运动疗法联合手指点穴治疗脑卒中患者胫前肌无力临床研究

Exercise therapy combined with finger point pressing in the treatment of anterior tibial muscle weakness in stroke patients

目的探讨运动疗法联合手指点穴治疗脑卒中偏瘫患者胫前肌无力的疗效。方法选择吉林省人民医院2019年1月至2020年1月收治的脑卒中胫前肌无力患者89例,随机分为对照组(44例)和研究组(45例)。对照组给予常规内科治疗及运动疗法,研究组在此基础上给予点穴治疗,比较两组治疗前后FMA评分、Barthel指数,胫骨前肌与股四头肌sEMG变化及Holden步行能力,采用生活质量综合评定问卷调查表(GQO-LI)对患者治疗前后生活质量进行评价。结果治疗前两组FMA评分、Barthel指数、胫骨前肌与股四头肌iEMG、RMS比较差异无统计学意义(P>0.05)。治疗2个疗程后,两组FMA评分、Barthel指数、iEMG均升高,RMS均降低(P<0.05),但研究组FMA评分、Barthel指数、iEMG均高于对照组,RMS低于对照组(P<0.05)。研究组治疗后步行能力分级情况优于对照组(P<0.05)。治疗前两组生活质量评分差异无统计学意义(P>0.05),治疗2个疗程后两组生活质量评分上升,研究组各维度评分均高于对照组(P<0.05)。结论运动疗法联合点穴疗法可提高脑卒中胫前肌无力患者胫前肌肌力水平,改善下肢运动功能,提高步行能力及日常生活活动能力,临床疗效满意。

Objective To explore the curative effect of exercise therapy combined with finger point pressing in the treatment of anterior tibial muscle weakness in stroke patients with hemiplegia.Methods 89 cases of stroke patients with anterior tibial myasthenia treated in Jilin Provincial People's Hospital from January 2019 to January 2020 were selected.They were randomly divided into control group(44 cases)and study group(45 cases).The control group was given routine medical treatment and exercise therapy,on this basis,the study group was given acupoint treatment.FMA score,Barthel index,sEMG changes of tibialis anterior muscle and quadriceps femoris and Holden walking ability were compared between the two groups before and after treatment.The quality of life of the patients was evaluated by GQO-LI before and after treatment.Results Before treatment,there were no significant differences in FMA score,Barthel index,iEMG and RMS between the two groups(P>0.05).After 2 courses of treatment,the FMA score,Barthel Index and iEMG of the two groups were increased,while the RMS was decreased(P<0.05),but the FMA score,Barthel Index and iEMG of the study group were higher than those of the control group,and the RMS was lower than that of the control group(P<0.05).After treatment,the walking ability of the study group was better than that of the control group(P<0.05).Before treatment,there was no significant difference in quality of life between the two groups(P>0.05),after two courses of treatment,the scores of quality of life in the two groups increased,and the scores of each dimension in the study group were higher than those in the control group(P<0.05).Conclusion Exercise therapy combined with acupoint therapy can improve the muscle strength level of tibialis anterior muscle in patients with stroke tibialis anterior muscle weakness,improve the motor function of lower limbs,improve walking ability and activities of daily living.