针灸治疗缺血性脑卒中偏瘫合并膝骨关节炎临床研究

Clinical Study on Acupuncture and Moxibustion for Cerebral Ischemic Stroke and Hemiplegia Complicated with Knee Osteoarthritis

目的:观察针灸治疗缺血性脑卒中(CIS)偏瘫合并膝骨关节炎(KOA)的临床疗效。方法:将81例气滞血瘀型CIS偏瘫合并KOA患者随机分为研究组41例与对照组40例。对照组给予西药阿司匹林、硫酸氨基葡萄糖治疗,研究组在对照组基础上联合中医针灸治疗,均治疗3个月。对比2组治疗前后C-反应蛋白(CRP)、脑钠肽(BNP)、同型半胱氨酸(Hcy)水平与日常生活活动能力(ADL)评分、Fugl-Meyer运动功能(FMA)评分,并比较2组治疗过程中的不良反应。结果:与同组治疗前比较,治疗后2组BNP、CRP、Hcy水平均降低(P<0.05),ADL进阶能力评分、基本能力评分及总分,FMA上肢评分、下肢评分及总分均升高(P<0.05);与对照组治疗后比较,研究组治疗后BNP、CRP、Hcy水平均较低(P<0.05),ADL进阶能力评分、基本能力评分及总分,FMA上肢评分、下肢评分及总分均较高(P<0.05)。2组不良反应比较,差异无统计学意义(P>0.05)。结论:针灸治疗CIS偏瘫合并KOA的疗效良好,可改善患者肌力及膝关节功能,提高患者日常生活能力。

Objective:To observe the clinical effect of acupuncture and moxibustion on patients with cerebral ischemic stroke(CIS)and hemiplegia complicated with knee osteoarthritis(KOA).Methods:A total of 81 cases with CIS and hemiplegia complicated with KOA of qi stagnation and blood stasis type were randomly divided into the study group(41 cases)and the control group(40 cases).The control group was treated with aspirin and glucosamine sulfate,and the study group was treated with acupuncture and moxibustion based on the treatment of the control group.Both groups were treated for three months.The levels of C-reactive protein(CRP),brain naturetic peptide(BNP),homocysteine(Hcy),and the scores of activity of daily living(ADL)and Fugl-Meyer Assessment(FMA)before and after treatment as well as the adverse reactions during treatment were compared between the two groups.Results:Compared with those within the same group before treatment,the levels of BNP,CRP and Hcy in both groups were decreased(P<0.05),and the advanced ability score,basic ability score and total score of ADL were increased(P<0.05);the upper limb score,lower limb score and total score of FMA were increased(P<0.05).Compared with those in the control group after treatment,the levels of BNP,CRP and Hcy in the study group were lower(P<0.05),the advanced ability score,basic ability score and total score of ADL as well as the upper limb score,lower limb score and total score of FMA were higher(P<0.05).There was no significant difference in the comparison of adverse reactions between the two groups(P>0.05).Conclusion:The therapy of acupuncture and moxibustion has a good therapeutic effect on the treatment of CIS and hemiplegia complicated with KOA,which can improve the muscle strength,knee function and daily living ability of patients.