火针经筋疗法联合枢经推拿法治疗脑卒中后上肢痉挛

Effect of Fire Needle Jing Jin Plus Shujing Massage Therapy on Stroke Patients′Muscle Tension of Upper Limb Muscle Spasticity and Serum Oxidative Stress Factors

目的:探讨火针经筋疗法联合枢经推拿法治疗脑卒中后上肢痉挛的临床疗效,以及对血清超氧化物歧化酶(superoxide dismutase,SOD)、过氧化脂质(lipid peroxide,LPO)的影响。方法:将脑卒中后上肢痉挛患者74例,采用随机数字表法分为两组。其中联合治疗组37例,采取火针经筋疗法联合枢经推拿法。常规治疗组37例,采用常规针刺联合枢经推拿法。比较两组患者偏瘫上肢治疗前后改良Ashworth评分(modified Ashworth Score,MAS)以及简式Fugl-Meyer运动功能评分(Fugl-Meyer analysis,FMA),治疗前后SOD和LPO水平。结果:两组患者治疗前MAS评分比较,差异无统计学意义(P>0.05),疗程结束后联合治疗组MAS(2.28±0.71)分,明显低于常规治疗组的(3.17±0.85)分;联合治疗组痉挛程度改善有效率为81.08%,明显高于常规治疗组的62.16%;同时两组患者治疗前FMA评分比较,差异无统计学意义(P>0.05),而联合治疗组FMA评分(52.74±18.63)分明显高于常规治疗组的(43.26±17.58)分;两组患者治疗前SOD和LPO水平比较,差异无统计学意义(P>0.05),治疗后联合治疗组SOD(28.62±3.54)nmol·L^-1明显高于常规治疗组的(23.93±3.17)nmol·L^-1,LPO水平(9.18±1.05)nmol·L^-1明显低于常规治疗组的(11.27±1.22)nmol·L^-1,差异均具有统计学意义(P<0.05)。结论:火针经筋疗法联合枢经推拿法治疗脑卒中上肢痉挛,可有效降低偏瘫上肢肌张力,恢复运动功能,并提高患者体内血清SOD含量,降低LPO含量,有利于患者神经功能恢复。

Objective:Investigate the effect of Fire Needle therapy under the theory of Meridian sinew plus Shujing Massage on the muscle tension of upper limb muscle spasticity of stroke patients,and its effect on the serum SOD(Superoxide dismutase)and LPO(Lipoperoxide).Methods:Based on the random number method,74 cases that met the inclusion criteria were randomly divided into two groups,combined treatment group(n=37),which used Fire needle therapy under the theory of Meridian sinew plus Shujing massage,and conventional treatment group(n=37),which treated with regular acupuncture method combining Shujing massage.Compare the indexes of MAS(modified Ashworth Score),FMA(Fugl-Meyer analysis),serum SOD,and LOP level of the two groups before and after the treatment.Results:Before the treatment,the difference in the MAS between the two groups wasn′t obvious.After the treatment,the MAS of the combined treatment group(2.28±0.71)was significantly lower than the conventional treatment group(3.17±0.85);And the effective rate of relief spasticity in the combined treatment group was 81.08%,which was notably higher than the 62.16%in the conventional treatment group;Before the treatment,the FMA scores between the two groups wasn′t distinct different,however,the FMA score of the combined treatment group(52.74±18.63)was significantly higher than that of the conventional treatment group(43.26±17.58)after the treatment.And in SOD and LPO levels,there was no significant difference before treatment.But the SOD of the combined treatment group(28.62±3.54)nmol·L^-1 was significantly higher than that of the conventional treatment group(23.93±3.17)nmol·L^-1,and the LPO level in the combined treatment group(9.18±1.05)Nmol/L was lower than the conventional treatment group(11.27±1.22)nmol·L^-1 evidently,and the differences were statistically significant(P<0.05).Conclusion:Fire Needle therapy under the theory of Meridian sinew combined with Shujing massage therapy for the treatment of the muscle tension of upper limb muscle spasticity of stroke patients can effectively reduce the muscle tension of the upper limbs of hemiplegia,restore motor function,and increase the serum SOD in the patient′s body and reduce the LOP level,which is conducive to the recovery of patients′nerve function.