针刺联合康复训练治疗脑卒中后上肢痉挛性偏瘫临床研究

Clinical Study on Acupuncture Combined with Rehabilitation Training for Spastic Hemiplegia of Upper Limb After Stroke

目的:观察针刺联合康复训练治疗脑卒中上肢痉挛性偏瘫的临床疗效。方法:选取124例脑卒中后上肢痉挛性偏瘫患者,按随机数字表法分为对照组和试验组各62例。对照组实施康复训练,试验组在此基础上给予针刺治疗。10 d为1个疗程,2组均治疗3个疗程。采用Fugl-Meyer运动功能评定量表(FMA)、上肢功能障碍评定量表(DASH)及功能综合评定量表(FCA)评估2组治疗前后的上肢运动功能,以改良Ashworth分级(MAS)评估2组治疗前后的肌张力,采用简明健康状况量表(SF-36)评估2组治疗前后的生活质量。结果:治疗后,2组FMA、FCA、SF-36评分均较治疗前升高(P<0.05),DASH评分均较治疗前降低(P<0.05);试验组FMA、FCA、SF-36评分均高于对照组(P<0.05),DASH评分低于对照组(P<0.05)。治疗后,2组MAS分级1~2级占比均较治疗前升高(P<0.05);试验组MAS分级1~2级占比79.03%,高于对照组58.06%(P<0.05)。结论:针刺联合康复训练治疗可显著改善脑卒中后上肢痉挛性偏瘫患者的上肢运动功能,促进其肌张力恢复,提升生活质量。

Objective:To observe the clinical effect of acupuncture combined with rehabilitation training for spastic hemiplegia of upper limb after stroke.Methods:A total of 124 cases of patients with spastic hemiplegia of upper limb after stroke were selected and divided into the control group and the experiment group according to the random number table method,with 62 cases in each group.The control group was treated with rehabilitation training,and the experiment group was additionally treated with acupuncture based on the treatment of the control group.Both groups were treated for three courses,with 10 days being one course.Before and after treatment,the upper limb motor function in the two groups was evaluated by Fugl-Meyer Assessment(FMA),Disabilities of the Arm,Shoulder,and Hand questionnaire(DASH)and Functional Capacity Assessments(FCA),the muscle tension by Modified Ashworth Scale(MAS),and the quality of life by 36-Item Short Form Health Survey(SF-36).Results:After treatment,the scores of FMA,FCA and SF-36 in the two groups were increased when compared with those before treatment(P<0.05),and the DASH scores were decreased(P<0.05);the scores of FMA,FCA and SF-36in the experiment group were higher than those in the control group(P<0.05),and the DASH score was lower(P<0.05).After treatment,the proportions of MAS at grade 1 to 2 in the two groups were increased compared with those before treatment(P<0.05);the proportion of MAS at grade 1 to 2 in the experimental group was 79.03%,higher than that of 58.06%in the control group(P<0.05).Conclusion:Acupuncture combined with rehabilitation training can effectively improve the upper limb motor function in patients with spastic hemiplegia of upper limb after stroke,promote the recovery of their muscle tension,and enhance the quality of life.