头针联合任务导向型训练对软瘫期卒中患者体感诱发电位及功能恢复的影响

Effect of Scalp Acupuncture plus Task-oriented Approach on Somatosensory Evoked Potential and Function Recovery in Cerebral Stroke Patients in Flaccid Paralysis Stage

目的观察头针联合任务导向型训练对软瘫期卒中患者体感诱发电位(SEP)及功能恢复的影响。方法68例脑卒中软瘫期患者,随机分为对照组和治疗组,每组34例。对照组常规给予任务导向型训练,治疗组在对照组基础上给予头针治疗。比较两组治疗前后简式Fugl-Meyer评测法(FMA)、Barthel指数(BI)、简易精神状态量表(MMSE)、中风专用生活质量量表(SS-QOL)评分和体感诱发电位(SEP)变化,并比较两组临床疗效。结果治疗组总有效率为94.1%,高于对照组的76.5%(P<0.05)。两组治疗后FMA、BI、MMSE、SS-QOL评分较同组治疗前升高(P<0.01),治疗组治疗后的FMA、BI、MMSE、SS-QOL评分高于对照组(P<0.01)。两组治疗后患侧SEP的N_(20)波幅均较同组治疗前增高,潜伏期缩短(P<0.01,P<0.05);治疗组治疗后患侧SEP的N_(20)波幅与潜伏期优于对照组(P<0.01)。结论头针联合任务导向型训练可有效改善卒中软瘫期患者的SEP、运动功能、日常生活能力、认知功能及生活质量。

Objective To observe the effect of scalp acupuncture plus task-oriented approach on somatosensory evoked potential(SEP)and function recovery in patients with cerebral stroke in flaccid paralysis stage.Method Sixty-eight patients with cerebral stroke in flaccid paralysis stage were randomized into a control group and a treatment group,with 34 cases in each group.The control group was given routine task-oriented approach,and the treatment group was additionally given scalp acupuncture.Changes in Fugl-Meyer Assessment(FMA),Barthel Index(BI),Mini-Mental State Examination(MMSE),Stroke-Specific Quality of Life Scale(SS-QOL)and SEP after treatment were compared,and the clinical efficacies of the two groups were also compared.Result The total effective rate was 94.1% in the treatment group,higher than 76.5% in the control group(P<0.05).After treatment,the scores of FMA,BI,MMSE and SS-QOL increased significantly in both groups(P<0.01),and the scores in the treatment group were higher than those in the control group(P<0.01).In both groups,the amplitude of N20 in SEP of the affected side increased and its latency was shortened after treatment(P<0.01,P<0.05);the amplitude and latency of N20 in SEP of the affected side were better in the treatment group than in the control group after intervention(P<0.01).Conclusion Scalp acupuncture plus task-oriented approach can effectively improve the SEP,motor function,activities of daily living,cognition and quality of life in patients with cerebral stroke in flaccid paralysis stage.