头皮针联合Bobath技术对脑梗死偏瘫患者血流动力学及患肢神经肌肉活动的影响

Effects of Scalp Acupuncture Combined with Bobath Technique on Hemodynamics and Neuromuscular Activities of the Affected Side in Patients with Hemiplegia After Cerebral Infarction

目的观察头皮针联合Bobath技术对脑梗死偏瘫患者血流动力学及患肢神经肌肉活动的影响。方法将110例脑梗死偏瘫患者随机分为对照组(55例)和联合组(55例)。对照组予患者Bobath技术治疗,联合组予头皮针联合Bobath技术治疗。观察两组治疗前后运动诱发电位(MEP)皮质潜伏期、中枢运动传导时间(CMCT)数值、中医证候积分、血流动力学指标[收缩峰血流速度(Vs)、舒张末血流速度(Vd)、平均血流速度(Vm)]、神经肌肉活动指标[肱二头肌、腕屈肌的积分肌电值(iEMG)和均方根值(RMS)]变化。结果治疗后,两组MEP皮质潜伏期以及CMCT数值降低(P<0.05),且联合组低于对照组(P<0.05);治疗后,两组患者主症积分、中医证候积分下降(P<0.05),且联合组低于对照组(P<0.05);治疗后,两组患者Vs、Vd、Vm上升(P<0.05),且联合组高于对照组(P<0.05);治疗后,两组肱二头肌、腕屈肌的iEMG值和RMS值上升(P<0.05),且联合组高于对照组(P<0.05)。结论头皮针联合Bobath技术能够改善脑梗死偏瘫患者血流动力学以及中医证候积分,增强患者患肢神经肌肉活动。

Objective To observe the effects of scalp acupuncture plus Bobath technique on the hemodynamics and neuromuscular activities of the affected side in patients with hemiplegia after cerebral infarction.Method A total of 110 patients with hemiplegia after cerebral infarction were randomized into a control group(55 cases)and an integration group(55 cases).The control group was given Bobath technique for treatment,and the integration group received scalp acupuncture and Bobath technique.The cortical motor evoked potential(MEP)latency,central motor conduction time(CMCT),symptom score of traditional Chinese medicine(TCM),hemodynamic parameters[peak systolic blood flow velocity(Vs),end-diastolic blood flow velocity(Vd),and mean blood flow velocity(Vm)],and neuromuscular activity indicators[the integral of electromyography(iEMG)and root mean square(RMS)of the biceps brachii muscle and wrist flexors]in both groups were observed before and after treatment.Result After treatment,the cortical MEP latency and CMCT declined in both groups(P<0.05)and were lower in the integration group than in the control group(P<0.05).The main symptom and TCM symptom scores dropped after treatment in the two groups and were lower in the integration group than in the control group(P<0.05).After intervention,the Vs,Vd,and Vm increased in the two groups(P<0.05)and were higher in the integration group than in the control group(P<0.05).The iEMG and RMS readings of the biceps brachii muscle and wrist flexors rose after treatment in both groups(P<0.05)and were higher in the integration group than in the control group(P<0.05).Conclusion Scalp acupuncture plus Bobath technique can improve the hemodynamics and TCM symptom score and strengthen the neuromuscular activities of the affected side in patients with hemiplegia after cerebral infarction.