中医综合康复方案治疗脑卒中后手功能障碍的临床疗效

Clinical efficacy of traditional Chinese medicine comprehensive rehabilitation plan in treating hand dysfunction after stroke

目的观察中医综合康复方案治疗脑卒中后手功能障碍的临床疗效。方法将符合纳入条件的脑卒中后手功能障碍患者120例随机分为试验组、对照组各60例。试验组接受脑卒中常规治疗和针刺加推拿结合中医导引技术的中医综合康复方案,对照组在脑卒中常规治疗基础上加常规康复治疗,治疗时间持续4 w。分别在入组时、入组后应用简化Fugl-Meyer上肢功能评定量表(FMA-UE)、Wolf运动功能测试(WMFT)、改良Ashworth痉挛评定(MAS)、功能独立性评定量表(FIM)评估,同时使用经颅磁刺激检测患者脑区运动诱发电位(MEP)的波幅和潜伏期,对两组进行疗效评价。结果两组FMA-UE、WMFT、FIM评分、MAS分级、MEP波幅及潜伏期治疗后均较治疗前改善,差异有统计学意义(P<0.05);试验组FMA-UE、WMFT评分、MEP波幅及潜伏期均显著优于对照组(P<0.05)。结论中医综合康复方案能有效改善脑卒中患者手功能障碍,提高生活质量,提高患者受损脑区兴奋性。

Objective To observe the clinical efficacy of traditional Chinese medicine comprehensive rehabilitation plan in treating hand dysfunction after stroke.Methods 120 patients with hand dysfunction after stroke who met the inclusion criteria were randomly divided into experimental group and control group,with 60 patients in each group.The experimental group received routine treatment for stroke and traditional Chinese medicine comprehensive rehabilitation plan of acupuncture and massage combined with guidance technology.The control group received routine rehabilitation treatment on the basis of routine treatment for stroke,and the treatment lasted for 4 w.The simplified Fugl-Meyer upper limb function assessment scale(FMA-UE),Wolf motor function test(WMFT),modified Ashworth spasm assessment(MAS)and functional independence assessment scale(FIM)were used at enrollment and post enrollment to evaluate.At the same time,transcranial magnetic stimulation was used to detect the amplitude and latency of the patient's brain motor evoked potential(MEP)to evaluate the efficacy of the two groups.Results The FMA-UE,WMFT,FIM score,MAS scale,MEP amplitude and latency between the two groups after treatment were improved compared to before treatment,with a statistically significant difference(P<0.05);the FMA-UE,WMFT,MEP amplitude and latency of the experimental group were significantly better than those of the control group(P<0.05).Conclusions The comprehensive rehabilitation plan of traditional Chinese medicine could effectively improve hand dysfunction,improve quality of life and increase excitability of damaged brain areas in stroke patients.