针刺头部督脉和足太阳经穴治疗卒中后下肢痉挛临床研究

Clinical Study of Applying of Acupuncturing at the Acupoints of head Du Meridian and Bladder Meridian in the Treatment of Spasticity of Lower Limbs after Stroke

目的:观察经针刺头部督脉和足太阳经穴对卒中后下肢痉挛的临床疗效,以期为中风后痉挛性偏瘫开发新的治疗手段。方法:纳入2017年1月至2019年12月本院收治的脑卒中伴下肢痉挛患者80例,按随机数字表法平均分作对照组及观察组,两组均40例。对照组行常规针刺治疗,观察组针刺头部督脉和足太阳经腧穴进行治疗,总疗程4周。采用改良Ashworth痉挛量表(MAS)、Fugl-Meyer(FMA)量表、日常生活能力巴氏指数(Barthelindex,BI)量表、临床痉挛指数(cliniespastieityindex,CSI)评估患者下肢痉挛、运动功能和日常生活活动能力。结果:经过治疗,两组MAS分级均较治疗前优,有统计学意义(P<0.05),且观察组分级优于对照组(P<0.05);观察组FMA分数为28.57±2.87,明显高于对照组25.97±4.13(P<0.01);两组BI分数显著升高(P<0.01),观察组升高幅度大于对照组,但无统计学意义;观察组的CSI评分中腱反射分数为2.43±0.55,肌张力分数为4.25±0.67,阵挛分数为1.41±0.51,均小于对照组各指数,降低幅度大于对照组(P<0.05)。结论:针刺头部督脉和足太阳经穴可有效缓解卒中患者下肢痉挛和改善步态异常情况,促使患者功能恢复,提高生活质量。

Objective:The purpose of this study was to observe the clinical effect of acupuncture on head Du meridian and bladder meridian on lower limb spasticity after stroke,with a view to developing new treatments for spastic hemiplegia after stroke.Methods:A total of 80patients with lower limb spasticity after stroke admitted to our hospital from January 2017to December 2019were included and divided into a controlled group and an observation group according to the random number table method,both groups had 40cases.The controlled group underwent routine acupuncture treatment,and the observation group was treated with acupuncture at the acupoints of head Du meridian and bladder meridian,and the total treatment course was 4weeks.Modified Ashwrth scale,Fugl-Meyer scale,Clinie spastieity index and Barthel index were used to evaluate patients'lower limb spasm,motor function and daily Life activity ability.Results:After treatment,the MAS grades of the two groups were better than before treatment,with statistical significance(P<0.05),and the grade of the observation group was better than the controlled group(P<0.05);The FMA score of the observation group was 28.57±2.87,which was significantly higher than that of the controlled group 25.97±4.13(P<0.01);The BI scores of the two groups increased significantly(P<0.01),and the increasing range of the observation group was greater than that of the controlled group,but there was no statistical significance;The CSI indexes of the observation group were all lower than those of the controlled group,which was the tendon reflex 2.43±0.55,the muscle tension 4.25±0.67,and the clonic sputum 1.41±0.51,and the decrement was greater than the controlled group(P<0.05).Conclusion:Acupuncturing at the acupoints of head Du meridian and bladder meridian can effectively relieve the spasticity of lower limbs and improve the abnormal gait of stroke patients,promote the recovery of patients' functions and improve the quality of life.