针灸联合推拿康复干预对脑卒中患者运动功能及神经生化标志物的影响

Effects of Acupuncture Combined with Tuina Rehabilitation on Motor Function and Neurobiochemical Markers in Stroke Patients

目的探究针灸联合推拿康复干预对脑卒中患者运动功能及神经生化标志物的影响。方法选取2018年5月—2021年6月在医院治疗的脑卒中患者102例,按照随机数字表法将其均分为观察组51例和对照组51例。观察组行针灸联合推拿康复干预,对照组行常规干预。采用美国国立卫生研究院卒中量表(NIHSS)评估两组神经功能;采用日常生活活动能力量表(ADL)评估两组日常生活活动能力;采用Fugl-Meyer运动功能评定量表(FMA)评估两组下肢功能;采用Fugl-Meyer平衡量表(FBS)评估两组平衡协调能力;比较两组S100蛋白B(S100B)、血清脑圆形神经营养因子(BDNF)及神经生长因子(NGF)水平;采用肌电图仪检测并记录两组干预前后MEP波幅与潜伏期;比较两组生活质量。结果干预后,观察组NIHSS、ADL、FMA、FBS、S100B、BDNF、NGF、MEP波幅、潜伏期水平及生活质量评分改善程度均大于对照组,差异有统计学意义(P<0.05)。结论针灸联合推拿康复干预能有效改善脑卒中患者的神经功能、日常生活能力、运动功能、平衡能力及生活质量。

Objective To explore the effects of acupuncture combined with Tuina rehabilitation on motor function and neurobiochemical markers in patients with cerebral apoplexy.Methods A total of 102 cases of stroke patients treated in the hospital from May 2018 to June 2021 were selected and divided into the observation group(51 cases)and control group(51 cases)according to the random number table method.The observation group received acupuncture combined with Tuina rehabilitation intervention and the control group received routine intervention.The national Institutes of Health Stroke Scale(NIHSS)was used to evaluate the neurological function of the two groups.Activities of daily Living scale(ADL)was used to evaluate the activities of daily living of the two groups.Fugl-meyer Motor Function Scale(FMA)was used to evaluate the lower limb function of the two groups.Fugl-meyer Balance Scale(FBS)was used to evaluate the balance and coordination ability of the two groups.The levels of S100 protein B(S100B),serum round brain neurotrophic factor(BDNF)and nerve growth factor(NGF)were compared between the two groups.The amplitude and latency of MEP were measured and recorded by electromyography before and after the intervention.The quality of life of the two groups was compared.Results After intervention,NIHSS,ADL,FMA,FBS,S100B,BDNF,NGF,MEP amplitude,latency level and quality of life improvement in the observation group were greater than those in the control group and the differences were statistically significant(P<0.05).Conclusion Acupuncture combined with Tuina rehabilitation intervention can effectively improve the neurological function,daily living ability,motor function,balance ability and quality of life of stroke patients.