电针联合康复机器人对脑卒中后偏瘫患者上肢功能及日常生活活动能力的影响

Effect of electroacupuncture combined with rehabilitation robots on upper limb function and daily living activities of post-stroke hemiplegic patients

目的研究旨在探讨电针与康复机器人联合治疗对脑卒中后偏瘫患者上肢功能及日常生活活动能力的康复效果。方法选取2023年1—12月在聊城市第三人民医院接受治疗的90例脑卒中后偏瘫患者,采用随机数表法分为联合治疗组和电针组,各45例。两组患者均接受临床常规药物治疗和日常康复训练。联合治疗组男性25例、女性20例,年龄(58.13±9.90)岁,病程(23.10±3.41)d,接受电针和康复机器人综合治疗,均为30 min/次,1次/d,5 d/周。电针组男性23例、女性22例,年龄(59.47±7.29)岁,病程(23.27±3.65)d,接受电针治疗,30 min/d,5 d/周。治疗4周后,采用简化Fugl-Meyer上肢运动功能量表(FMA-UE)评价上肢功能恢复情况,改良Barthel指数(MBI)评价日常生活活动能力,表面肌电图评价肌肉恢复状况,以评价治疗效果。统计学方法采用χ^(2)检验和t检验。结果治疗前,两组的三角肌、肱二头肌、肱三头肌积分肌电值(iEMG)及FMA-UE、MBI评分差异均无统计学意义(均P>0.05)。治疗4周后,两组的三角肌、肱二头肌、肱三头肌iEMG及FMA-UE、MBI评分均高于治疗前,且联合治疗组均高于电针组[(177.10±34.80)mV/s比(147.60±50.02)mV/s、(260.74±46.79)mV/s比(235.40±48.06)mV/s、(98.36±17.30)mV/s比(88.33±17.04)mV/s、(33.47±5.51)分比(27.23±5.64)分、(47.83±8.48)分比(39.00±10.70)分],差异均有统计学意义(t=2.652、P=0.010,t=2.069、P=0.043,t=2.264、P=0.027,t=4.330、P<0.001,t=3.544、P=0.001)。结论综合应用电针和康复机器人对改善脑卒中后偏瘫患者的上肢功能和日常生活活动能力具有明显疗效。

Objective To explore the rehabilitation effect of the combination of electroacupuncture and rehabilitation robots on upper limb function and daily living activities in patients with post-stroke hemiplegia.Methods Ninety patients with post-stroke hemiplegia who received treatment in Liaocheng Third People's Hospital from January to December 2023 were selected and were divided into a combined treatment group and an electroacupuncture group by the random number table method with 45 cases in each group.In the combined treatment group,there were 25 males and 20 females,the age was(58.13±9.90)years old,and the course of disease was(23.10±3.41)days.In the electroacupuncture group,there were 23 males and 22 females,the age was(59.47±7.29)years old,and the course of disease was(23.27±3.65)days.Both groups received clinical routine drug treatment and daily rehabilitation training.The combined treatment group received electroacupuncture and rehabilitation robot therapy,30 min/time,once a day,5 days every week.The electroacupuncture group received electroacupuncture treatment,30 min/d,5 days every week.After 4 weeks of treatment,the simplified Fugl-Meyer Upper Extremity Motor Function Scale(FMA-UE)was used to assess the functional recovery of the upper extremities,the modified Barthel index(MBI)was used to assess the ability to perform activities of daily living,and the surface electromyography was used to assess the muscle recovery,in order to evaluate the treatment effect.Statistical methods wereχ^(2) test and t test.Results Before treatment,there were no statistically significant differences in the iEMG values of deltoid,biceps,and triceps and FMA-UE and MBI scores between the two groups(all P>0.05).After 4 weeks of treatment,the iEMG values of deltoid,biceps,and triceps and FMA-UE and MBI scores in both groups were higher than those before treatment,and those in the combined treatment group were all higher than those in the electroacupuncture group[(177.10±34.80)mV/s vs.(147.60±50.02)mV/s,(260.74±46.79)mV/s vs.(235.40±48.06)mV/s,(98.36±17.30)mV/s vs.(88.33±17.04)mV/s,(33.47±5.51)points vs.(27.23±5.64)points,(47.83±8.48)points vs.(39.00±10.70)points],with statistically significant differences(t=2.652,P=0.010;t=2.069,P=0.043;t=2.264,P=0.027;t=4.330,P<0.001;t=3.544,P=0.001).Conclusion The comprehensive application of electroacupuncture and rehabilitation robots has significant therapeutic effects on improving upper limb function and daily living activities in post-stroke hemiplegic patients.