雷火灸对中风后偏瘫患侧肢体功能、肌力和平衡能力的影响

Effect of Thunder-fire Moxibustion on Limb Function,Muscle Strength and Balance Ability of Affected Side in Patients with Post-stroke Hemiplegia

目的观察雷火灸联合抗痉挛手法治疗中风后偏瘫的临床疗效。方法选取2017年10月—2020年10月沈阳市中西医结合医院收治的105例中风后偏瘫患者为研究对象,采用随机数字法分为对照组52例和观察组53例,对照组采用抗痉挛手法治疗,观察组在对照组基础上采用雷火灸治疗,比较2组临床疗效、中医证候积分、肢体功能评分(Fugl-meyer assessment,FMA)、功能独立性评分(Functional independence measure,FIM)、肌张力评分(Modified ashworth Scale,MAS)、Berg平衡能力评分(Berg balance scale,BBS)、血液流变学指标及炎性因子水平。结果观察组治疗总有效率92.45%(49/53)高于对照组78.85%(41/52),差异有统计学意义(P<0.05);治疗后,观察组患者中医证候积分、MAS评分、血液流变动力学相关指标(HSV、LSV、PSV、HCT)和血清炎症因子(IL-4、CRP、TNF-α)水平均显著低于对照组(P<0.05),FMA、FIM和Berg评分显著高于对照组(P<0.05)。结论雷火灸皇帝内针针方联合抗痉挛手法可降低患者血清炎性因子水平,改善患者患侧肢体功能、肌张力、平衡能力及血液流变学水平。

Objective To explore the effect of thunder-fire moxibustion combined with anti-spasm manipulation on limb function,muscle strength and balance ability of affected side in patients with post-stroke hemiplegia.Methods A total of 105 patients with post-stroke hemiplegia who were admitted to the hospital from October 2017 to October 2020 were enrolled as subjects.They were divided into control group(n=52)and observation group(n=53)by random number table method.The control group was treated with anti-spasm manipulation,while observation group was additionally treated with emperor-acupuncture based thunder-fire moxibustion.The clinical curative effect,scores of TCM syndromes,Fugl-Meyer assessment(FMA),Functional Independence Measure(FIM),modified Ashworth scale(MAS)and Berg balance scale(Berg),levels of hemodynamic indexes and inflammation factors were compared between the two groups.Results The total effective rate of the observation group was 92.45%(49/53)higher than that of the control group(78.85%(41/52)),and the difference was statistically significant(P<0.05).After treatment,TCM syndrome score,MAS score,hemorheological dynamics related indexes(HSV,LSV,PSV,HCT)and serum inflammatory factors(IL-4,CRP,TNF-α)levels in observation group were significantly lower than those in control group(P<0.05),FMA,FIM And Berg score were significantly higher than those of control group(P<0.05).Conclusion Thunder fire moxibustion emperor inner needle formula combined with anti-spasmodic manipulation can improve the limb function,muscle tension,balance ability and hydrodynamics of the affected side in patients with hemiplegia after stroke,and reduce inflammatory factors.