针康法对脑卒中上肢痉挛患者肌张力、上肢功能及生活质量的影响

Effect of acupuncture-rehabilitation on muscle tension,upper limb function and quality of life in patients with upper limb spasticity after stroke

目的观察针康法对脑卒中上肢痉挛患者肌张力、上肢功能及生活质量的影响。方法将2018年1月—2019年3月黑龙江中医药大学附属第二医院收治的82例脑卒中上肢痉挛患者随机分为2组,对照组41例在脑卒中常规内科处理基础上给予新Bobath技术康复训练治疗,观察组41例在对照组治疗基础上给予头针丛刺针法治疗,2组均连续治疗4周。对比2组治疗前后上肢功能(FMA评分)、肌张力(MAS评分)、肘关节屈伸功能(肘关节屈协同收缩率、肘关节伸协同收缩率)、日常生活活动能力(Barthel指数评分)、生活质量(SF-36评分)情况,评估2组临床疗效。结果2组治疗后FMA评分、Barthel指数评分、SF-36评分均较治疗前明显升高(P均<0.05),且观察组明显高于对照组(P均<0.05);2组治疗后MAS评分及肘关节屈协同收缩率、肘关节伸协同收缩率均较治疗前明显降低(P均<0.05),且观察组均明显低于对照组(P均<0.05)。治疗4周后,观察组和对照组治疗总有效率分别为85.4%(35/41)、63.3%(26/41),观察组明显高于对照组(P<0.05)。结论针康法能够明显改善脑卒中上肢痉挛患者肌张力、上肢功能、肘关节屈伸功能及日常生活活动能力,有助于改善患者痉挛状态,提高生活质量。

Objective It is to observe the effect of acupuncture-rehabilitation on the muscle tone,upper limb function and quality of life in patients with upper limb spasticity after stroke.Methods A total of 82 patients with upper limb spasticity after stroke admitted to the Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine from January 2018 to March 2019 were randomly divided into 2 groups,41 patients in the control group were given rehabilitation training with the new Bobath technique based on the routine medical treatment of stroke,41 cases in the observation group were treated with cluster needling of scalp point therapy on the basis of the control group.Both groups were treated for 4 weeks.The upper limb function(FMA score),muscle tension(MAS score),elbow joint flexion and extension function(elbow joint flexion co-contraction ratio,elbow joint extension co-contraction ratio),activities of daily living(Barthel index score),life quality(SF-36 score)before and after treatment were compared between the two groups,and the clinical efficacy of the two groups was evaluated.Results After treatment,the FMA score,Barthel index score,and SF-36 score of the two groups were increased significantly compared with before treatment(P<0.05),and the scores in the observation group were significantly higher than those in the control group(P<0.05);the MAS score and elbow joint flexion co-contraction ratio,elbow joint extension co-contraction ratio were significantly reduced in the two groups(P<0.05),and the score and ratios in the observation group were significantly lower than those in the control group(P<0.05).After 4 weeks of treatment,the total effective rates of the observation group and the control group were 85.4%(35/41)and 63.3%(26/41)respectively,the rate in the observation group was significantly higher than that in the control group(P<0.05).Conclusion Acupuncture-rehabilitation can significantly improve the muscle tone,upper limb function,elbow joint flexion and extension function and activities of daily living in patients with upper limb spasm after stroke,it is helpful to improve the patients'spasticity and quality of life.