温阳通督针刺结合MOTOmed智能主被动康复训练器在51例偏瘫中应用的研究

Application of Wenyang Tongdu acupuncture combined with MOTOmed intelligent active and passive rehabilitation training device in 51 cases of hemiplegia

目的探讨温阳通督针刺结合MOTOmed智能主被动康复训练器在偏瘫中应用效果。方法选取2018年12月至2020年12月张家口市中医院偏瘫病人102例,以随机数字表法分为观察组、对照组,各51例。常规治疗与康复基础上,予以对照组智能主被动康复训练(MOTOmed智能主被动康复训练器),予以观察组温阳通督针刺结合智能主被动康复训练(MOTOmed智能主被动康复训练器),均治疗4周。比较两组疗效,治疗前、治疗2周、4周后Fugl-Meyer运动功能评定量表(FMA)下肢部分、Berg平衡量表(BBS)、日常生活活动能力量表(BI)、美国国立卫生院卒中量表(NIHSS)评分、三维步态时空和时相参数(步频、步速、跨步长比率)、表面肌电图指标[胫骨前肌、腓肠肌、股四头肌表面肌电积分值(iEMG)、方根振幅]、神经保护因子[脑源性神经营养因子(BDNF)、神经生长因子(NGF)、神经营养素-3(NT-3)]水平。结果观察组治疗4周后疗效优于对照组,总有效率为94.12%(48/51),高于对照组的78.43%(40/51)(P<0.05);观察组治疗2周、4周后FMA下肢部分、BBS、BI评分与步频、步速、跨步长比率均较对照组高,NIHSS评分均较对照组低(P<0.05);观察组治疗2周、4周后胫骨前肌、腓肠肌、股四头肌iEMG水平均较对照组高,方根振幅水平均较对照组低(P<0.05);观察组治疗2周、4周后血清BDNF、NGF、NT-3水平均高于对照组(P<0.05)。结论应用温阳通督针刺结合MOTOmed智能主被动康复训练器治疗偏瘫可提升病人下肢功能、平衡能力与日常生活能力,减轻神经损伤,改善偏瘫步态与表面肌电图情况,上调神经保护因子表达,提高疗效。

Objective To explore the application effect of Wenyang Tongdu acupuncture combined with MOTOmed intelligent active and passive rehabilitation training devices in hemiplegia.Methods A total of 102 patients with hemiplegia in Zhangjiakou Hospital of Traditional C.hinese Medicine from December 2018 to December 2020 were selected and divided into an observation group and a control group by the random number table method,with 51 cases in each group.The control group was given intelligent active and passive rehabilitation training(MOTOmed intelligent active and passive rehabilitation training device)on the basis of conventional treatment and rehabilitation,and the observation group was given Wenyang Tongdu acupuncture combined with MOTOmed intelligent active and passive rehabilitation training device,and both were treated for 4 weeks.The curative effects before treatment and 2 weeks and 4 weeks after treatment were compared between the two groups,including Fugl-Meyer Motor Assessment Scale(FMA)lower extremity,Berg Balance Scale(BBS),Activities of Daily Living Scale(BI),National Health Center Stroke Scale(NIHSS)score,three-dimensional gait spatiotemporal and temporal parameters(step frequency,stride speed,stride length ratio),surface electromyography indicators[tibialis anterior muscle,gastrocnemius muscle,quadriceps and surface muscles integrated electromyogram(iEMG),square root amplitude],neuroprotective factor[brain-derived neurotrophic factor(BDNF),nerve growth factor(NGF),neurotrophin-3(NT-3)]levels.Results The curative effect of the observation group was better than that of the control group after 4 weeks of treatment,and the total effective rate was 94.12%(48/51),which was higher than 78.43%(40/51)of the control group(P<0.05).After 2 weeks and 4 weeks of treatment,the FMA lower extremity,BBS,BI scores,and the ratio of stride frequency,pace,and stride length in the observation group were higher than those in the control group,and the NIHSS scores were lower than those in the control group(P<0.05);the iEMG levels of tibial anterior muscle,gastrocnemius muscle and quadriceps femoris muscle in the observation group were higher than those in the control group,and the amplitude of the square root was lower than those in the control group(P<0.05);the serum levels of BDNF,NGF,and NT-3 were higher than those in the control group(P<0.05).Conclusion The application of Wenyang Tongdu acupuncture combined with MOTOmed intelligent active and passive rehabilitation training devices for hemiplegia can improve lower limb function,balance ability and daily living ability of patients,reduce nerve damage,improve hemiplegic gait and surface iEMG,upregulate the expression of neuroprotective factors,and improve curative effects.