分期针刺法治疗对BrunnstromⅠ~Ⅱ期脑卒中患者肢体运动功能与神经功能缺损的影响及相关性研究

Effect and Correlation of Staged Acupuncture Therapy on Limb Motor Function and Neurological Function Deficit in Brunstrom Stage Ⅰ-Ⅱ Stroke Patients

目的:研究肢体运动功能及神经缺损程度变化相关性与BrunnstromⅠ~Ⅱ期脑卒中患者应用分期针刺法的治疗效果。方法:以2020年1月—2022年1月本院收治的146例脑卒中分期为BrunnstromⅠ~Ⅱ期患者为研究对象,将146例患者按照随机数字表法将其分为研究组(73例)、常规组(73例);在常规康复训练基础上常规组患者采用传统针刺治疗,研究组患者采用分期针刺治疗;采用肢体运动功能量表(FMA)、日常活动Barthel指数(BI)、神经功能缺损程度量表(NIHSS)及精神状态量表(MMSE)评估两组患者治疗前后的肢体功能评分、日常活动指数、神经功能损伤及认知功能变化并进行比较;比较两组患者治疗前及治疗1个月后的血清甘氨酸(Gly)、血-氨基丁酸(GABA)水平、脂蛋白相关磷脂酶A2(Lp-PLA2)和超氧化物歧化酶(SOD)水平变化情况;采用Pearson相关性分析FMA评分与NIHSS评分的相关性。结果:比较常规组治疗后,研究组患者的FMA评分、BI指数和MMSE评分明显升高且NIHSS评分明显降低,差异有统计学意义(P<0.05);对比常规组治疗后,研究组BrunnstromⅡ期比例明显升高,差异有统计学意义(P<0.05);对比常规组治疗后,研究组的Gly、GABA与SOD水平明显升高且Lp-PLA2明显降低,差异有统计学意义(P<0.05);Pearson相关性分析结果显示,FMA评分与NIHSS评分之间呈现负相关,差异有统计学意义(P<0.05)。结论:给予BrunnstromⅠ~Ⅱ期脑卒中患者进行分期针刺治疗能够有效提高患者的肢体运动功能,降低神经功能缺损程度,具有较好的临床疗效。

Objective:To study the correlation between changes in limb motor function and neurological deficits and the therapeutic effects of staged acupuncture in Brunnstrom Ⅰ-Ⅱ stroke patients.Methods:A total of 146 patients with Brunnstrom Ⅰ-Ⅱ stage of stroke were randomly divided into the study group(n=73) and the routine group(n=73).On the basis of routine rehabilitation training,the routine group was treated with traditional acupuncture,and the study group was treated with staged acupuncture.Limb Motor Function Scale(FMA),Daily Activity Barthel Index(BI),Degree of Neurological Impairment Scale(NIHSS) and Mental State Scale(MMSE) were used to evaluate the limb function score,daily activity index,neurological function injury and cognitive function changes of the two groups before and after the treatment.The changes in serum levels of glycine(Gly),GABA,lipoprotein-associated phospholipase A2(Lp-PLA2) and superoxide dismutase(SOD) were compared before the treatment and one month after the treatment in the two groups.Pearson correlation was used to analyze the correlation between FMA score and NIHSS score.Results:Compared with those in the routine group,the FMA score,BI index and MMSE score were significantly increased and the NIHSS score was significantly decreased in the study group after the treatment(P<0.05).Compared with that in the routine group,the proportion of Brunnstrom stage II was significantly increased in the study group after the treatment(P<0.05).Compared with those in the routine group,the levels of Gly,GABA and SOD were significantly increased(P<0.05),and Lp-PLA2 was significantly decreased in the study group after the treatment(P<0.05).Pearson correlation analysis showed that there was a negative correlation between FMA score and NIHSS score(P<0.05).Conclusion:Staged acupuncture therapy for Brunnstrom stage Ⅰ-Ⅱ stroke patients can effectively improve the limb motor function and reduce the degree of neurological impairment,with better clinical efficacy.