手三针配合颞三针治疗脑卒中患者痉挛期手功能障碍的临床观察

Clinical Observation of Hand Three Needles Combined with Temporal Three Needles in the Treatment of Stroke Patients with Hand Dysfunction

目的观察手三针配合颞三针疗法对脑卒中患者痉挛期手功能障碍的临床疗效及卫生经济学评价。方法将100例脑卒中痉挛期手功能障碍患者随机分为手三针组(50例)和康复组(50例)。康复组予常规康复治疗,包括缓解肌张力、上肢控制能力训练等;手三针组予手三针配合颞三针常规针刺;两组患者均每日治疗1次,时间30min,每周5次,共连续治疗4周。观察患者治疗前后Fugl-Meyer运动功能评分(FMA)、临床神经功能缺损程度评定量表(NDS)手肌力部分、静息状态下偏瘫侧手被动活动时的改良Ashworth痉挛分级(MAS)以及医疗总费用。结果手三针组总有效率为97.9%,康复组总有效率为90%,两组疗效有显著性差异(P<0.05),提示手三针组的临床疗效优于康复组;且手三针组可明显提高脑卒中患者的FMA评分(与治疗前比较,均P<0.05);降低脑卒中患者MAS、NDS分级(与治疗前比较,P<0.05);且其作用均优于康复组(P<0.05);康复组患者的医疗总费用高于手三针组,两组患者总医疗费用未见明显差异(P>0.05)。结论手三针配合颞三针疗法治疗脑卒中患者痉挛期手功能障碍较常规康复治疗,更能够缓解患者手痉挛、肌张力程度,促进手功能的恢复,且经济简效,更利于临床推广使用。

Objective To observe the clinical efficacy and economics evaluation of hand three needles combined with temporal three needles therapy on spasticity of hand dysfunction in stroke patients.Methods 100 cases of hand dysfunction in spasmodic phase of stroke were randomly divided into hand three needles group(50 cases)and rehabilitation group(50 cases).The rehabilitation group was given routine rehabilitation,including relief muscle tension and control ability training of upper limbs,hand three needles group was given in hand three needles and temporal three needles needling,and two groups of patients were treated 1 times a day,30 min,5 times a week,for 4 weeks.The Fugl-Meyer motor function score(FMA),the clinical nerve function defect degree assessment scale(NDS),the modified Ashworth spasmodic classification(MAS)and the total medical cost were observed before and after the treatment.Results The total effective rate of the hand three needles group was 97.9%,the total effective rate of the rehabilitation group was 90%,the two groups had significant difference(P<0.05),suggesting that the clinical curative effect of the hand three needles group was better than the rehabilitation group,and the hand three needles group could obviously improve the FMA score of the stroke patients(P<0.05 compared with that before the treatment),and reduce the stroke patients’MAS and NDS score(compared with before treatment,P<0.05),and its effect was better than that of the rehabilitation group(P<0.05);the total medical cost of the patients in the rehabilitation group was higher than that of the hand three needles group,and the total medical cost of the 2 groups had no significant difference(P>0.05).Conclusion Hand three needles combined with temporal three needles therapy in the treatment of stroke patients’hand dysfunction in spasmodic stage is more effective than rehabilitation therapy.It can relieve hand spasm and muscle tension,promote the recovery of hand function,more economical and effective,which is more beneficial to clinical application.