基于肌骨超声观察“交通跷脉”针法对中风后足内翻患者下肢肌肉形态的影响

Effect of jiaotong qiaomai needling technique of acupuncture on the morphology of lower limb muscle based on muscle-skeleton ultrasound measurement in patients with post-stroke strephenopodia

目的:评价"交通跷脉"针法治疗中风后足内翻的疗效。方法:将64例患者随机分为观察组(纳入30例,脱落2例)和对照组(纳入30例,脱落2例)。对照组给予常规针刺和康复功能锻炼;观察组在对照组治疗方案的基础上,加用"交通跷脉"针法,穴取患侧风池、然谷、照海及风府,均每天1次,每周治疗5 d,共治疗4周。于治疗前、治疗2周后、治疗4周后对患者分别进行足内翻角度测量、Holden功能步行分级评定,并于治疗前、治疗4周后采用肌骨超声测量患者静息状态下胫骨前肌、胫骨后肌的厚度。结果:治疗4周后两组足内翻角度、Holden功能步行分级均较治疗前改善(P<0.01,P<0.05),且观察组优于对照组(P<0.01,P<0.05)。治疗前两组健侧胫前和胫后肌厚度均较患侧厚(P<0.05);治疗后两组患侧胫前和胫后肌厚度均较治疗前增厚(P<0.01,P<0.05),观察组健侧厚度治疗前后相当(P>0.05),而对照组健侧厚度较治疗前增厚(P<0.05);治疗后两组患侧胫前和胫后肌厚度与健侧相当(P>0.05),观察组患侧胫前和胫后肌厚度均较对照组厚(P<0.05)。结论:"交通跷脉"针法能有效改善中风后足内翻患者的足内翻角度、步行功能,并能有效改善其胫骨前肌、胫骨后肌的肌肉形态。

Objective To evaluate the therapeutic effect on post-stroke strephenopodia treated with jiaotong qiaomai(harmonizing the heel vessel) needling technique of acupuncture. Methods A total of 64 patients were randomized into an observation group(30 cases included, 2 cases dropped off) and a control group(30 cases included, 2 cases dropped off). In the control group, the routine needling technique of acupuncture and rehabilitation exercise were provided. In the observation group, on the base of the therapeutic regimen as the control group, the jiaotong qiaomai needling technique of acupuncture was added. Fengchi(GB 20), Rangu(KI 2), Zhaohai(KI 6) on the affected side and Fengfu(GV 16) were selected. The treatment was given once daily, 5 times a week, for 4 weeks totally in either group. Separately, before treatment, in 2 weeks and 4 weeks of treatment, the strephenopodia angle was measured and Holden functional ambulation classification(FAC) was evaluated in the patients. Additionally, before treatment and in 4 weeks of treatment, the muscle-skeleton ultrasound was adopted to measure the thickness of anterior tibia muscle and posterior tibia muscle in the resting state of the patients. Results The strephenopodia angle and Holden FAC were all improved after 4-week treatment in the two groups as compared with those before treatment(P<0.01, P<0.05), and the results in the observation group were better than those in the control group(P<0.01, P<0.05). Before treatment, the thickness of anterior tibia muscle and posterior tibia muscle on the healthy side was higher than that on the affected side in the patients of the two groups(P<0.05). After treatment, the thickness of anterior tibia muscle and posterior tibia muscle on the affected side was increased as compared with that before treatment in the two groups(P<0.01, P<0.05). The thickness on the healthy side was similar before and after treatment in the observation group(P>0.05), and it was increased on the healthy side after treatment as compared with that before treatment in the control group(P<0.05). After treatment, the thickness of anterior tibia muscle and posterior tibia muscle on the affected side was similar to that on the healthy side in the two groups(P>0.05), and the thickness on the affected side in the observation group was higher than that in the control group after treatment(P<0.05). Conclusion The jiaotong qiaomai needling technique of acupuncture effectively improves the strephenopodia angle and ambulation function, as well as the morphology of anterior tibia muscle and posterior tibia muscle in the patients with post-stroke strephenopodia.