针刺治疗脑卒中后手功能障碍临床观察

Clinical observation on acupuncture treatment of hand dysfunction after stroke

目的:观察针刺治疗脑卒中后手功能障碍的临床疗效。方法:纳入脑卒中后手功能障碍患者171例,随机分为针刺组(86例)和对照组(85例)。两组均采用康复训练,针刺组同时给予针刺治疗。治疗前后采用Fugl-Meyer运动功能评分上肢部分(FMA-UE)、腕屈肌群改良Ashworth痉挛量表(MAS)、手运动功能状态评分、WOLF运动功能测试评分表(WMFT)评定手及上肢功能,采用美国国立卫生院脑卒中量表(NIHSS)、Barthel指数(MBI)评定日常生活活动能力及神经功能缺损程度,并比较两组有效率。结果:治疗后针刺组FMAUE、手运动功能状态、WMFT、MBI评分显著高于对照组(P<0.05);腕屈肌群MAS和NIHSS评分显著低于对照组(P<0.05)。针刺组有效率(91.86%,79/86)显著高于对照组(69.41%,59/85)(P<0.05)。结论:针刺联合康复训练可以改善脑卒中患者手功能、提高日常生活活动能力及生活质量,疗效优于单纯康复训练。

Objective:To observe the effect of acupuncture on hand dysfunction after stroke.Methods:A total of 171 patients with hand dysfunction after stroke were selected as the research subjects and randomly divided into the acupuncture group(86 cases)and the control group(85 cases).Both groups received basic rehabilitation,while the acupuncture group received acupuncture in addition.Before and after treatment,the function of hand and upper extremity was assessed by the Fugl-Meyer motor assessment upper extremity(FMA-UE)score,the wrist flexor modified Ashworth scale(MAS)score,the hand movement function score and the Wolf motor function test(WMFT)score.The National Institutes of Health Stroke Scale(NIHSS)and Barthel Index(MBI)were used to evaluate the activities of daily living and the degree of neurological deficit,and the effective rate of the two groups were evaluated and compared.Results:After the treatment,the FMA-UE score,the hand movement function score,the WMFT score,and the MBI score of the acupuncture group were significantly higher than those of the control group(P<0.05).The wrist flexor MAS score and the NIHSS score were significantly lower than the control group(P<0.05).The clinical efficiency of the acupuncture group(91.86%,79/86)was significantly higher than the control group(69.41%,59/85)(P<0.05).Conclusion:Acupuncture combined with rehabilitation training can significantly promote the recovery of hand function and the activities of daily living in patients after stroke,the curative effect of which is better than rehabilitation training alone.