温针灸联合"醒脑开窍"针刺法治疗脑卒中后上肢痉挛性瘫痪的效果观察

Observation of the efficacy of warm acupuncture and moxibustion combined with acupuncture for brain awakening in the treatment of spastic paralysis of the upper limbs after stroke

目的:分析温针灸联合"醒脑开窍"针刺法治疗脑卒中后上肢痉挛性瘫痪的临床效果。方法:回顾性抽取2021年7月至2022年12月安康市中医医院针灸康复科收治的120例脑卒中后上肢痉挛性瘫痪患者作为研究对象,按照随机数字表法分为对照1组、对照2组和观察组,每组40例。对照1组采用温针灸臂臑、尺泽穴治疗,对照2组采用醒脑开窍针刺法治疗,观察组采用醒脑开窍针刺法配合温针灸臂臑、尺泽穴治疗。对比三组患者的疗效,采用简化Fugl-Meyer运动功能评定量表评价治疗前后患侧上肢运动功能;采用Barthel指数评定表评价治疗前后日常生活活动能力。结果:观察组总有效率(90%,36/40)高于对照1组(27.5%,11/40)和对照2组(43.5%,17/39),P<0.05;观察组患侧上肢运动功能及日常生活活动能力改善程度高于对照1组和对照2组(P<0.05)。结论:温针灸联合"醒脑开窍"针刺法对脑卒中后上肢痉挛性瘫痪的方案安全可行,疗效显著,可降低脑卒中患者的肌张力,抑制上肢痉挛,提高上肢运动功能及生活质量。

Objective:To analyze the effect of warm acupuncture and moxibustion combined with acupuncture for brain awakening in the treatment of spastic paralysis of the upper limbs after stroke.Methods:A total of 120 patients with spastic paralysis of the upper limbs after stroke admitted to the Department of Acupuncture and Moxibustion Rehabilitation of Ankang Hospital of Traditional Chinese Medicine from July 2021 to December 2022 were retrospectively selected as the research objects.And they were divided into a control group 1,a control group 2 and an observation group using a random number table method,with 40 cases in each group.The control group 1 was treated by warm acupuncture and moxibustion at the points of Binao and Chize,while the control group 2 was treated by acupuncture for brain awakening.The observation group was treated by acupuncture for brain awakening combined with warm acupuncture and moxibustion at the points of Binao and Chize.The efficacy of the three groups were compared;the simplified Fugl-Meyer motor function assessment scale was used to evaluate the motor function of the affected upper limb before and after treatment.The Barthel index assessment scale was used to evaluate the activities of daily living before and after treatment.Results:The total effective rate of the observation group(90.0%,36/40)was higher than that of the control group 1(27.5%,11/40)and the control group 2(43.5%,17/39),P<0.05;the improvement of motor function and activities of daily living in the affected upper limb of the observation group was higher than that of the control group 1 and the control group 2(P<0.05).Conclusions:Warm acupuncture and moxibustion combined with acupuncture for brain awakening is safe and feasible for the treatment of spastic paralysis of the upper limbs after stroke,with significant therapeutic effects.It can reduce muscle tension in stroke patients,inhibit upper limb spasticity,and improve motor function of the upper limbs and quality of life.