中医针灸辅助现代康复治疗脑梗死患者的疗效观察

Application of Traditional Chinese Medicine Acupuncture Assisted with Modern Re-habilitation Therapy in Patients with Cerebral Infarction

目的 探讨中医针灸辅助现代康复治疗脑梗死患者的疗效观察。方法 选取2018年1月—2022年2月期间张家港市中医医院收治的100例脑梗死患者,按随机数字表法分为对照组与试验组,每组各50例。两组患者均给予脑梗死基础治疗,病情稳定后开展康复训练,在此基础上,对照组给予低频重复经颅磁刺激,试验组给予中医针灸辅助重复经颅磁刺激,均治疗4周。观察比较两组患者临床疗效、中医证候疗效及治疗前后肢体运动功能(Fugl-Meyer Assessment, FMA)、运动诱发电位(Motor evoked potential, MEP)波幅、潜伏期、中枢运动传导时间(Central motor conduction time, CMCT)、神经功能评分[美国国立卫生院卒中量表(National Institutes of Health Stroke Scale, NIHSS)]、自理能力(Self-care ability in daily life, ADL)变化。结果 治疗后试验组临床疗效总有效率95.92%(47/49)优于对照组83.33%(40/48),差异有统计学意义(P<0.05)。治疗后试验组中医证候疗效总有效率91.84%(45/49)优于对照组72.92%(35/48),差异有统计学意义(P<0.05)。治疗后两组患者FMA上、下肢评分及总分均较治疗前升高,差异有统计学意义(P<0.05),且试验组FMA上、下肢评分及总分明显高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者MEP波幅、潜伏期及CMCT均较治疗前改善,差异有统计学意义(P<0.05),且试验组优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者NIHSS评分及ADL评分均较治疗前降低,差异有统计学意义(P<0.05),且试验组低于对照组,差异有统计学意义(P<0.05)。结论 中医针灸辅助现代康复技术治疗脑梗死效果显著,有利于改善患者肢体运动功能、MEP、CMCT、神经功能及生活自理能力。

Objective To explore the therapeutic effect of traditional Chinese medicine(TCM)acupuncture assis-ted with modern rehabilitation therapy in patients with cerebral infarction.Methods A total of 100 patients with cerebral infarction treated in Zhangjiagang Hospital of Traditional Chinese Medicine from January 2018 to February 2022 were se-lected,and they were divided into the control group and the experimental group by random number table method,with 50 cases in each group.Both groups were given basic treatment for cerebral infarction,and rehabilitation training was carried out after the condition was stable.On this basis,the control group was given low-frequency repetitive transcranial magnetic stimulation,and the experimental group was given TCM acupuncture-assisted repetitive transcranial magnetic stimulation.Both groups were treated for four weeks.Clinical efficacy,TCM syndrome efficacy,limb movement function[Fugl-Meyer assessment(FMA)],and motor evoked potential(MEP)amplitude were compared between the two groups.The latent peri-od,central motor conduction time(CMCT),nerve function score[National Institutes of Health Stroke Scale,(NIHSS)],and self-care ability in daily life(ADL)changes were also observed.Results The total effective rate of clinical efficacy(95.92%)and that of TCM syndromes(91.84%)in the experimental group were higher than those(83.33%and 72.92%)in the control group after treatment,and the difference was statistically significant(P<0.05).The FMA upper and lower extremity scores and total scores in the two groups were increased,and those in the experimental group were higher than those in the control group,with a statistically significant difference(P<0.05).In addition,the MEP amplitude,latent period,and CMCT in the two groups were improved,and the experimental group was better than the control group,with the difference statistically significant(P<0.05).After treatment,the NIHSS scores and ADL scores of the two groups were de-creased,and the experimental group was lower than the control group,with the difference statistically significant(P<0.05).Conclusion TCM acupuncture assisted with modern rehabilitation technology has a significant effect on the treat-ment of cerebral infarction,which is beneficial to improve the patient′s limb movement function,MEP,CMCT,neurological function,and self-care ability.