巨刺配合脐灸对缺血性中风偏瘫患者肢体功能及下肢肌肉电生理活动的影响

Effect of opposing needling combined with umbilical moxibustion on limb function and lower limb muscle electrophysiological activity in patients with ischemic stroke hemiplegia

目的探讨巨刺配合脐灸对缺血性中风偏瘫患者肢体功能及下肢肌肉电生理活动的影响。方法将2018年5月—2020年2月青岛市中心医院收治的90例缺血性中风偏瘫患者随机分成对2组,对照组45例给予缺血性中风规范化的治疗+康复功能训练干预,观察组45例在此基础上给予巨刺配合脐灸治疗,2组均治疗6周。观察2组治疗前后神经功能缺损程度评分、改良Barthel指数评分、简易Fugl-Meyer评分、临床症状积分、下肢肌电生理指标[表面肌电值(iEMG)、均方根值(RMS)及中位频率(MF)],比较2组临床疗效,记录不良反应情况。结果治疗后,2组神经功能缺损评分及半身不遂、口舌歪斜、肢体麻木、舌强语蹇、心烦易怒积分均明显降低(P均<0.05),Barthel指数评分、Fugl-Meyer评分及iEMG、RMS、MF均明显升高(P均<0.05),且观察组以上各指标改善程度均优于对照组(P均<0.05);观察组总有效率为91.1%(41/45),对照组为75.6%(34/45),观察组明显高于对照组(P<0.05);2组治疗期间均无明显不良反应发生。结论巨刺法配合脐灸能更好地促进缺血性中风偏瘫患者神经功能和肢体运动功能恢复,缓解局部症状。

Objective It is to investigate the effect of opposing needling combined with umbilical moxibustion on limb function and lower limb muscle electrophysiological activities in patients with ischemic stroke hemiplegia.Methods Ninety patients with ischemic stroke hemiplegia admitted to Qingdao Central Hospital from May 2018 to February 2020 were randomly divided into 2 groups,45 patients in the control group were given standardized treatment of ischemic stroke+rehabilitation function training,45 patients in the observation group were treated with opposing needling combined with umbilical moxibustion.Both groups were treated for 6 weeks.The scores of neurological deficits,modified Barthel index score,simple Fugl-Meyer score,clinical symptom score,lower limb electrophysiological indicators[integrated electromyogram(iEMG),root mean square(RMS)and median frequency(MF)]before and after treatment were observed in the two groups,the clinical efficacy of the two groups was compared,and the adverse reactions were recorded.Results After treatment,the scores of neurological deficits,and the scores of hemiplegia,crooked tongue,deviation of the eye and mouth,limb numbness,stiff tongue and dysphasia and upset and irritability were significantly reduced in the two groups(all P<0.05),Barthel index score,Fugl-Meyer score,iEMG,RMS,MF were significantly increased(all P<0.05),and the improvements of the above scores and index in the observation group were better than those in the control group(all P<0.05);the total effective rate was 91.1%(41/45)in the observation group,and 75.6%(34/45)in the control group,the observation group was significantly higher than the control group(P<0.05);there were no obvious adverse reactions in the two groups during the treatment period.Conclusion The opposing needling combined with umbilical moxibustion can better promote the recovery of nerve function and limb motor function and relieve local symptoms in patients with ischemic stroke hemiplegia.