头针联合镜像疗法对脑梗死偏瘫患者上肢运动功能恢复的影响

Effects of Scalp Acupuncture Combined with Mirror Therapy on Recovery of Upper Limb Motor Function in Patients with Hemiplegia after Ischemic Stroke

目的:探讨头针联合镜像疗法对脑梗死偏瘫患者上肢运动功能恢复的影响。方法:将90例脑梗死后偏瘫患者随机分为对照组(30例)、镜像疗法组(30例)与头针联合镜像疗法组(30例)。对照组患者采用常规康复疗法,镜像疗法组患者在对照组基础上加用镜像疗法,头针联合镜像疗法组患者在对照组基础上加用头针联合镜像疗法。治疗前和治疗4周后采用上肢FMA评分(FMA-UE)、Wolf量表(WMFT)和改良Barthel指数(MBI)进行康复评定,并评估临床疗效。结果:头针联合镜像疗法组总有效率高于对照组、镜像疗法组(P<0.01);治疗4周后,3组患者FMA-UE评分、WMFT评分及MBI评分均较治疗前明显提高(P<0.01),且镜像疗法组患者FMA-UE评分、WMFT评分及MBI评分均明显高于对照组(P<0.01),头针联合镜像疗法组患者FMA-UE评分、WMFT评分及MBI评分均明显高于对照组、镜像疗法组(P<0.01或P<0.05)。结论:头针联合镜像疗法可促进脑梗死偏瘫患者上肢运动功能恢复,疗效优于单纯镜像疗法。

Objective: To investigate the effects of scalp acupuncture combined with mirror therapy on recovery of upper limb motor function in patients with hemiplegia after ischemic stroke. Methods: Totally 90 patients of hemiplegia after ischemic stroke were randomly divided into the control group(30 cases), mirror therapy group(30 cases) and combined group(30 cases). Patients received conventional rehabilitation therapy in control group, and mirror therapy on the basis of the control group in mirror therapy group. Patients were treated with scalp acupunture combined with mirror therapy on the basis of the control group in combined group. Patients were evaluated by Fugl-Meyer assessment-upper extremities(FMA-UE), Wolf scale(WMFT) and modified Barthel index(MBI) before treatment and four weeks after treatment, and the clinical effect was evaluated. Results: The combined group showed higher total effective rate than control group and mirror therapy group(P<0.01). After four weeks of treatment, the FMA-UE score, WMFT score and MBI score significantly increased in three groups(P<0.01), and the mirror therapy group showed higher FMA-UE score, WMFT score and MBI score than control group(P<0.01). The combined group showed higher FMA-UE score, WMFT score and MBI score than control group and mirror therapy group(P<0.01 or P<0.05). Conclusion: Scalp acupuncture combined with mirror therapy can significantly restore upper limb motor function in patients with hemiplegia after ischemic stroke, and the efficacy is better than that of mirror therapy alone.