针刺“腰痛穴”治疗中风后手指拘挛临床疗效观察

Clinical Observation of Needling EX-UE6 in Treating Post-Stroke Finger Contracture

目的:比较针刺"腰痛穴"与常规腧穴治疗中风后手指拘挛的疗效差异。方法:将60例中风后手指拘挛患者随机分为治疗组和对照组,每组30例。治疗组:穴取腰痛穴;对照组:穴取八邪、合谷,两组均行平补平泻手法,均留针50 min,每日1次,每周6次,连续治疗3周后观察疗效。以改良Ashworth痉挛分级评定量表(MAS)评价两组治疗前后手指痉挛程度的改变;简化Fugl-Meyer运动功能评分量表(FMA)评价两组治疗前后手运动功能的变化。结果:两组患者在治疗后MAS评分较治疗前均下降(P<0.05),治疗组MAS评分比对照组降低更明显(P<0.05);两组患者在治疗后Fugl-Meyer运动功能评分较治疗前均增高(P<0.05),治疗组Fugl-Meyer运动功能评分比对照组增高更明显(P<0.05);治疗组愈显率显著高于对照组(P<0.05)。结论:针刺腰痛穴治疗中风后手指拘挛疗效确切,在降低患者手指肌张力、缓解手指拘挛状态,促进手指运动功能恢复方面优于常规腧穴。

Objective:To compare the therapeutic effect between needling Yaotong point(EX-UE6)and needling routine acupoints in the treatment of post-stroke finger contracture.Methods:60 patients with post-stroke finger contracture were randomly divided into the treatment group(n=30)and the control group(n=30).The treatment group was treated with needling EX-UE6,and the control group was treated with needling Baxie(EX-UE9)and Hegu(LI4),both groups were treated with mild reinforcing and reducing method,all needles were kept for 50 minutes,the acupuncture was once a day and 6 times a week.The effect was observed after 3 weeks of the treatment.Changes in the degree of hand contracture were evaluated by the modified Ashworth grading scale(MAS),and the simplified Fugl-Meyer motor function rating scale(FMA)was used to evaluate the changes of hand movement function before and after the treatment in the two groups.Results:The MAS scores were significantly decreased after the treatment compared to those before the treatment in the two groups(P<0.05);of which the decreases in the treatment group were more significant(P<0.05).The scores of FMA were significantly increased after the treatment compared to those before the treatment in the two groups(P<0.05);of which the increases in the treatment group was better than the control group(P<0.05).The markedly effective rate of the treatment group was significantly higher than that of the control group(P<0.05).Conclusion:The effect of needling EX-UE6 is significant in treating post-stroke finger contracture,which is superior to needling the routine points in terms of reducing the tension of finger muscles,relieving the state of finger contracture and promoting the recovery of finger movement function.