经皮穴位电刺激结合针刺辅助脑卒中后偏瘫患者康复训练的效果

Effect of percutaneous acupoint electrical stimulation combined with acupuncture assisted rehabilitation training for patients with hemiplegia after stroke

目的探讨经皮穴位电刺激结合针刺辅助脑卒中后偏瘫患者康复训练的效果。方法选取2020年9月至2022年12月内蒙古自治区包头市第四医院收治的脑卒中后偏瘫患者136例,按照随机数字表法将其分为试验组和传统组,每组68例。传统组给予常规康复训练干预,试验组在此基础上给予经皮穴位电刺激结合针刺干预,两组患者均持续治疗3个月。比较两组干预前后美国国立卫生研究院卒中量表(NIHSS)评分、日常生活能力巴塞尔指数(BI)评分、Fugl-Meyer评估量表(FMA)评分,观察两组干预前后步行空间参数,比较两组患者干预前后中医证候积分变化情况,并比较干预后两组患者生活质量评分,统计两组患者不良反应发生情况。结果干预后两组患者NIHSS评分低于干预前,BI、FMA评分高于干预前,试验组NIHSS评分低于传统组,BI、FMA评分高于传统组(P<0.05)。干预后两组患者步速快于干预前,步频高于干预前,患侧步长长于干预前,试验组步速快于传统组,步频高于传统组,患侧步长长于传统组(P<0.05)。干预后两组患者半身不遂、偏身麻木、口舌歪斜和言语謇涩评分均低于干预前;试验组低于传统组(P<0.05)。试验组社会功能、物质生活、躯体功能、心理功能评分高于传统组(P<0.05)。试验组压疮、肺部感染、泌尿感染、肌肉萎缩、运动异常和肩手综合征发生率均低于传统组(P<0.05)。结论经皮穴位电刺激结合针刺可提高脑卒中后偏瘫患者神经功能和运动功能,改善患者步行状态,提高其中医证候积分,提高生活质量,减少不良反应,值得临床进一步推广应用。

Objective To explore the effect of percutaneous acupoint electrical stimulation combined with acupuncture assisted rehabilitation training for patients with hemiplegia after stroke.Methods A total of 136 patients with hemiplegia after stroke admitted to the Fourth Hospital of Baotou,Inner Mongolia Autonomous Region from September 2020 to December 2022 were selected and they were divided into the experimental group and the traditional group according to random number table method,with 68 cases in each group.The traditional group was given routine rehabilitation training intervention measures,and the experimental group was given percutaneous acupoint electrical stimulation combined with acupuncture intervention on this basis.Both groups were treated for three months.National Institutes of health stroke scale(NIHSS)score,Basle index(BI)of daily living ability score,Fugl-Meyer assessment scale(FMA)score before and after intervention were compared between the two groups.The spatial parameters of walking in the two groups were observed before and after intervention,the changes of traditional Chinese medicine syndrome scores before and after intervention were compared between the two groups,and the quality of life scores of the two groups were compared after intervention, and the incidence of adverse reactions in the two groups were analyzed. Results After intervention, NIHSS scores of the two groups were lower than those before intervention, BI and FMA scores were higher than those before intervention;NIHSS scores of the experimental group were lower than those of the traditional group, BI and FMA scores were higher than those of the traditional group (P<0.05). After intervention, the walking speed of the two groups was faster than that before intervention, the step frequency was higher than that before intervention, and the step length of the affected side was longer than that before intervention;and the walking speed of the experimental group was faster than that of the traditional group, the step frequency was higher than that of the traditional group, and the step length of the affected side was longer than that of the traditional group (P<0.05). After intervention, the scores of hemiplegia, heminumbness, skew of tongue, and skew of speech in the two groups were lower than those before intervention;and the scores of hemiplegia, heminumbness, skew of tongue, and skew of speech in the experimental group were lower than those in the traditional group (P<0.05). The scores of social function, material life, physical function, and psychological function in experimental group were higher than those in traditional group (P<0.05). The incidence of pressure ulcer, pulmonary infection, urinary infection, muscle atrophy, movement abnormality, and shoulder and hand syndrome in experimental group were lower than those in traditional group (P<0.05). Conclusion Percutaneous acupoint electrical stimulation combined with acupuncture can improve the nerve function and motor function of patients with hemiplegia after stroke, improve their walking status, increase their traditional Chinese medicine syndrome score, improve their quality of life, and reduce adverse reactions, which is worthy of further clinical application.