超声引导下针刺肌筋膜触发点治疗脑卒中后下肢肌痉挛的疗效

Clinical efficacy of ultrasound-guided acupuncture myofascial trigger point in treating lower limb muscle spasm after stroke

目的观察超声引导下针刺肌筋膜触发点对脑卒中后下肢肌痉挛的临床治疗效果。方法60例脑卒中后下肢肌痉挛患者随机均分为试验组和对照组。在基本药物及康复训练方案基础上,对照组使用常规针刺,试验组于超声引导下针刺肌筋膜触发点。比较两组治疗前后10-m步行速度、Fugl-Meyer评定量表(FMA)评分以及小腿三头肌积分肌电值(iEMG)和均方根值(RMS)。结果与治疗前相比,两组治疗后10-m步行速度和FMA评分增加,小腿三头肌iEMG和RMS减少(P<0.05);试验组治疗后各观察指标改善程度均优于对照组(P<0.05)。结论在基本药物及康复训练方案基础上,超声引导下针刺肌筋膜触发点可有效改善脑卒中后偏瘫侧下肢伸肌异常痉挛,降低小腿三头肌肌张力,提高患者运动能力、运动功能协同能力及步行能力。

Objective To investigate the clinical efficacy of ultrasound-guided acupuncture myofascial trigger point in treating lower limb muscle spasm after stroke.Methods Sixty patients with lower limb muscle spasm after stroke were equally randomized into two groups of A and B.On the basis of basic drugs and rehabilitation training,the patients in group A were treated with regular acupuncture and those in group B received ultrasound-guided acupuncture myofascial trigger point.The 10-meter walking speed,Fugl-Meyer assessment(FMA)score,integrated electromyography(iEMG)and root mean square(RMS)of triceps surae were compared before and after treatment.Results Compared with before treatment,the 10-meter walking speed and FMA score were increased,while the iEMG and RMS of the triceps surae were decreased after treatment in both groups(P<0.05).The improvement of all the observation indexes in group B was better than that in group A after treatment(P<0.05).Conclusion On the basis of basic drugs and rehabilitation training,ultrasound-guided acupuncture myofascial trigger point can effectively improve the abnormal spasm of the lower limb extensor muscle in the hemiplegic side after stroke,reduce the muscle tension of the triceps calf muscle,and improve the patient's exercise ability,motor function coordination ability and walking ability.