温针灸疗法联合推拿康复治疗对老年脑梗死病人脑神经递质及肢体功能恢复的影响

The Effect of Warming Acupuncture Combined with Massage Therapy on Rehabilitation of Cerebral Neurotransmitter and Limb Function in Elderly Patients with Cerebral Infarction

目的 探讨温针灸治疗法联合推拿康复治疗对老年脑梗死病人脑神经递质及肢体功能的影响。方法 选取2015年4月—2016年5月于我院就诊的老年脑梗死病人93例,采用随机数表法分为观察组(48例)和对照组(45例)。对照组给予推拿康复训练,观察组给予温针灸疗法联合推拿康复训练干预。对比两组治疗后临床效果,记录治疗前后肢体功能、生活质量评分、多巴胺(DA)、5-羟色胺(5-HT)、去甲肾上腺素(NE)等变化。结果 治疗后,观察组总有效率95.83%,高于对照组的75.76%(P<0.05)。治疗1个月后,两组DA、5-HT表达水平均提高,观察组高于对照组(P<0.05);两组NE表达水平均降低,观察组低于对照组(P<0.05);两组疼痛数字评估量表(NRS)、Ashworth痉挛评分明显低于同组治疗前,且观察组低于对照组。Fugl-Meyer评分、关节活动度评分高于同组治疗前(P<0.05),观察组Fugl-Meyer评分、关节活动度评分明显高于对照组(P<0.05);两组躯体功能、社会功能、心理功能等生活质量评分均提高,观察组高于对照组(P<0.05)。结论 温针灸疗法联合推拿康复训练干预有助于提高老年脑梗死病人的临床疗效,调节脑神经递质表达水平,促进肢体功能恢复,改善生活质量。

Objective To investigate the effects of warming acupuncture combined with massage therapy on rehabilitation of cerebral neurotransmitter and limb function in elderly patients with cerebral infarction.Methods Ninty-three elderly patients with cerebral infarction were were divided into the observation group ( n =48) and the control group ( n = 45).The control group was treated with massage training,and the observation group was treated with warm acupuncture plus massage rehabilitation training intervention.The clinical efficacy,dopamine (DA),5-serotonin (5-HT),and norepinephrine (NE) were were compared between two groups.Results After treatment,the clinical efficacy of the observation group was higher than that of the control group (95.83% vs 75.76%, P < 0.05).After treatment,the levels of DA and5-HT in the two groups were improved,and the observation group was significantly higher than that in the control group ( P < 0.05).After treatment,the levels of NE in the two groups decreased and that in the observation group was lower than that in the control group ( P < 0.05).Compared with data before treatment,the scores of NRS and Ashworth spasm in two groups were significantly lower,and the scores of Fugl-Meyer and joint activity were significantly higher ( P <0.05),and those in the observation group were significantly lower than those in the control group,and the scores of Fugl-Meyer and joint activity in the observation group were significantly higher than those in the control group ( P <0.05).After treatment,the scores of life quality of body function,social function and psychological function of two groups were increased,and that in the observation group was higher than that of the control group ( P <0.05).Conclusion Acupuncture and moxibustion combined with massage could improve the clinical efficacy of senile cerebral infarction,regulate the level of neurotransmitter expression,promote the recovery of limb function and improve the quality of life.