悬钟穴、丘墟穴为主穴电针治疗脑卒中后足下垂的临床研究

Clinical study on the treatment of foot drop after stroke with electroacupuncture at Xuanzhong and Qiuxu as the main points

目的:观察分析悬钟穴、丘墟穴为主穴电针治疗对肝肾亏虚型脑卒中后足下垂患者下肢功能的影响。方法:本研究选择80例肝肾亏虚型脑卒中后足下垂患者,随机分为治疗组和对照组,每组40例。两组均接受中药足浴和康复训练治疗,对照组给予普通针刺治疗;治疗组选取悬钟穴、丘墟穴为主穴进行电针治疗。两组均每天治疗1次,每周治疗6天,共治疗4周。观察两组患者患侧足下垂及步行功能改善情况,治疗前后分别观察踝关节活动度(Active Range of Motion,AROM)、改良Ashworth量表(Modified Ashworth Scale,MAS)评分、Berg平衡量表(Berg Balance Scale,BBS)评分、Holden步行功能评定及中医证候积分,进行统计学分析,观察和评价电针悬钟穴、丘墟穴治疗本病的临床疗效。结果:治疗4周后,治疗组在足背屈角度、足内翻角度、MAS分级、Holden步行功能、BBS评分、中医证候积分改善等指标上均优于对照组。结论:以悬钟穴、丘墟穴为主穴电针治疗能够改善肝肾亏虚足下垂患者垂患者脑卒中后的中医证候,减小足下垂角度,显著改善足背屈功能,同时可减小足内翻,促进足外翻,并降低下肢肌张力,提升下肢的平衡能力。

Objective:To observe and analyze the effect of electroacupuncture Xuanzhong(GB39)and Qiuxu(GB40)as the main points on lower limb function of patients with liver and kidney deficiency type foot drop after stroke.Methods:A total of 80 patients foot drop of liver and kidney deficiency type after stroke who meet the inclusion criteria were randomly divided into the conventional acupuncture group(40 cases)and the electroacupuncture group(40 cases).Both groups were received TCM foot bath and rehabilitation training.The conventional acupuncture group was given ordinary acupuncture,and the electroacupuncture group was selected Xuanzhong(GB39)and Qiuxu(GB40)as the main points.Both groups were treated once a day for 4 weeks,and 6 days a week.The improvement of foot droop and walking function of the affected side in the two groups were observed.Before and after treatment,the active range of motion(AROM),modified Ashworth scale(MAS),Berg balance scale(BBS),Holden’s walking function evaluation and TCM syndrome score were observed respectively.Statistical analysis was made to observe and evaluate the clinical efficacy of electroacupuncture at Xuanzhong and Qiuxu.Results:After 4 weeks of treatment,the electroacupuncture group was superior to the conventional acupuncture group in terms of foot dorsiflexion angle,foot varus angle,MAS classification,Holden walking function,BBS score,and TCM syndrome score improvement.Conclusion:Electroacupuncture at Xuanzhong and Qiuxu as the main points can improve the TCM syndromes of liver and kidney deficiency type after stroke,reduce the foot drooping angle,significantly improve dorsiflexion function reduce the angle of varus,promote valgus of patients,reduce muscle tension,and improve the balance ability of lower limbs.