肌肉牵伸模式下的电针拮抗法治疗脑卒中足下垂的临床观察

Clinical efficacy of electro-acupuncture to antagonistic muscle therapy in muscle stretching mode for patients with foot drop after cerebral apoplexy

目的:观察痉挛肌牵伸模式下的电针拮抗法治疗脑卒中足下垂患者的临床疗效。方法:选取病程≤3个月的首次脑卒中偏瘫患者40例,随机分成对照组和观察组各20例。2组均给予常规康复治疗,在此基础上,对照组给予常规电针拮抗法,观察组则给予痉挛肌牵伸模式下的“电针拮抗法”,疗程为3周。利用下肢简式Fugl-Meyer运动评分量表(FMA)、改良Ashworth痉挛评定量表(MAS)及表面肌电(iEMG)技术分别评估患者的患侧下肢运动功能、小腿三头肌痉挛程度及踝背屈时胫骨前肌与小腿三头肌的协同收缩率(CR)。结果:治疗后2组FMA评分较治疗前均有明显提高(P<0.01),MAS分级优于治疗前(P<0.01);与对照组比较,观察组的FMA评分提高则更为显著(P<0.05),观察组MAS分级更优于对照组(P<0.05)。治疗后,2组患者胫骨前肌和小腿三头肌iEMG均高于治疗前(均P<0.05)、踝背屈CR低于治疗前(均P<0.05),治疗后观察组患者胫骨前肌和小腿三头肌iEMG均高于对照组(均P<0.05)、踝背屈CR低于对照组(均P<0.05)。结论:痉挛肌牵伸模式下的电针拮抗法治疗能有效地降低小腿三头肌张力,改善脑卒中偏瘫患者踝背屈功能,促进下肢运动的改善。

Objective:To observe the clinical efficacy of electro-needle antagonism in spastic muscle stretching mode in patients with stroke foot drop.Methods:Totally,40 cases of first stroke paraplegia in 3 months were selected,and divided into control group(n=20)and observation group(n=20)by the random number table method.On the basis of routine rehabilitation treatment,the control group was subjected to the conventional“electric needle antagonism”,and the observation group was given the“electric needle antagonism method”in spastic muscle stretching mode,with a course of 3 weeks.The patient’s lateral lower limb movement function,the degree of triceps spasms in the lower leg,and the co-contraction rate(CR)of the tibia and calf triceps were assessed using the lower limb simplified Fugl-Meyer exercise scale(FMA),the improved Ashworth spasm scale(MAS)and surface myoelectric(iEMG)techniques.Results:There was no significant difference in FMA scores,MAS scores,iEMG and CR values between two groups before treatment.After treatment,the scores of the above-mentioned indicators were significantly higher than before treatment,and the difference was statistically significant(P<0.01).The score improvement was more significant in the observation group than in the control group and the difference was statistically significant(P<0.05).Conclusion:The treatment of electro-needle antagonism in spastic muscle stretching mode can effectively reduce triceps tension in the lower leg,improve ankle back flexor function and improve lower limb movement in patients with stroke paraplegia.