体外冲击波联合针灸对脑卒中患者上肢屈肌痉挛状态的疗效观察

Effect of Extracorporeal Shock Wave Therapy Combined with Acupuncture on Stroke Patients with Upper Limb Flexor Spasticity

目的:观察体外冲击波治疗(ESWT)联合针灸对脑卒中上肢屈肌痉挛状态患者的治疗效果。方法:脑卒中后上肢单瘫恢复期伴有上肢屈肌肌张力增高的患者80例,随机分为对照组、针灸组、ESWT组和联合组,每组20例,均给予常规康复治疗,针灸组另予针灸治疗,ESWT组另予ESWT,联合组另予针灸联合ESWT治疗,连续治疗4周。应用改良Ashworth量表(MAS)、简化Fugl-Meyer评定法上肢部分(U-FMA)和Barthel指数(BI)分别于治疗前后对患者的上肢屈肌痉挛情况、运动功能及日常生活能力进行评定。结果:治疗前各组MAS、U-FMA、BI评分差异均无统计学意义(P>0.05);治疗4周后,各组MAS评分较治疗前明显降低,U-FMA、BI评分较治疗前升高(P<0.05),联合组的MAS评分低于对照组、ESWT组、针灸组,U-FMA、BI评分高于对照组、ESWT组、针灸组(P<0.05)。结论:ESWT联合针灸对脑卒中上肢屈肌痉挛状态患者疗效显著,且安全无副作用。

Objective:To observe therapeutic effect of extracorporeal shock wave therapy(ESWT)combined with acupuncture on patients with upper limb flexor spasm after stroke.Methods:Total 80 patients with hemiplegia of the upper limbs and increased upper limb flexor tension after stroke were recruited and randomly divided into groups control,acupuncture,ESWT,and combined treatment,with 20 patients in each.All groups were treated with standard rehabilitation,and the acupuncture group was additionally given acupuncture therapy,the ESWT group given ESWT,and the combined treatment group given acupuncture and ESWT.Treatment was continued for 4 weeks.The modified Ashworth Scale(MAS),simplified Fugl-Meyer assessment for upper extremity(U-FMA),and modified Barthel Index(BI)were used to evaluate muscle spasm,motor function,and daily living ability before and after treatment.Results:There was no significant difference in the MAS,U-FMA,and BI scores between the groups before treatment(P>0.05).After 4 weeks of treatment,all groups showed a decrease in MAS scores and increase in U-FMA and BI scores compared to before treatment(P<0.05).The combined treatment group showed a lower MAS score and higher U-FMA and BI scores than the control,ESWT,and acupuncture groups.Conclusion:ESWT combined with acupuncture has a significant curative effect on patients with upper limb flexor spasm after stroke;additionally,this treatment is safe and has no side effects.