早期肢体功能训练结合穴位针灸在脑卒中伴偏瘫患者康复中的应用效果

Application effect of early limb function training combined with acupoint acupuncture in the rehabilitation of stroke patients with hemiplegia

目的 分析早期肢体功能训练结合穴位针灸在脑卒中伴偏瘫患者康复中的应用效果。方法 纳入阜阳市中医院2020年3月至2022年3月收治的106例脑卒中偏瘫患者,以分层随机法分别纳入观察组(53例)和对照组(53例)。2组均接受常规药物及早期肢体功能训练,观察组加用穴位针灸。分别于干预前及出院时,使用Fugl-Meyer量表、Barthel指数评估2组的肢体运动功能和日常生活活动能力变化,并评估2组的神经功能缺损评分(NIHSS),以及大脑中动脉(MCA)、大脑前动脉(ACA)血流速度变化。结果 2组在出院时和出院1个月后的Fugl-Meyer评分、Barthel指数均较干预前升高,NIHSS评分均较干预前下降(P均<0.05);观察组在出院时和出院1个月后的Fugl-Meyer评分和Barthel指数均高于同期对照组,NIHSS评分均低于同期对照组(P均<0.05)。2组在出院1个月后的MCA、ACA血流速度均较干预前加快(P均<0.05);观察组在出院1个月后的MCA、ACA血流速度均优于对照组(P均<0.05)。结论 在早期肢体功能训练的基础上加用穴位针灸能够进一步提高脑卒中偏瘫患者的肢体运动功能和日常生活活动能力,并改善其神经功能及脑血流速度。

Objective To analyze the application effect of early limb function training combined with acupoint acupuncture in the rehabilitation of stroke patients with hemiplegia.Methods A total of 106 stroke patients with hemiplegia admitted to Fuyang Traditional Chinese Medicine Hospital from March 2020 to March 2022 were included in the study.They were allocated into an observation group(53 cases)and a control group(53 cases)by stratified randomization.Both groups received routine medication and early limb function training,while the observation group additionally received acupoint acupuncture.The Fugl-Meyer Assessment and Barthel Index were measured before the intervention and at discharge to evaluate the changes of limb motor function and activities of daily living in the two groups,and the National Institutes of Health Stroke Scale(NIHSS),blood flow velocity of middle cerebral artery(MCA)and anterior cerebral artery(ACA)in the two groups were also evaluated.Results The scores of the Fugl-Meyer Assessment and Barthel Index in both groups at discharge and 1 month after discharge were higher than those before the intervention,and the NIHSS scores were lower than those before the intervention(all P<0.05).The scores of the Fugl-Meyer Assessment and Barthel Index were higher in the observation group than in the control group at discharge and 1 month after discharge,and the NIHSS scores were lower in the observation group(all P<0.05).The blood flow velocity of MCA and ACA in both groups increased at 1 month after discharge compared with those before the intervention(all P<0.05).The blood flow velocity of MCA and ACA was higher in the observation group than in the control group at 1 month after discharge(both P<0.05).Conclusion On the basis of early limb function training,acupoint acupuncture can further improve the limb motor function,activities of daily living,neurological function,and cerebral blood flow velocity of stroke patients with hemiplegia.