头皮针联合Bobath康复疗法治疗脑梗死后偏瘫临床研究

Clinical Study on Scalp Acupuncture Combined with Bobath Rehabilitation Therapy for Hemiplegia After Cerebral Infarction

目的:观察头皮针联合Bobath康复疗法治疗对脑梗死后偏瘫患者脑血流和肢体运动功能的影响。方法:选取152例脑梗死后偏瘫患者,按随机数字表法分为联合组和Bobath组各76例。Bobath组给予Bobath康复疗法治疗,联合组给予头皮针联合Bobath康复疗法治疗,2组均治疗3个月。比较2组治疗前后症状积分,大脑中动脉阻力指数(RI)、最大峰值流速(Vs),Fugl-Meyer运动功能评定量表(FMA)评分,以及患侧腕屈肌、腓肠肌积分肌电值(iEMG)。结果:治疗后,2组半身不遂、言语不利、口舌歪斜积分均较治疗前降低,联合组半身不遂、言语不利、口舌歪斜积分均低于Bobath组,差异均有统计学意义(P<0.05)。2组大脑中动脉RI均较治疗前降低,大脑中动脉Vs均较治疗前升高,差异均有统计学意义(P<0.05);联合组大脑中动脉RI低于Bobath组,大脑中动脉Vs高于Bobath组,差异均有统计学意义(P<0.05)。2组上肢、下肢FMA评分及患侧腕屈肌、腓肠肌iEMG均较治疗前升高,联合组上肢、下肢FMA评分及患侧腕屈肌、腓肠肌iEMG均高于Bobath组,差异均有统计学意义(P<0.05)。结论:头皮针联合Bobath康复疗法治疗可改善脑梗死后偏瘫患者的脑血液循环,促进其患肢运动功能恢复,缓解临床症状。

Objective:To observe the effect of scalp acupuncture combined with Bobath rehabilitation therapy on cerebral blood flow and motor function of limb in patients with hemiplegia after cerebral infarction.Methods:A total of 152 cases of patients with hemiplegia after cerebral infarction were selected and divided into the combination group and the Bobath group according to the random number table method,with 76 cases in each group.The Bobath group was treated with Bobath rehabilitation therapy,and the combination group was treated with scalp acupuncture combined with Bobath rehabilitation therapy.Both groups were treated for 3 months.Before and after treatment,symptom scores,resistance index(RI)and maximum peak velocity(Vs)in middle cerebral artery,Fugl-Meyer Motor Function Assessment(FMA)scores,and integrated electromyographic values(iEMG)of flexor carpi and gastrocnemius muscle of the affected side were compared between the two groups.Results:After treatment,the scores of hemiplegia,speech impairment,and deviated of tongue and mouth in the two groups were decreased when compared with those before treatment,and the scores of hemiplegia,speech impairment,and deviated of tongue and mouth in the combination group were lower than those in the Bobath group,differences being significant(P<0.05).RI in middle cerebral artery in the two groups were decreased when compared with those before treatment,and Vs in middle cerebral artery were increased where compared with those before treatment,differences being significant(P<0.05);RI in middle cerebral artery in the combination group was lower than that in the Bobath group,and Vs in middle cerebral artery was higher than that in the Bobath group,differences being significant(P<0.05).FMA scores of upper and lower limbs,and iEMG of flexor carpi and gastrocnemius muscle of the affected side in the two groups were increased when compared with those before treatment,and FMA scores of upper and lower limbs,and iEMG of flexor carpi and gastrocnemius muscle of the affected side in the combination group were higher than those in the Bobath group,differences being significant(P<0.05).Conclusion:Scalp acupuncture combined with Bobath rehabilitation therapy can improve cerebral circulation in patients with hemiplegia after cerebral infarction,promote the recovery of motor function of the affected limbs,and relieve clinical symptoms.