肌内效贴联合康复训练对脑卒中后上肢及手功能障碍的影响

Effect of intramuscular effect combined with rehabilitation training on upper limb and hand dysfunction after stroke

目的探讨肌内效贴在治疗脑卒中后上肢及手功能障碍中的治疗效果,并与常规康复和针刺治疗相比较,为其在临床应用提供客观依据。方法选取2015年12月~2017年12月在杭州市中医院针推康复分中心进行康复治疗的患者共59例。通过随机数字表法随机分为基础组(n=20)、针刺组(n=19)和贴扎组(n=20)。基础组采用常规康复治疗,其余两组在基础组治疗的基础上分别联合针刺治疗和肌内效贴治疗,共治疗6周。分别于治疗前及治疗后采用Fugl-Meyer评分(上肢部分)进行上肢功能评定,使用改良Ashworth评分评定痉挛,改良巴氏指数(Barthel)评估日常生活活动能力。结果三组治疗后Fugl-Meyer评分(上肢部分)明显高于治疗前(P<0.01),且针刺组、贴扎组的效果优于基础组,差异有统计学意义(P<0.01);治疗6周后,三组改良Ashworth评分较治疗前降低,但三组组内及组间比较均无统计学差异(P>0.05);治疗6周后,三组改良巴氏指数评分较治疗前各组均有提高(P<0.01),但三组组间比较无统计学差异(P>0.05)。结论肌内效贴治疗能改善脑卒中后偏瘫上肢及手功能障碍,效果与针刺治疗相似,优于基础康复治疗;肌内效贴治疗能提高患者的日常生活活动能力。

Objective To investigate the therapeutic effect of intramuscular effect in the treatment of upper limb and hand dysfunction after stroke,and to compare with conventional rehabilitation and acupuncture,providing objective evidence for its clinical application.Methods A total of 59 patients who underwent rehabilitation at the Acupuncture and Massage Rehabilitation Sub-center of Hangzhou Traditional Chinese Medicine from December 2015 to December 2017 were selected.They were randomly divided into basic group(n=20),acupuncture group(n=19),and sticking group(n=20)by the random number table method.The basic group was treated with conventional rehabilitation,and the other two groups were treated with acupuncture and intramuscular effect therapy on the basis of the treatment of basic group for a total of 6 weeks.Fugl-Meyer scores(upper limbs part)were used for upper limb function assessment before and after treatment,and modified Ashworth scores were used to assess sputum and Barthel was used to assess daily living activities.Results The Fugl-Meyer score(upper limb part)of the three groups was significantly higher than that before treatment(P<0.01),and the effect of the acupuncture group and the sticking group was better than that of the basic group.The difference was statistically significant(P<0.01).After 6 weeks of treatment,the modified ashworth scores of the three groups were lower than those before treatment,but there was no statistical comparison within and between groups(P>0.05).After 6 weeks of treatment,the improved Barthel scores of the three groups were higher than those before treatment(P<0.01),but there was no significant difference between the three groups(P>0.05).Conclusion Intramuscular effect can improve the upper limbs and hand dysfunction after stroke,and its effect is similar to acupuncture treatment,which is superior to basic rehabilitation therapy.Intramuscular effect therapy can improve patients'daily living activities.