手足十二针联合肢体训练在脑梗死偏瘫患者康复治疗中的应用价值

Application Value of Hand-Foot Twelve Needling Combined with Limb Training in Rehabilitation Treatment for Patients with Cerebral Infarction Hemiplegia

目的:观察手足十二针联合肢体训练在脑梗死偏瘫患者康复治疗中的应用价值。方法:将2019年5月—2021年8月间北京中医医院顺义医院收治的156例经《中国脑梗死中西医结合诊治指南》诊断为脑梗死偏瘫的患者按照简单随机法分为对照组(常规针刺加肢体训练)78例和观察组(手足十二针联合肢体训练)78例。比较两组疗效,观察两组脑源性神经营养因子(BDNF)、正五聚体蛋白(PTX-3)及步行能力、美国国立卫生院神经功能缺损评分(NIHSS)、改良Barthel指数(BI)评分和Fugl-Meyer量表(FMA)评分的差异。结果:观察组的效率94.87%(74/78),明显高于对照组的84.62%(66/78),差异具有统计学意义(P<0.05)。观察组治疗前PTX-3、BDNF及步行能力与对照组差异无统计学意义(P>0.05),两组治疗后步宽和血清PTX-3低于治疗前,血清BDNF和步长、步幅、步速高于治疗前,且观察组血清BDNF和步长、步幅、步速明显高于对照组,PTX-3明显低于对照组,差异均具有统计学意义(P<0.05),但步宽与对照组比较差异无统计学意义(P>0.05)。观察组治疗前NIHSS评分、BI评分和FMA评分(包括上肢和下肢评分)与对照组比较,差异无统计学意义(P>0.05),两组治疗后BI评分、FMA评分高于治疗前,NIHSS评分低于治疗前,且观察组BI评分、FMA评分明显高于对照组,NIHSS评分低于对照组,差异具有统计学意义(P<0.05)。结论:手足十二针联合肢体训练可促进脑梗死偏瘫患者肢体障碍的恢复,提高步行能力和生活能力。

Objective:To observe the application value of hand-foot twelve needling combined with limb training in the rehabilitation treatment for patients with cerebral infarction hemiplegia.Methods:156 patients with cerebral infarction hemiplegia diagnosed according to Guidelines For Diagnosis And Treatment Of Integrated Traditional Chinese And Western Medicine For Cerebral Infarction from May 2019 to August 2021,were randomly divided into the control group(n=78)and the observation group(n=78).The control group was treated with conventional acupuncture and limb training,whereas the observation group was treated with hand-foot twelve needling combined with limb training.The curative effects of the two groups were compared,and the differences in BDNF,PTX-3,walking ability,NIHSS score,modified BI score and FMA score were observed in the two groups.Results:The curative effect of the observation group was 94.87%(74/78),which was significantly higher than 84.62%(66/78)of the control group(P<0.05).There were no statistical differences in the data of PTX-3,BDNF and walking ability between the observation group and the control group before the treatment(P>0.05);the step width and the serum level of PTX-3 were lower after the treatment than those before the treatment in the two groups;the serum level of BDNF,the step length,the stride and the step speed were higher after the treatment than those before the treatment in the two groups;the serum level of BDNF,the step length,the stride and the step speed were significantly higher,and the serum level of PTX-3 was significantly lower in the observation group than those in the control group after the treatment;there was no statistical difference in the step width between the two groups after the treatment(P>0.05).There were no statistical differences in NIHSS score,BI score and FMA score(including upper and lower limb scores)between the observation group and the control group before the treatment(P>0.05);BI score and FMA score were higher,and NIHSS score was lower after the treatment than those before the treatment in the two groups;BI score and FMA score were significantly higher,and NIHSS score was lower in the observation group than those in the control group after the treatment(P<0.05).Conclusion:Hand-foot twelve needling combined with limb training can promote the recovery of limb disorders in patients with cerebral infarction hemiplegia,and it can improve walking ability and living ability of the patients.