针刀联合绳带疗法对脑卒中偏瘫患者下肢运动功能、神经功能的影响

Effect of Acupotomy Combined Rope Belt Therapy on Lower Limb Motor Function and Nerve Recovery Function of Stroke Hemiplegia Patients

目的:观察针刀联合绳带疗法对脑卒中恢复期偏瘫患者步行能力的影响。方法:将120例脑卒中恢复期偏瘫患者随机分为对照组、绳带组、针刀组和针刀联合绳带治疗组(以下简称联合治疗组),4组患者均应用康复运动疗法及物理疗法,绳带组辅以绳带对偏瘫患者的躯干、髋、膝、踝进行捆绑保持全身肌肉平衡及患肢抗重力伸展;针刀组对患侧下肢进行穴位刺激、神经触激和深层韧带松解;联合治疗组将针刀疗法与绳带疗法相结合。治疗前、治疗2周及治疗4周分别用Barthel指数评分(modified Barthel index,MBI)、Fugl-Meyer(Fugl-Meyer assessment,FMA)下肢运动功能评分、偏瘫步行能力评定量表评级(functional ambulation category scale,FAC)、Berg评分(Berg balance scale,BBS)进行疗效评估,同时采用改良的Rankin量表评分(modified rankin scale,mRS)于治疗前及治疗后3个月进行效果评价。结果:绳带组MBI、针刀组FMA及联合治疗组MBI、FMA、BBS评分在治疗2周时均较治疗前提高(P<0.05);对照组、绳带组、针刀组及联合治疗组治疗4周时MBI、FMA、FAC、BBS评分及3个月后mRS评分均较治疗前提高(P<0.05),绳带组、针刀组及联合治疗组与对照组比较,差异均有统计学意义(P<0.05);治疗4周时联合治疗组与绳带组、针刀组比较,MBI、FMA、FAC、BBS、mRS评分显著改善(P<0.05)。结论:应用针刀联合绳带疗法可以显著提高脑卒中恢复期偏瘫患者的下肢运动能力,改善神经功能,具有临床推广应用价值。

Objective: To observe the clinical efficacy of acupotomy combined with rope belt therapy in improving the walking ability of stroke patients with hemiplegia. Methods: A total of 120 patients with hemiplegia due to stroke were randomly divided into control group, rope group, acupotomy group and acupotomy combined with rope group (combined treatment group). Patients were treated with rehabilitation and exercise therapy and physiotherapy in 4 groups. On this basis, the rope group was additionally treated with a rope, which bound the trunk, hip, knee and ankle of patients with hemiplegia to maintain whole-body muscle balance and anti-gravity extension of the affected limbs. In the acupotomy group, acupoint stimulation, nerve stimulation and deep ligament release were additionally performed on the affected lower limbs. The combined treatment group additionally received acupotomy therapy combined with rope belt therapy. The efficacy was evaluated before treatment and 2 and 4 weeks after treatment according modified Barthel index (MBI) score, Fugl-Meyer assessment (FMA) score for lower-limb motor function, Functional Ambulation Category (FAC) score and Berg Balance Scale (BBS) score. In addition, the efficacy was evaluated with a modified Rankin Scale (mRS) score before treatment and 3 months after treatment. Results: Compared with those before treatment, MBI score in the rope group, FMA score in the acupotomy group as well as MBI, FMA and BBS scores in the combined treatment group increased significantly 2 weeks after treatment (P<0.05). Compared with those before treatment, MBI, FMA, FAC and BBS scores 4 weeks after treatment as well as mRS score 3 months after treatment increased significantly in control group, rope group, acupotomy group and combined treatment group (P<0.05). Compared with the control group, the rope group, acupotomy group and combined treatment group showed significant difference in MBI, FMA, FAC and BBS scores 4 weeks after treatment as well as mRS score 3 months after treatment (P<0.05). Compared with the rope group and the acupotomy group, MBI, FMA, FAC, BBS and mRS scores were significantly improved in the combined treatment group 4 weeks after treatment (P<0.05). Conclusion: The application of acupotomy combined with rope belt therapy can significantly improve the lower limb motor ability of stroke patients with hemiplegia, and improve the neurological recovery function, which has clinical application value.