS),and Barthel Index(BI)for Activities of Daily Living were used for assessment.Results After 6 weeks of treatment,both groups had significant increases in FMA,BI,and BBS scores(P<0.05),and the treatment group had significantly better scores than the control group(P<0.05);both groups had a significant reduction in SCP score after treatment(P<0.05),and the treatment group had a significantly better SCP score than the control group(P<0.05).Conclusion Acupuncture combined with WM therapy can significantly improve the symptom of body tilt in patients with pusher syndrome and has a good clinical effect on the recovery of the center line of the body.It can also significantly improve patients'motor function and balance function,restore the upright position as early as possible,accelerate rehabilitation,and improve self-care ability in daily life.