电针拮抗肌运动点结合康复训练治疗中风后足下垂的疗效分析

Analysis of curative effect of electroacupuncture on antagonistic muscle movement points combined with rehabilitation training for foot drop after stroke

目的:探讨对于中风足下垂,使用电针拮抗肌运动点联合康复训练治疗的效果。方法:选取东莞市横沥医院2018年1月-2019年12月收治的56例中风后足下垂的患者为研究对象,对选取的研究对象遵循随机数字表法原则分成观察组与对照组,每组28例,对照组单纯采取康复训练治疗,主要是做分阶段的康复训练,1~4周取仰卧位做双下肢伸直、肢体被动运动及足背屈训练;5~12周取仰卧位进行足跟下牵拉、足背伸屈、坐位主动运动、踝背屈训练。观察组采取康复训练+电针拮抗肌运动点治疗,两组均进行12周的干预,干预12周对比两组治疗效果,治疗前后足内翻角度、Fugl-Meyer运动功能评定量表(Fugl-Meyer Assessment,FMA)评分及Tinetti步态评分。结果:观察组治疗总有效率为96.43%(27/28),显著高于对照组78.57%(22/28)(χ^(2)=4.082,P=0.043);治疗12周观察组患者足内翻角度、FMA下肢评分与Tinetti步态评分分别为(20.24±2.41)°、(26.62±3.41)分、(40.12±4.36)分,对照组分别为(17.51±2.12)°、(20.11±3.05)分、(31.12±4.15)分,两组患者各项指标均显著高于治疗前,但观察组治疗后各项指标均显著高于对照组治疗后(t=4.501,7.530,7.912,P=0.000,0.000,0.000);治疗前观察组踝背屈活动下最大均方根值(Root Mean Square,RMS)(1.12±0.31)mVs与对照组(1.14±0.32)mVs无显著差异(χ^(2)=0.330,P=0.742),治疗4周、8周、12周观察组RMS分别为(1.71±0.38)mVs、(2.26±0.45)mVs、(2.71±0.23)mVs,对照组分别为(1.48±0.36)mVs、(1.82±0.41)mVs、(2.33±0.28)mVs,观察组各指标显著高于对照组(t=3.380,5.678,7.181,P=0.001,0.000,0.000)。结论:采取电针拮抗肌运动点联合康复训练治疗中风后足下垂具有满意的疗效,显著改善患者的下肢功能,促使患者早日康复及提高生活质量,因此值得在临床中推广应用。

Objective:To explore the effect of electroacupuncture on antagonistic muscle movement points combined with rehabilitation training for stroke foot drop.Methods:56 patients with foot drop after stroke admitted to Dongguan Hengli Hospital from January 2018 to December 2019 were selected as the research subjects.The selected research subjects were divided into the observation group and the control group according to the grouping principle of the number table method,with 28 cases in each group.The control group received only rehabilitation training,mainly for staged rehabilitation training.For 1 to 4 weeks,the supine position was used for double leg extension,passive movement of limbs and dorsiflexion training;the supine position was used for foot dorsiflexion training for 5-12 weeks in addition to follow-down traction,dorsiflexion of the foot,active sitting position exercises,and ankle dorsiflexion training.The observation group received rehabilitation training combined with electroacupuncture on antagonistic muscle movement point therapy.Both groups were treated for 12 weeks.The treatment effect,the foot varus angle,Fugl-Meyer rating scale(FMA)score before and after treatment and Tinetti gait score of the two groups were observed after the intervention of 12 weeks.Results:The total effective rate of treatment in the observation group was 96.43%(27/28),which was significantly higher than the total effective rate of 78.57%(22/28)in the control group(χ^(2)=4.082,P=0.043);the angle of foot varus,FMA lower limb score and Tinetti in the observation group after 12 weeks were(20.24±2.41)°,(26.62±3.41)points and(40.12±4.36)points respectively,and those of the control group were(17.51±2.12)°,(20.11±3.05)points and(31.12±4.15)points respectively.The indicators of the two groups of patients were significantly higher than those before treatment,but the indicators of the observation group after treatment were significantly higher than those of the control group(t=4.501,7.530,7.912,P=0.000,0.000,0.000).Before treatment,the maximum root mean square value(RMS)of dorsiflexion activity in the observation group(1.12±0.31)mVs was not significantly different from that in the control group(1.14±0.32)mVs(χ^(2)=0.330,P=0.742).RMS of 4,8 and 12 weeks of treatment were(1.71±0.38)mVs,(2.26±0.45)mVs and(2.71±0.23)mVs in the observation group and(1.48±0.36)mVs,(1.82±0.41)mVs and(2.33±0.28)mVs in the control group,respectively.All indexes in observation group were significantly higher than control group(t=3.380,5.678,7.181,P=0.001,0.000,0.000)Conclusion:The combination of electroacupuncture on antagonistic muscle movement points combined with rehabilitation training has a satisfactory effect in the treatment of foot drop after stroke,it significantly improves the patient's lower extremity function,promotes the patient's early recovery and improves the quality of life,so it is worthy of clinical application.