穴位按摩治疗卒中偏瘫患者的效果

Effects of acupoint massage on patients with stroke hemiplegia

目的:观察穴位按摩治疗卒中偏瘫患者的效果。方法:选取2018年1月至2022年6月该院收治的92例卒中偏瘫患者进行前瞻性研究,按照随机数字表法分为对照组和观察组各46例。对照组给予常规康复训练,观察组在对照组基础上给予穴位按摩,两组均治疗1个月。比较两组治疗总有效率,治疗前后主要证候积分、运动耐力[6 min步行试验(6MWT)]水平、运动功能[Fugl Meyer运动功能评定表(FMA)]评分、日常生活活动能力[改良Barthel指数(MBI)]评分和血清学指标[血清神经生长因子(NGF)、脑源性神经营养因子(BDNF)、神经元特异性烯醇化酶(NSE)、γ-氨基丁酸(GABA)、甘氨酸(Gly)]水平。结果:观察组治疗总有效率为95.65%,高于对照组的80.43%,差异有统计学意义(P<0.05);治疗后,两组眩晕耳鸣、肢体麻木、神疲气短等主要证候积分均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05);治疗后,两组6MWT距离、FMA评分、MBI评分均高于治疗前,且观察组高于对照组,差异有统计学意义(P<0.05);治疗后,两组血清NGF、GABA、Gly、BDNF水平均高于治疗前,且观察组高于对照组,两组血清NSE水平均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:在常规康复训练基础上采用穴位按摩治疗可提高卒中偏瘫患者治疗总有效率、6MWT距离、FMA评分和MBI评分,改善血清学指标水平,降低主要证候积分,优于单纯常规康复训练治疗。

Objective:To observe effects of acupoint massage on patients with stroke hemiplegia.Methods:A prospective study was conducted on 92 patients with stroke hemiplegia admitted to the hospital from January 2018 to June 2022.They were divided into control group and observation group according to the random number table method,46 cases in each.The control group was treated with routine rehabilitation training,while the observation group was treated with acupoint massage on the basis of that of the control group.Both groups were treated for 1 month.The total effective rate,the main syndrome scores before and after the treatment,the exercise endurance[6 min walking test(6MWT)]level,the motor function[Fugl-Meyer motor the function assessment(FMA)]score,the activity of daily living[modified Barthel index(MBI)]score,and the serological index levels[serum nerve growth factor(NGF),brain-derived neurotrophic factor(BDNF),neuron-specific enolase(NSE),γ-aminobutyric acid(GABA),glycine(Gly)]were compared between the two groups.Results:The total effective rate of treatment in the observation group was 95.65%,which was significantly higher than 80.43%in the control group,and the difference was statistically significant(P<0.05).After the treatment,the main syndrome scores of vertigo and tinnitus,limb numbness,mental fatigue and shortness of breath in the two groups were lower than those before the treatment,those in the observation group were lower than those in the control group,and the differences were statistically significant(P<0.05).After the treatment,the 6MWT distance,the FMA scores and the MBI scores of the two groups were higher than those before the treatment,those of the observation group were higher than those in the control group,and the differences were statistically significant(P<0.05).Further,after the treatment,the levels of serum NGF,GABA,Gly and BDNF in the two groups were higher than those before the treatment,and those in the observation group were higher than those in the control group;the serum NSE levels of the two groups were lower than those before the treatment,and that in the observation group was lower than that in the control group;and the difference was statistically significant(P<0.05).Conclusions:On the basis of the routine rehabilitation training,the acupoint massage therapy can improve the total effective rate,the 6MWT distance,the FMA scores and the MBI scores of the patients with stroke hemiplegia,improve the levels of serological indexes,and reduce the main syndrome scores.Moreover,it is superior to single routine rehabilitation training.