针刺联合镜像疗法对脑卒中后偏瘫患者上肢运动功能的疗效观察

Effect of acupuncture combined with mirror therapy on upper limb motor function in patients with hemiplegia after stroke

目的:观察针刺联合镜像疗法(MT)对脑卒中后偏瘫患者上肢运动功能的疗效。方法:选取脑卒中患者80例,按照随机数字表法将患者分为4组,对照组(A组)、针刺组(B组)、镜像组(C组)、联合组(D组),每组20人。4组患者均进行常规综合康复训练,在此基础上,B组增加针刺治疗,C组增加MT,D组增加针刺治疗和MT。治疗前及治疗4周后评估4组Fugl-Meyer运动功能量表的上肢部分(FMA-UE)评分,改良Barthel指数(MBI)评分,Wolf上肢运动功能(WMFT)评分。结果:治疗后,4组FMA-UE评分、MBI评分、WMFT评分较治疗前均有所升高(P<0.01),上述3项评分:D组明显高于A、B、C组(P<0.05),B组高于A组(P<0.05),C组高于A组(P<0.05),B、C组间比较差异无统计学意义。结论:针刺联合镜像疗法能有效改善脑卒中偏瘫患者上肢运动功能,比单一使用针刺或镜像疗法更有利于偏瘫患者上肢运动功能的恢复。

Objective:To observe the effect of acupuncture combined with mirror therapy(MT)on the function of upper limbs in patients with post-stroke hemiplegia.Methods:Totally,80 stroke inpatients in the Rehabilitation Department of Nantong Third People’s Hospital were selected on January 1,2020.According to the random number table method,the patients were divided into 4 groups(20 cases in each group):control group A,acupuncture group B,MT group C,and joint group D.The four groups of patients all were given routine comprehensive rehabilitation training.Group A was simply given conventional comprehensive rehabilitation training.Patients in group B were given acupuncture treatment on the basis of group A,and those in group C were given MT on the basis of group A.Group D was given acupuncture treatment and posterior MT on the basis of group A.After 4 weeks,Fugl-Meyer assessment(FMA)upper limb and hand movement function(FMA-UE)score,modified Barthel index(MBI)score,and Wolf motor function test(WMFT)score were assessed in the four groups of patients.Results:After 4 weeks of treatment,the FMA-UE score,MBI score and WMFT score in the four groups of patients were significantly higher than those before treatment(P<0.05).The FMA-UE score,MBI score and WMFT score in group D were significantly higher than in the rest groups(P<0.05),those in the group B were higher than in the group A(P<0.05),those in the group C were higher than in the group A(P<0.05),and there was no statistically significant difference between groups B and C.Conclusion:Acupuncture combined with MT can effectively improve the motor function of the upper limbs of patients with stroke and hemiplegia.It is more conducive to the recovery of the motor function of the upper limbs of patients with hemiplegia than acupuncture or MT alone.