针刺联合镜像视觉反馈训练对卒中偏瘫患者上肢功能及日常生活能力的影响

Effects of Acupuncture Combined with Mirror Vision Feedback Training on Upper Limb Function and Daily Life Ability of Patients with Hemiplegic Stroke

目的:观察针刺联合镜像视觉反馈训练(MVF)对脑卒中偏瘫患者上肢功能及日常生活能力的影响。方法:2018年1月至2019年6月,选择住院治疗的脑卒中患者64例,采用随机数字表法分为观察组、对照组各32例。对照组采用靳三针疗法,选取病灶侧头部行颞三针,患侧上肢行肩三针、手三针,观察组在对照组基础上增加MVF。治疗6周后,采用临床神经功能缺损程度评分标准进行疗效等级判定,采用简化Fugl-Meyer运动功能评分量表(FMA)评定上肢运动功能,Carroll手功能评定(UEFT)评估手部精细运动能力,改良Barthel指数(MBI)评定日常生活活动能力。结果:治疗后,观察组总有效率(81.25%)明显高于对照组(59.38%),两组疗效差异具有统计学意义(P<0.01)。治疗后,两组患者FMA(上肢部分)、UEFT、MBI评分均较治疗前显著增加,差异具有统计学意义(P<0.01);治疗后观察组FMA(上肢部分)、UEFT、MBI评分较对照组显著增加,差异具有统计学意义(P<0.01)。结论:针刺联合MVF相较单一疗法,能够有效改善脑卒中患者上肢功能障碍及日常生活活动能力。

Objective:To observe the effect of acupuncture combined with mirror vision feedback training(MVF)on upper limb function and daily life ability of patients with hemiplegic stroke.Methods:From January 2018 to June 2019,64 patients hospitalized with hemiplegic stroke were numbered according to the admission order,and were divided into observation group and control group with a random number table,32 patients in each group.The control group was treated with Jin’s three-needle therapy,in which three temporal needles were applied on the head side of the lesion,three shoulder needles and three hand needles on the upper limb of the affected side.In the observation group,mirror therapy was applied besides the treatment of the control group.After 6 weeks of treatment,the clinical neurological defect scale was used to evaluate the efficacy,modified Fugl-Meyer assessment(FMA)to assess the upper limb motor function,carroll hand function upper extremity function test(UEFT)to assess the fine motor ability of the hand,and the modified Barthel index(MBI)to assess the daily life activity.Results:After the treatment,the total effectiveness rate of the observation group(81.25%)was significantly higher than that of the control group(59.38%),and the difference between the two groups was significant(P<0.01).After the treatment,FMA(upper limb),UEFT and MBI scores in the two groups were significantly increased compared with those before treatment,with statistical difference(P<0.01).FMA(upper limb),UEFT and MBI scores in the MVF group after treatment were significantly higher than those in the control group after treatment,with significant differences(P<0.01).Conclusion:Compared with monotherapy,acupuncture combined with MVF training can effectively improve upper limb dysfunction and daily life activity in stroke patients.