调督灸法联合康复训练治疗中风后上肢痉挛性偏瘫

Tiaodu moxibustion combined with rehabilitation training in the treatment of upper limb spastic hemiplegia after stroke

目的观察调督灸法联合康复训练治疗中风后上肢痉挛性偏瘫的临床疗效。方法根据随机数法将我院2020年4月-2022年3月接收的70例中风后上肢痉挛性偏瘫患者分为对照组(康复训练治疗,35例)和研究组(调督灸法联合康复训练治疗,35例)。对比2组临床疗效、神经元特异性烯醇化酶(NSE)、相关量表评分、转化生长因子β1(TGF-β1)水平、肌电图指标及不良反应发生情况。结果研究组的临床总有效率高于对照组(P<0.05)。研究组治疗3个疗程后TGF-β1高于对照组,NSE低于对照组(P<0.05)。研究组治疗3个疗程后改良ashworth痉挛量表(MAS)评分低于对照组,Fugl-meyer运动功能评定法(FMA)、Barthel指数(BI)评分高于对照组(P<0.05)。研究组治疗3个疗程后F波的波幅低于对照组;时限及阈值高于对照组(P<0.05)。2组不良反应发生率组比较无统计学意义(P>0.05)。结论调督灸法联合康复训练治疗中风后上肢痉挛性偏瘫,可促进症状改善,改善F波的波幅、时限及阈值,调节血清NSE、TGF-β1水平。

Objective To observe the clinical efficacy of Tiaodu moxibustion combined with rehabilitation training in the treatment of upper limb spastic hemiplegia after stroke.Methods 70 patients with upper limb spastic hemiplegia after stroke who were admitted to Hebei Provincial Hospital of Traditional Chinese Medicine from April 2020 to March 2022 were divided into the control group(rehabilitation training treatment,35 cases)and the study group(Tiaodu moxibustion combined with rehabilitation training treatment,35 cases)according to the random number table method.The therapeutic efficacy,serum neuron-specific enolase(NSE)level,related scale scores,transforming growth factor-β1(TGF-β1)levels,electromyography indexes and the incidence of adverse reactions were compared between the two groups.Results The total effective rate of the study group was higher than that of the control group(P<0.05).After three courses of treatment,in the study group TGF-β1 level was higher than that in the control group,and NSE level was lower than that in the control group(P<0.05).After three courses of treatment,in the study group the modified ashworth spasm scale(MAS)score was lower than that in the control group,and the Fugl-meyer motor function assessment(FMA)and Barthel index(BI)score were higher than those in the control group(P<0.05).After 3 courses of treatment,in the study group the amplitude of F wave was lower than that in the control group,and the time limit and threshold were higher than those in the control group(P<0.05).There was no statistically significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion Tiaodu moxibustion combined with rehabilitation training in the treatment of upper limb spastic hemiplegia after stroke can promote the improvement of symptoms,improve the amplitude of F wave,time limit and threshold,and regulate the serum NSE and TGF-β1 levels.