拮抗肌取穴电针治疗脑卒中后运动功能障碍临床研究

Clinical Study on Electroacupuncture at Point Selection of Antagonistic Muscle for Post-stroke Motor Dysfunction

目的:观察拮抗肌取穴电针治疗脑卒中后运动功能障碍的临床效果。方法:选取97例脑卒中后运动功能障碍患者为研究对象,按照随机数字表法分为观察组49例和对照组48例。2组均给予常规基础治疗,对照组在此基础上给予常规康复治疗,观察组在对照组基础上加拮抗肌取穴的电针疗法治疗,共治疗8周。比较2组临床疗效及药物不良反应发生情况,比较2组治疗前后中医证候评分、关节活动度、肢体活动功能[Fugl-Meyer运动功能量表、Berg平衡量表(BBS)、Barthel指数(BI)]、肌电信号、血清神经因子[甘氨酸(Gly)、γ一氨基丁酸(GABA)、神经元特异性烯醇化酶(NSE)、神经肽Y (NPY)]水平变化。结果:治疗后,观察组临床总有效率93.88%,高于对照组77.08%(P<0.05)。治疗后,2组中医证候评分均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗后,2组肩关节、肘关节、髋关节、膝关节、踝关节活动度均增大(P<0.05),且观察组大于对照组(P<0.05)。治疗后,2组Fugl-Meyer评分、BBS评分、BI评分均升高(P<0.05),且观察组高于对照组(P<0.05)。治疗后,2组肱二头肌、胫前肌肌电信号均增大(P<0.05),且观察组大于对照组(P<0.05)。治疗后,2组血清GABA、Gly水平均升高(P<0.05),且观察组高于对照组(P<0.05),2组血清NSE、NPY水平均降低(P<0.05),且观察组低于对照组(P<0.05)。治疗期间2组均无明显不良反应。结论:拮抗肌取穴的电针疗法可有效减轻脑卒中后运动功能障碍患者的临床症状,改善关节活动度和肢体活动功能,促进神经功能恢复。

Objective:To observe the clinical effect of electroacupuncture at point selection of antagonistic muscle for post-stroke motor dysfunction.Methods:A total of 97 cases of patients with poststroke motor dysfunction were selected as the research subjects and divided into the observation group and the control group according to the random number table method,with 48 cases in each group.Both groups received routine basic treatment;the control group received routine rehabilitation treatment,and the observation group received electroacupuncture at point selection of antagonistic muscle based on the treatment of the control group.Both groups were treated for 8 weeks.The clinical effects and incidence of adverse drug reactions were compared between the two groups.Before and after treatment,the changes in traditional Chinese medicine(TCM) syndrome scores,joint motion,limb movement function [FuglMeyer Assessment Scale,Berg Balance Scale(BBS),and Barthel Index(BI)],electromyographic signals,and serum neurological factors [glycine(Gly),γ-aminobutyric acid(GABA),neuron specific enolase(NSE),and neuropeptide Y(NPY)] were compared between the two groups.Results:After treatment,the total clinical effective rate was 93.88% in the observation group,higher than that of 77.08% in the control group(P<0.05).After treatment,the TCM syndrome scores in the two groups were decreased(P<0.05),and the score in the observation group was lower than that in the control group(P<0.05).After treatment,the range of motion of the shoulder,elbow,hip,knee,and ankle was increased in the two groups(P<0.05),and the one in the observation group was greater than that in the control group(P<0.05).After treatment,the Fugl-Meyer scores,BBS scores,and BI scores in the two groups were increased(P<0.05),and the scores in the observation group were higher than those in the control group(P<0.05).After treatment,the electrical signals of the biceps brachii and tibialis anterior muscles in the two groups were increased(P<0.05),and the ones in the observation group were greater than those in the control group(P<0.05).After treatment,the levels of GABA and Gly in serum in the two groups were increased(P<0.05),and the levels in the observation group were higher than those in the control group(P<0.05).The levels of NSE and NPY in serum in the two groups were decreased(P<0.05),and the levels in the observation group were lower than those in the control group(P<0.05).During the treatment period,there were no significant adverse reactions in the two groups.Conclusion:The electroacupuncture at point selection of antagonistic muscle can effectively alleviate the clinical symptoms of patients with post-stroke motor dysfunction,improve joint motion and limb function,and promote neurological recovery.