不同时机针灸结合康复治疗对脊髓损伤患者神经功能的影响

Effects of Acupuncture Combined with Rehabilitation at Different Times on Neurological Function of Patients with Spinal Cord Injury

目的探讨不同时机针灸结合康复干预对脊髓损伤患者神经功能的影响。方法将61例脊髓损伤患者按照随机数字表法分为对照组(n=30)与观察组(n=31),2组患者均给予椎板减压术治疗,对照组给予晚期针灸结合康复治疗(椎板减压术后2个月),观察组给予早期针灸结合康复治疗(术后返回病房后即予以针灸并在脊髓损伤2周后予以康复治疗)。治疗2个月后,观察并比较2组患者临床疗效、神经功能、日常生活能力和综合功能以及肌力改善情况。结果治疗后,观察组总有效率为93.55%,显著高于对照组的80.00%(P<0.05);2组运动、触觉及痛觉功能评分均升高(P<0.05),且观察组高于对照组(P<0.05);2组日常生活能力和综合功能评分均升高(P<0.05),且观察组高于对照组(P<0.05);2组肌电图躯体体感诱发电位(somatosensory evoked potential,SEP)波幅和运动诱发电位(motor evoked potential,MEP)波幅均增大(P<0.05),且观察组大于对照组(P<0.05)。结论早期针灸结合康复治疗较晚期针灸结合康复治疗更能有效改善脊髓损伤患者神经功能和肌力,促进其日常生活能力和综合功能的恢复,进而提高临床疗效。

Objective To explore the effects of acupuncture combined with rehabilitation intervention at different times on the neurological function of patients with spinal cord injury.Methods Sixty-one patients with spinal cord injury were randomly divided into control group(n=30)and observation group(n=31).Both groups were treated with laminectomy.The control group was given acupuncture combined with rehabilitation at the late stage(two months after laminectomy),while the observation group was given acupuncture combined with rehabilitation at the early stage(acupuncture can be given after returning to the ward after operation and rehabilitation after two weeks of spinal cord injury).After two months of treatment,the clinical efficacy,neurological function,activities of daily living,comprehensive functions and muscle strength improvement of the two groups were observed and compared.Results After treatment,the total effective rate of the observation group was 93.55%,which was significantly higher than that of the control group(P<0.05).The scores of motor,touch and pain in the two groups were increased(P<0.05),and the observation group were higher than the control group(P<0.05).The scores of daily living ability and comprehensive functions in the two groups were increased(P<0.05),and the observation group were higher than the control group(P<0.05).The amplitude of somatosensory evoked potential(SEP)and motor evoked potential(MEP)in the two groups were increased(P<0.05),and the observation group was higher than the control group(P<0.05).Conclusion Compared with late-stage acupuncture combined with rehabilitation,early acupuncture combined with rehabilitation could effectively improve the neurological function and muscle strength of patients with spinal cord injury,promote the recovery of their daily living ability and comprehensive functions,and then improve the clinical efficacy.