电针联合温针灸辅助治疗脑卒中后偏瘫临床研究

Clinical Study on Electroacupuncture Combined with Warming-Needle Moxibustion in Adjuvant Treatment of Stroke-Induced Hemiplegia

目的:观察电针联合温针灸辅助治疗脑卒中后偏瘫的临床疗效。方法:选取130例脑卒中后偏瘫患者,按随机数字表法分成温针灸组和电针组各65例。2组均接受常规调脂、抗血小板聚集等药物和康复训练治疗,电针组仅给予电针治疗,温针灸组在电针治疗基础上加用温针灸治疗,2组均每周连续治疗5 d,共治疗6周。治疗前后评价患侧肢体功能(Fugl-Meyer评分)、神经功能缺损程度[美国国立卫生研究院卒中量表(NIHSS)评分]、日常生活能力(Barthel指数)及生活质量[简明健康状况量表(SF-36)评分]。比较2组临床疗效,观察2组患者治疗期间不良反应的发生情况。结果:治疗后,温针灸组临床疗效总有效率84.62%,高于电针组69.23%(P<0.05)。2组上肢、下肢Fugl-Meyer评分及总分均较治疗前升高(P<0.05),温针灸组上肢、下肢Fugl-Meyer评分及总分均高于电针组(P<0.05)。2组NIHSS评分均较治疗前降低(P<0.05),Barthel指数、SF-36评分均较治疗前升高(P<0.05);温针灸组NIHSS评分低于电针组(P<0.05),Barthel指数、SF-36评分均高于电针组(P<0.05)。治疗期间,温针灸组出现1例轻微皮下红肿,冷敷后症状消退,电针组未见明显不良反应。结论:在现代医学常规用药与康复训练治疗基础上予电针联合温针灸治疗脑卒中后偏瘫,效果优于仅使用电针治疗,可有效改善患者的肢体痉挛状态、运动功能及神经功能,提高其生活质量,安全性高。

Objective: To observe the clinical effect of electroacupuncture combined with warmingneedle moxibustion in adjuvant treatment of stroke-induced hemiplegia. Methods:A total of 130 cases of patients with stroke-induced hemiplegia were selected and divided into the warming-needle moxibustion group and the electroacupuncture group by random number table method,with 65 cases in each group.Both groups were given routine treatment including medicines for regulating lipids and inhibiting platelet aggregation and rehabilitation training. The electroacupuncture group was only treated with electroacupuncture,and the warming-needle moxibustion group was additionally treated with warmingneedle moxibustion based on the treatment of electroacupuncture. Both groups were treated for 5 consecutive days every week for a total of 6 weeks. The affected side limb function(Fugl-Meyer scores),degree of neurological impairment [National Institutes of Health Stroke Scale(NIHSS) scores],activities of daily living(Barthel indexes) and quality of life [36-Item Short Form Health Survey(SF-36) scores] before and after treatment were evaluated. The clinical effects in the two groups were compared. The adverse reactions of the two groups during treatment were observed. Results: After treatment, the total effective rate was84.62% in the warming-needle moxibustion group,higher than that of 69.23% in the electroacupuncture group(P<0.05). The Fugl-Meyer scores of upper and lower limbs as well as the total scores in the two groups were increased when compared with those before treatment(P<0.05),and the above scores in the warming-needle moxibustion group were higher than those in the electroacupuncture group(P<0.05).NIHSS scores in the two groups were decreased when compared with those before treatment(P<0.05),and Barthel indexes and SF-36 scores were increased when compared with those before treatment(P<0.05);NIHSS score in the warming-needle moxibustion group was lower than that in the electroacupuncture group(P<0.05), and Barthel index and SF-36 score were higher than those in the electroacupuncture group(P<0.05). During the treatment period,one case of mild subcutaneous redness and swelling occurred in the warming-needle moxibustion group,and the symptoms subsided after cold compresses, and no significant adverse effects were observed in the electroacupuncture group.Conclusion:Based on routine medication and rehabilitation training,the application of electroacupuncture combined with warming-needle moxibustion for stroke-induced hemiplegia has a better effect than only use electroacupuncture,which can effectively improve the spasm,motor function and nerve function of patients and enhance their quality of life,with high safety.