“肿八针”联合艾柱灸水分穴对中风后偏瘫病人患肢功能和水肿程度的影响

Influences of Manual Acupuncture"Zhongbazhen"Combined with Moxibustion"Shuifen"on Limb Function and Limb Edema in Stroke Patients with Hemiplegia

目的探讨“肿八针”联合艾柱灸水分穴对中风后偏瘫病人患肢功能和水肿程度的影响。方法回顾性收集2017年5月—2018年10月北京中医药大学东直门医院通州院区脑病科收治的脑中风后偏瘫病人120例,随机分为治疗组与对照组,每组60例。对照组行常规肢体康复治疗;治疗组行针刺配合艾柱灸加常规肢体康复,以治疗第14天为疗效评价时点,采用统一疾病严重程度判定标准和疗效判定标准,客观评价“肿八针”配合艾柱灸水分穴对中风后患肢水肿和功能恢复的疗效。结果治疗后两组水肿程度、神经功能、运动功能和日常生活能力均改善;治疗组肿胀值降低程度及水肿疗效优于对照组(P<0.05);治疗组美国国立卫生研究院卒中量表(NIHSS)评分、肢体运动功能评分明显优于对照组(P<0.05),日常生活能力评分明显高于对照组(P<0.05)。治疗前两组股静脉与肱静脉峰流速、平均流速和管壁内径比较,差异均无统计学意义(P>0.05),治疗后治疗组股静脉与肱静脉峰流速、平均流速较对照组均增高,管壁内径较对照组降低(P<0.05)。结论针刺“肿八针”穴配合艾柱灸对中风后偏瘫病人肢体功能恢复及减轻水肿疗效确切。

Objective To observe the influences of manual acupuncture"Zhongbazhen"combined with moxibustion"Shuifen"on limb function and limb edema in stroke patients with hemiplegia.Methods From May 2017 to October 2018,one hundred and twenty patients with stroke hemiplegia were randomly divided into treatment group(60 cases)and control group(60 cases).The patients in control group were treated with routine rehabilitation treatment,and the patients in treatment group were treated with manual acupuncture"Zhongbazhen"combined with moxibustion"Shuifen"therapy on the basis of control group,both groups were treated for 2 weeks.The efficacy and practicability of manual acupuncture"Zhongbazhen"combined with moxibustion"Shuifen"therapy on limb edema and limb function after stroke were objectively evaluated by the unified disease severity judgment standard and the efficacy judgment standard.Results After treatment,the edema degree,neurological function,motion function,activities of daily living in both groups were improved than those before treatment(P<0.05).The edema index and NIHSS score in treatment group were lower than those in control group(P<0.05).The Limb function score and Barthel index in treatment group were significantly better than those in control group(P<0.05).There were no significant differences in peak flow rate,average flow rate and wall diameter of femoral vein and brachial vein between two groups before treatment(P>0.05).Compared with control group,the peak flow rate and average flow rate in treatment group were increased,and the inner diameter of tube wall was decreased after treatment(P<0.05).Conclusion Acupuncture at"Zhongbazhen"point combined with moxibustion"Shuifen"is effective for the recovery of limb edema and rehabilitation of limb function after stroke hemiplegia.