针灸推拿联合中药熏蒸治疗中风后偏瘫痉挛临床研究

Clinical Study on Acupuncture and Massage Combined with Chinese Herbal Fumigation for Hemiplegic Spasm after Stroke

目的:观察针灸推拿联合中药熏蒸治疗中风后偏瘫痉挛的临床疗效。方法:将68例中风后偏瘫痉挛患者随机分为2组,每组34例,对照组给予中药熏蒸治疗,试验组给予针灸推拿联合中药熏蒸治疗,疗程均为4周;观察比较2组治疗前后肌肉痉挛程度[应用Ashworth量表及临床痉挛指数(CSI)进行价]、肢体运动功能[应用简式Fugl-Meyer(FMA)评分进行评定]、日常生活能力(应用Barthel指数分级法评分进行评定)的变化,并统计2组临床疗效。结果:治疗后,总有效率试验组为88.2%,对照组为73.5%,2组比较,差异有统计学意义(P<0.05)。治疗后,2组患者Ashworth、CSI评分较治疗前降低(P<0.05),FMA、Barthel评分较治疗前升高(P<0.05);且试验组各项评分改善均较对照组更显著(P<0.05)。结论:针灸推拿联合中药熏蒸治疗脑中风偏瘫痉挛,能较好地改善患肢肌肉痉挛及肢体运动功能,提高患者生活质量,疗效优于单纯中药熏蒸治疗。

Objective: To observe the clinical effect of acupuncture and massage combined with Chinese herbal fumigation for hemiplegic spasm after stroke. Methods:A total of 68 cases of patients with hemiplegic spasm after stroke were randomly divided into two groups, 34 cases in each group. The control group was treated with Chinese herbal fumigation,and the experiment group was treated with acupuncture and massage combined with Chinese herbal fumigation.Both groups were treated for four weeks. The degree of muscle spasm was evaluated by Ashworth Scale and clinical spasticity index(CSI),the extremity motor function was measured by short-form Fugl-Meyer assessment(FMA),and the daily living ability was assessed by Barthel index grading method;before and after treatment, the changes of the above indexes in the two groups were observed and compared. The clinical effect in the two groups was recorded. Results:After treatment,the total effective rate was 88.2% in the experiment group and 73.5% in the control group,the difference being significant(P<0.05). After treatment, the scores of Ashworth and CSI in the two groups were decreased when compared with those before treatment(P<0.05),and the scores of FMA and Barthel were increased when compared with those before treatment(P<0.05);the improvement of the above scores in the experiment group was more significant than that in the control group(P<0.05). Conclusion: The therapy of acupuncture and massage combined with Chinese herbal fumigation in treating hemiplegic spasm after stroke can effectively improve the muscle spasm of affected limb and the extremity motor function of patients and enhance the quality of life, whose curative effect is better than that of simple Chinese herbal fumigation.