针灸结合运动再学习康复疗法对缺血性脑卒中患者神经功能及肢体运动功能恢复的影响

Effect of acupuncture combined with exercise relearning rehabilitation therapy on the recovery of nerve function and limb motor function in patients with cerebral ischemic stroke

目的观察以针刺全身穴位、温针灸腹部穴位并结合运动再学习康复疗法对缺血性脑卒中患者神经功能以及肢体运动功能恢复的影响。方法选取2017年2月~2019年2月在新疆医科大学第一附属医院收治的缺血性脑卒中患者共90例。采用随机对照的研究方法根据随机数字表法将其分为治疗组和对照组,每组各45例。研究前结合患者具体病情给予控制血压、改善脑循环、稳定生命体征以及预防并发症等西医治疗。治疗组采用以针灸结合运动再学习康复疗法为主治疗,针灸治疗均为1次/d,以治疗10次为1个疗程。对照组采用单纯康复治疗,康复治疗10次为1个疗程,两组患者共治疗2个疗程。以神经功能缺损程度评分标准1995(CSS)和国际通用运动功能Fugl-Meyer评分法(FMA)测评其神经缺损功能和运动功能,同时比较两组患者临床疗效。结果两组患者治疗前FMA评分和CSS评分比较,差异无统计学意义(P>0.05)。治疗后,两组患者FMA评分均高于治疗前,CSS评分均低于治疗前,且治疗组FMA评分高于对照组,CSS评分低于对照组,差异均有统计学意义(均P<0.05)。治疗组总有效率高于对照组,差异有统计学意义(P<0.05)。结论运用针灸结合运动再学习康复疗法对缺血性脑卒中患者的神经功能以及肢体运动功能的改善优于单纯康复治疗,值得临床进一步推广应用。

Objective To observe the effect of acupuncture on nerve function and limb motor function recovery in patients with cerebral ischemic stroke by acupoints of whole body,warm acupuncture of abdominal acupoints and exercise relearning rehabilitation therapy.Methods A total of 90 patients with cerebral ischemic stroke admitted to the First Affiliated Hospital of Xinjiang Medical University from February 2017 to February 2019 were selected.A randomized controlled study was conducted to divide the patients into treatment group and control group according to the random number table,with 45 patients in each group.Before the test,all patients were treated with Western medicine,including blood pressure control,improvement of brain circulation,stabilization of vital signs and prevention of complications.In the treatment group,acupuncture and moxibustion combined with exercise relearning rehabilitation therapy were used as the main treatment,and acupuncture and moxibustion were treated once a day and 10 times as a course of treatment.The control group was given rehabilitation treatment alone,10 times of rehabilitation treatment for 1 course of treatment,and the patients in the two groups received a total of 2 courses of treatment.The nerve defect function and motor function were evaluated by the nerve defect function rating scale 1995(CSS)and the international general motion function Fugl-Meyer assessment(FMA),and the clinical efficacy of the two groups of patients was compared.Results There was no significant difference in FMA score and CSS score between the two groups before treatment(P>0.05).After treatment,FMA score in both groups was higher than before treatment,while CSS score was lower than before treatment.FMA score in the treatment group was higher than that in the control group,while CSS score was lower than that in the control group,with statistically significant differences(P<0.05).The total effective rate of the treatment group was higher than that of the control group,and the difference was statistically significant(P<0.05).Conclusion The improvement of nerve function and limb motor function in patients with ischemic stroke by acupuncture and moxibustion combined with cerebral exercise relearning rehabilitation therapy is superior to rehabilitation therapy alone,and is worthy of further promotion and application in clinic.