温针灸联合肌电生物反馈对脑卒中痉挛性偏瘫患者脊髓运动神经元兴奋性及运动功能的影响

Effects of warm acupuncture combined with electromyography biofeedback on neuronal excitability of spinal cord motor and motor function in patients with spastic hemiplegia after stroke

目的探讨温针灸联合肌电生物反馈在脑卒中痉挛性偏瘫患者中的应用效果。方法将2020年3月至2021年3月在我院接受治疗的82例脑卒中痉挛性偏瘫患者根据治疗方案不同分为对照组(41例,肌电生物反馈)和研究组(41例,温针灸联合肌电生物反馈)。比较两组的治疗效果。结果治疗8周后,研究组的H波最大波幅、M波最大波幅、H波最大波幅/M波最大波幅低于对照组(P<0.05)。治疗8周后,研究组的Fugl-Meyer运功功能评价量表(FMA)、Berg平衡量表(BBS)评分高于对照组,腕关节、踝关节主动活动度大于对照组(P<0.05)。随访后,研究组的神经功能缺损程度评分(CSS)评分低于对照组,脑卒中专用生活质量量表(SS-QOL)评分高于对照组(P<0.05)。研究组的治疗总有效率高于对照组(P<0.05)。随访后,研究组的临床痉挛指数(CSI)、改良Ashworth痉挛评定量表(MAS)评分低于对照组(P<0.05)。结论温针灸联合肌电生物反馈能有效改善脑卒中痉挛性偏瘫患者的脊髓运动神经元兴奋性,提高运动功能。

Objective To explore the application effect of warm acupuncture combined with electromyography biofeedback in patients with spastic hemiplegia after stroke.Methods Eighty-two patients with spastic hemiplegia after stroke treated in our hospital from March 2020 to March 2021 were divided into control group(41 cases,electromyography biofeedback)and study group(41 cases,warm acupuncture combined with electromyography biofeedback)according to different treatment schemes.The therapeutic effects of the two groups were compared.Results After 8 weeks of treatment,maximum amplitude of H wave,maximum amplitude of M wave and maximum amplitude of H wave/maximum amplitude of M wave in the study group were lower than those in the control group(P<0.05).After 8 weeks of treatment,the scores of Fugl-Meyer Motor Function Assessment(FMA)and Berg Balance Scale(BBS)in the study group were higher than those in the control group,the active range of motion of wrist joint and ankle joint were greater than those in the control group(P<0.05).After follow-up,the Chinese Stroke Scale(CSS)score of the study group was lower than that of the control group,and the Stroke Specific Quality of Life Scale(SS-QOL)score was higher than that of the control group(P<0.05).The total effective rate of treatment in the study group was higher than that in the control group(P<0.05).After follow-up,the Clinic Spasticity Index(CSI)and Modified Ashworth Scale(MAS)scores of the study group were lower than those of the control group(P<0.05).Conclusion Warm acupuncture combined with electromyography biofeedback can effectively ameliorate neuronal excitability of spinal cord motor in patients with spastic hemiplegia after stroke,and improve motor function.