益气活血通络法联合针刺对脑卒中后偏瘫肢体功能及认知功能的影响

Effects of benefiting Qi and Activating Blood Circulation and Dredging Collateral Method Combined with Acupuncture on Limb Function and Cognitive Function of Hemiplegia after Stroke

目的探究益气活血通络法联合针刺对脑卒中后偏瘫肢体功能及认知功能的影响。方法选取2019年1月—2021年12月该院中医康复科收治符合纳入标准的脑卒中患者80例为研究对象,根据患者对治疗方案的选择分为研究组(46例)及对照组(34例)。对照组采用加减补阳还五汤+患肢功能训练治疗,研究组在对照组基础上联用针刺法。采用Barthel指数评定量表、Brunnstrom偏瘫运动功能恢复6级分期、偏瘫手功能实用能力、Holden步行功能、简短精神状态量表(MMSE)分别检测两组患者治疗前后独立生活能力、运动功能恢复情况、肢手指精细功能、独立行走能力及认知功能。结果治疗后研究组生活能力评分、各文化水平患者MMSE认知评分均高于治疗前及对照组,对照组高于治疗前,差异有统计学意义(P<0.05);治疗后研究组偏瘫肢运动功能、偏瘫肢手实用功能及步行功能等级分布与治疗前及对照组比较,差异有统计学意义(P<0.05);对照组治疗前后偏瘫肢运动功能、偏瘫肢手实用功能等级分布比较,差异有统计学意义(P<0.05),步行功能等级分布与治疗前比较差异无统计学意义(P>0.05)。结论采用益气活血通络法联合针刺可促进脑卒中后偏瘫肢运动功能的恢复,改善认知障碍,显著提高卒中后患者独立生活能力,该联合疗法适宜临床推广应用。

Objective To explore the effect of benefiting Qi and activating blood circulation and dredging collateral method combined with acupuncture on limb function and cognitive function of hemiplegia after stroke.Methods Eighty stroke patients who met the inclusion criteria in the hospital from January 2019 to December 2021 were divided into the study group(46 cases)and the control group(34 cases)according to the patients'choice of treatment plan.Both groups were treated with oral Modified Buyang Huanwu Decoction(加减补阳还五汤)+limb function training,and the study group was treated with acupuncture on this basis.The Barthel Index Rating Scale,Brunnstrom Hemiplegia Motor Function Recovery 6-Grade Stage,Hemiplegia Hand Function Practical Ability,Holden's Walking Function and Brief Mental State Scale(MMSE)were used to detect the independent living ability,motor function recovery and recovery of the two groups before and after treatment.Limb and finger fine function,independent walking ability and cognitive function.Results After treatment,the living ability score and the MMSE cognitive score of patients with different educational levels in the study group were higher than those before treatment and the control group,and the control group was higher than before treatment(P<0.05).After treatment,the motor function of hemiplegic limb,practical function of hemiplegic limb and hand and walking function grade distribution in the study group were compared with those before treatment and the control group,and the differences were statistically significant(P<0.05).There was a statistically significant difference in the distribution of the motor function of the hemiplegic limb and the practical function of the hemiplegic limb and hand in the control group before and after treatment(P<0.05).There was no significant difference in the distribution of walking function grades compared with before treatment(P>0.05).Conclusion The combination of benefiting Qi and activating blood circulation and dredging collateral method combined with acupuncture can promote the recovery of motor function of hemiplegic limbs after stroke,improve cognitive impairment,and significantly improve the independent living ability of post-stroke patients.This combined therapy is suitable for clinical application.