跷脉针刺联合对称负重式训练对脑卒中偏瘫患者肌张力、足内翻角及坐站转移能力的影响

Impacts of Qiao channel acupuncture combined with symmetrical weight-bearing training on muscle tension,foot varus angle,and sitting-standing transfer ability in patients with hemiplegia after stroke

目的:探讨跷脉针刺联合对称负重式训练对脑卒中偏瘫患者肌张力、足内翻角及坐站转移能力的影响。方法:选取2021年3月~2022年4月本院收治的130例脑卒中后痉挛性偏瘫(SPAS)患者,并采用随机数字表法分成训练组和研究组各65例。训练组开展对称负重式训练,研究组在训练组基础上实施跷脉针刺干预。比较2组干预前、干预6周后下肢肌张力[采用改良Ashworth分级(MAS)]、痉挛状况[采用综合痉挛量表(CSS)]、步态参数、足内翻角、坐站转移能力[5次坐立测试(FTSST)]及下肢功能[采用Fugl-meyer评定量表(FMA)]。结果:干预6周后,2组下肢MAS分级均优于干预前(P<0.05),且研究组下肢MAS分级优于训练组(P<0.05);2组CSS评分及5次坐立测试(FTSST)数值均低于干预前(P<0.05),且研究组均低于训练组(P<0.05);2组步速均大于干预前(P<0.05),且研究组大于训练组(P<0.05);2组步宽、步态周期、支撑相时间、步长偏差、足内翻角均小于干预前(P<0.05),且研究组均小于训练组(P<0.05);2组FMA下肢评分均高于干预前(P<0.05),且研究组高于训练组(P<0.05)。结论:对SPAS患者实施跷脉针刺联合对称负重式训练,可有效改善下肢肌张力、痉挛状况及步态,显著提高坐站转移能力及下肢功能。

Objective:To explore the impacts of Qiao channel acupuncture combined with symmetrical weight bearing training on muscle tension,foot varus angle,and sitting-standing transfer ability in patients with hemiplegia after stroke.Methods:A total of 130 patients with spastic paralysis after stroke(SPAS)admitted to our hospital from March 2021 to April 2022 were selected and randomly grouped into training group(n=65)and research group(n=65)using a digital table method.The training group was given symmetrical weight bearing training,and the research group was subjected to Qiao channel acupuncture intervention on the basis of the training group.The lower limb muscle tone[modified Ashworth scale(MAS)],spasticity status[comprehensive spasticity scale(CSS)],gait parameters,foot varus angle,sitting and standing transfer ability[Five-Times-Sit-to-Stand Test(FTSST)],and lower limb function[Fugl-Meyer Assessment(FMA)]were compared between the two groups before and after 6 weeks of intervention.Results:After 6 weeks of intervention,the lower limb MAS grading in both groups was better than before intervention(P<0.05),and the lower limb MAS in the study group was better than that in the training group(P<0.05).The CSS scores and FTSST value in both groups were lower than those before intervention(P<0.05),and those in the research group were lower than those in the training group(P<0.05).The walking speed in both groups was faster than before intervention(P<0.05),and that in the research group was faster than in the training group(P<0.05).The stride width,gait cycle,support phase time,stride deviation,and foot varus angle in the two groups were significantly decreased as compared with those before intervention(P<0.05),and those in the research group were significantly reduced as compared with those in the training group(P<0.05).The lower limb FMA score in both groups was higher than before intervention(P<0.05),and that in the research group was higher than in the training group(P<0.05).Conclusion:Applying Qiao channel acupuncture combined with symmetrical weight bearing training to patients with SPAS can effectively improve the muscle tension and spasticity of the lower limbs,greatly improve the sitting-standing transfer ability and lowerlimb function.