电针肘部经筋结点对中风后痉挛期肘关节活动度的影响

Effect of Electro-Needling Elbow Meridian Sinew Knot on Elbow Motion in Post-Stroke Spastic Period

目的:比较电针针刺经筋结点和电针针刺常规腧穴两种治疗方案治疗中风后痉挛期上肢肘关节痉挛性瘫痪的疗效。方法:将符合纳入标准的40例肘关节痉挛的患者,按入院的先后顺序随机分成电针针刺经筋结点组和电针针刺常规腧穴组,各20例,记录两组治疗前及治疗7、14、21、28 d后的肘关节活动度(ROM)、肌张力等级(MAS)、上肢Fugl-Meyer运动功能评分(FMA),并运用改良Ashworth法(MAS)评估两组的临床疗效。结果:治疗7、14、21、28 d后,电针针刺经筋结点组和电针针刺常规腧穴组ROM及FMA评分较同组治疗前均显著改善(P<0.01),治疗14、21、28 d后电针针刺经筋结点组ROM和FMA评分改善明显优于电针针刺常规腧穴组(P<0.05)。治疗14、21、28 d后,电针针刺经筋结点组和电针针刺常规腧穴组MAS评级较同组治疗前均降低(P<0.05),且治疗14、21、28 d后电针针刺经筋结点组MAS等级评级明显低于电针针刺常规腧穴组(P<0.05)。电针针刺经筋结点组总有效率为95%(19/20),电针针刺常规腧穴组总有效率为65%(13/20),两组比较有统计学意义(P<0.05)。结论:电针针刺经筋结点疗法在增大肘关节活动度、减轻上肢肌张力增高和改善上肢运动功能等方面优于电针针刺常规腧穴治疗。

Objective:To compare the curative effect of electro-needling meridian sinew knot and electroneedling conventional acupoints in the treatment of post-stroke spasmodic paralysis of elbow joint.Methods:40 patients with elbow spasms were randomly divided into the study group(electro-needling meridian sinew knot)and the control group(electro-needling conventional acupoints),with 20 cases in each group.The ROM of elbow,MAS level and FMA score of upper limb were observed before the treatment,on 7 d,14 d,21 d and 28 d of the treatment.Modified Ashworth method(MAS)was used to assess the efficacy of both groups.Results:After 7 d,14 d,21 d,28 d of the treatment,the scores of ROM and FMA were significantly improved compared to those before the treatment in the two groups(P<0.01);of which the improvements were more significant in the study group than those in the control group after 14 d,21 d and 28 d of the treatment(P<0.05).The MAS rating was significantly decreased after 14 d,21 d and 28 d of the treatment compared to that before the treatment in the two groups(P<0.05);of which the decrease in the study group was more significant(P<0.05).The total effective rate was 95%(19/20)in the study group,which was significantly higher than 65%(13/20)in the control group(P<0.05).Conclusion:Electro-needling meridian sinew knot is better than electro-needling conventional acupoints in terms of increasing elbow motion,reducing muscle tension and improving motor function of upper limb.