针刺联合平衡调筋解痉推拿对中风后偏瘫患者肢体平衡能力及肌张力恢复的影响

Effects of Acupuncture Combined with Tuina for Balancing Tendon and Relieving Spasm on Limb Balance and Muscular Tension Recovery in Patients with Hemiplegia after Stroke

目的研究针刺联合平衡调筋解痉推拿对中风后偏瘫患者肢体平衡能力及肌张力恢复的影响。方法选择医院2017年1月—2020年1月诊治的中风后偏瘫患者80例作为研究对象,按照随机数字表法随机分为两组,每组40例。对照组采用常规康复训练,观察组在对照组基础上增加针刺联合平衡调筋解痉推拿治疗。观察比较两组总有效率,中医症状积分,肢体平衡能力,肌张力,日常生活能力。结果观察组、对照组总有效率分别为97.5%(39/40)、80.0%(32/40),观察组显著高于对照组(P<0.05)。治疗前两组中医症状积分差异无统计学意义(P>0.05),治疗后观察组中医症状积分显著低于对照组(P<0.05)。治疗前两组Berg平衡量表(BBS)、起立-行走计时测试(TUGT)、Fugl-Meyer运动积分(FMA)比较差异均无统计学意义(P>0.05),治疗后观察组BBS、FMA评分显著高于对照组、TUGT显著短于对照组(P<0.05)。治疗前两组肌张力分级情况差异无统计学意义(P>0.05),治疗后观察组的0级、1级患者比例显著高于对照组(P<0.05)。治疗前两组日常生活能力量表(ADL)评分差异无统计学意义(P>0.05),治疗后观察组ADL总分以及生活自理维度、工具性日常生活能力维度评分均显著低于对照组(P<0.05)。结论针刺联合平衡调筋解痉推拿能够改善中风后偏瘫患者的临床症状,临床疗效满意,有利于患者肢体平衡能力及肌张力的恢复,显著提高患者的日常生活能力。

Objective To study the effect of acupuncture combined with Tuina for balancing tendon and relieving spasm on limb balance and muscular tension recovery in patients with hemiplegia after stroke. Methods Eighty patients with hemiplegia after stroke in our hospital from January 2017 to January 2020 were selected as the research objects, and they were randomly divided into two groups according to the random number table method, 40 cases in each group. The control group received conventional rehabilitation training, and the observation group added acupuncture combined with Tuina for balancing tendon and relieving spasm on the basis of the control group. The total effective rate, TCM symptom score, limb balance ability, muscle tension and daily life ability of two groups were observed and compared. Results The total effective rates of the observation group and the control group were 97.5%(39/40) and 80.0%(32/40), respectively. The observation group’s total effective rate was significantly higher than that of the control group(P<0.05). There was no significant difference in TCM symptom scores between two groups before treatment(P>0.05). The TCM symptom scores in the observation group were significantly lower than those in the control group after treatment(P<0.05). There were no significant differences in the Berg Balance Scale(BBS), the Standing-Walking Timing Test(TUGT) or the Fugl-Meyer Exercise Score(FMA) between two groups before treatment(P>0.05). After treatment, the BBS and FMA scores were significantly higher than those of the control group, and TUGT was significantly shorter than that of the control group(P<0.05). There was no significant difference in muscle tension classification between two groups before treatment(P>0.05), and the proportions of patients in the observation group at level 0 and 1 were significantly higher than those of the control group after treatment(P<0.05). There was no significant difference in the ADL scores between two groups before treatment(P>0.05). The total ADL scores, self-care dimensions and instrumental daily life ability scores of the observation group after treatment were significantly lower than those of the control group(P<0.05). Conclusion Acupuncture combined with Tuina for balancing tendon and relieving spasm can improve the clinical symptoms of patients with hemiplegia after stroke, and the clinical effect is satisfactory. It is beneficial to the recovery of limb balance and muscular tension, and significantly improves the daily living ability of patients.