分期针刺结合核心稳定性训练治疗缺血性脑卒中临床研究

Clinical Study on the Treatment of Ischemic Stroke with Staging Acupuncture Combined with Core Stability Training

目的:观察分期针刺结合核心稳定性训练(core stability training,CST)治疗缺血性脑卒中的临床疗效及其对患者血清小而密低密度脂蛋白胆固醇(small dense Low-Density Lipoprotein,sdLDL)和同型半胱氨酸(homocysteine,Hcy)的影响。方法:选取2018年1月至2020年12月十堰市太和医院康复院区治疗的缺血性脑卒中患者120例作为研究对象,按照患者入院先后顺序,随机分为分期针刺组、CST组和联合组,每组40例。分期针刺组给予分期针刺治疗,CST组给予核心稳定性训练,联合组给予分期针刺联合核心稳定性训练。观察三组患者治疗前后Berg平衡量表(Berg balance scale,BBS)、Fugl-Meyer评定量表(Fugl-Meyer assessment,FMA)、改良Barthel指数(modified barthel index,MBI)、躯干控制测试(trunk control test,TCT)评分及血清sdLDL和Hcy含量变化情况。结果:三组治疗后FMA评分和MBI评分均高于治疗前,且联合组治疗后FMA评分和MBI评分高于分期针刺组和CST组,差异有统计学意义(P<0.05)。三组治疗后BBS评分和TCT评分均高于治疗前,且联合组治疗后BBS评分和TCT评分高于分期针刺组和CST组,差异又统计学意义(P<0.05)。三组治疗后sdLDL、Hcy水平均低于治疗前,且联合组sdLDL、Hcy水平低于分期针刺组和CST组,差异有统计学意义(P<0.05)。结论:分期针刺配合核心稳定性训练能明显改善缺血性脑卒中患者的肢体运动能力和日常生活活动能力,提升患者的平衡能力和躯干控制能力,降低sdLDL、Hcy水平。

Objective:To observe the clinical efficacy of staging acupuncture combined with core stability training(CST)on ischemic stroke and its influence on serum small dense Low-Density Lipoprotein(sdLDL)and homocysteine(Hcy).Methods:A total of 120 patients with ischemic stroke treated in the rehabilitation ward of Taihe Hospital of Shiyan City from January 2018 to December 2020 were selected as the study objects,and randomly divided into the staging acupuncture group,the CST group and the combined group according to the order of admission,with 40 cases in each group.The staging acupuncture group was given staging acupuncture treatment,the CST group was given core stability training,and the combined group was given staging acupuncture combined with core stability training.The changes in Berg balance scale(BBS),Fugl-Meyer assessment(FMA)and modified Barthel index(MBI),trunk control test(TCT)score and serum sdLDL and Hcy content in the three groups before and after treatment were observed.Results:After treatment,the FMA score and MBI score of the three groups were higher than those before treatment,and the FMA score and MBI score of the combined group were higher than those of the staging acupuncture group and CST group,and all the differences were statistically significant(P<0.05);The BBS score and TCT score of the three groups were higher than those before treatment,and the BBS score and TCT score of the combined group were higher than those of the staging acupuncture group and CST group,and all the differences were statistically significant(P<0.05);The levels of sdLDL and Hcy in the three groups were lower than those before treatment,and the levels of sdLDL and Hcy in the combined group were lower than those in the staging acupuncture group and CST group,and all the differences were statistically significant(P<0.05).Conclusion:Staging acupuncture combined with core stability training can significantly improve the limb mobility and daily activity in patients with ischemic stroke,improve the balance ability and trunk control ability,and reduce the levels of sdLDL and Hcy.