头针结合绳带疗法治疗缺血性卒中偏瘫患者恢复期步行功能的疗效及对其血清炎症因子的影响

Therapeutic Effect of Scalp Acupuncture Combined with Rope Therapy on Walking Function in Patients with Hemiplegia After Ischemic Stroke During Recovery and its Impact on Serum Inflammatory Factors

目的 探讨头针结合绳带疗法用于缺血性卒中偏瘫患者恢复期步行功能的疗效及对其血清炎症因子的影响。方法 选取2022年1月—2022年10月期间株洲市中心医院康复科收治的缺血性卒中偏瘫恢复期患者105例,按照随机数字表法分为头针组、绳带组和联合组,每组各35例。3组患者均接受常规内科治疗(包括:抗血小板治疗、他汀类药物治疗及脑血管病危险因素的控制)和常规康复治疗。在常规治疗基础上头针组采用头针治疗,绳带组采用绳带疗法治疗,联合组采用头针结合绳带疗法治疗。治疗4周后,观察比较3组患者临床疗效、不良反应发生情况,治疗前后简化Fugl-Meyer量表(Fugl-Meyer Assessment,FMA)评分、Holden步行功能分级量表(Functional amby iation category scale,FAC)评分、Tinetti步态平衡量表(Tinetti Balance and Gait Analysis,Tinetti)评分、10 m行走时间测试(10m walking time test,10MWT)、血清炎症因子[白细胞介素-1(Interleukin-1,IL-1)、白细胞介素-6(Interleukin-6,IL-6)、超敏C反应蛋白(Hypersensitivity C-reactive protein,hs-CRP)]水平。结果 治疗后联合组临床疗效总有效率94.29%(33/35)明显高于头针组77.14%(27/35)和绳带组65.71%(23/35),差异有统计学意义(P<0.05)。治疗后3组患者FMA、FAC、Tinetti评分均较治疗前升高,10MWT较治疗前降低,差异有统计学意义(P<0.05);且联合组FMA、FAC、Tinetti评分均高于头针组和绳带组,10MWT低于头针组和绳带组,差异有统计学意义(P<0.05)。治疗后3组患者血清IL-1、IL-6、hs-CRP水平均较治疗前降低,差异有统计学意义(P<0.05);联合组血清IL-1、IL-6、hs-CRP水平均低于头针组和绳带组,差异有统计学意义(P<0.05)。治疗期间,3组患者不良反应发生比较,差异无统计学意义(P>0.05)。结论 头针结合绳带疗法用于治疗缺血性卒中偏瘫恢复期能够有效改善患者下肢运动功能,减轻炎症因子水平,且安全性较高。

Objective To explore the therapeutic effect of scalp acupuncture combined with rope therapy for improving walking function in patients with hemiplegia after ischemic stroke and its impact on serum inflammatory factors during the recovery phase.Methods A total of 105 patients with hemiplegia after ischemic stroke during the recovery phase admitted to the Rehabilitation Department of Zhuzhou Central Hospital between January 2022 and October 2022 were enrolled and randomly divided into a scalp acupuncture group,a rope therapy group,and a combination group,with 35 patients in each group.All three groups received conventional internal medicine treatment(including antiplatelet therapy,statin medication,and control of cerebrovascular disease risk factors)and routine rehabilitation therapy.In addition to conventional treatment,the scalp acupuncture group received scalp acupuncture therapy,the rope therapy group received rope therapy,and the combination group received scalp acupuncture combined with rope therapy.After four weeks of treatment,the clinical efficacy and adverse reactions of the three groups were observed and compared.Changes in simplified Fugl-Meyer Assessment(FMA)scores,Holden functional ambulation category(FAC)scores,Tinetti Balance and Gait Analysis(Tinetti)scores,10-meter walking time test(10MWT),and serum inflammatory factors[interleukin-1(IL-1),interleukin-6(IL-6),and hypersensitivity C-reactive protein(hs-CRP)]levels were evaluated before and after treatment.Results After treatment,the total effective rate in the combination group was 94.29%(33/35),significantly higher than 77.14%(27/35)in the scalp acupuncture group and 65.71%(23/35)in the rope therapy group(P<0.05).After treatment,FMA,FAC,and Tinetti scores in all three groups increased,while 10MWT decreased(P<0.05).Moreover,the combination group had higher FMA,FAC,and Tinetti scores than the scalp acupuncture group and the rope therapy group,and a lower 10MWT than both groups(P<0.05).After treatment,serum IL-1,IL-6,and hs-CRP levels decreased in all three groups(P<0.05).The combination group had lower serum IL-1,IL-6,and hs-CRP levels than the scalp acupuncture group and the rope therapy group(P<0.05).During the treatment period,there were no statistically significant differences in adverse reactions among the three groups(P>0.05).Conclusion Scalp acupuncture combined with rope therapy effectively improves lower limb motor function and reduces inflammatory factor levels during the recovery phase of patients with hemiplegia after ischemic stroke.This approach is considered safe and well-tolerated.