Possibilities of transcatheter treatment of patients after extensive ischemic stroke

The research investigates the efficacy of brain transcatheter laser revascularization in patients who have had extensive ischemic stroke. 1125 patients aged 29 - 81 (average age 75) with cerebral atherosclerosis were examined. The examination plan included: CT brain scan, magnetic resonance imaging (MRI), brain scintigraphy (SG), rheoencephalography (REG), cerebral multi-gated angiography (MUGA), laboratory tests, assessment of severity of dementia (CDR), cognitive impairment (MMSE) and activities of daily living (IB). 93 patients suffered extensive ischemic stroke of whom 7 (7.53%) had 10 - 15 IB points, 25 (26.88%)—20 - 30 IB points, 61 (65.59%)—35 - 45 IB points. 69 patients underwent transcatheter treatment (Test Group). 24 patients underwent conservative treatment (Control Group). High-energy laser systems were used for revascularization of major intracranial arteries;lowenergy laser systems were used for revascularization of distal intracranial branches. Test Group: 67 (97.10%) patients had good immediate angiographic outcome manifested in the restoration of lumen and patency of the affected vessels as well as in collateral revascularization. 12 - 24 months later the following positive trend was observed: 14 (20.59%) patients demonstrated good clinical outcome (IB 90 - 100);26 (38.24%) patients had satisfactory clinical outcome (IB 75 - 85);28 (41.18%) patients showed relatively satisfactory clinical outcome (IB 60 - 70);relatively positive clinical outcome (IB < 60) was not obtained in any case. Control Group: 4 (16.67%) patients showed relatively satisfactory clinical outcome (IB 60 - 70), relatively positive clinical outcome (IB < 60) was achieved in 20 (83.33%) cases. Evaluating the data obtained, it can be concluded that the method of transluminal laser revascularization of cerebral blood vessels is an effective one for the treatment of extensive ischemic strokes. The effect is maintained for a long time;it causes regression of mental, intellectual and motor disorders, promotes regression of post-stroke dementia and significantly improves the quality of life, which makes it noticeably different from the conservative methods of treatment.

Melatoninergic Antidepressant in Post-Stroke Depression Therapy

This paper presents the results of the effects of Melitor (25 mg during two months) on the psychic-emotional state, cerebral hemodynamic and bioelectrical activity of the brain in 30 patients (average age 66.2 ± 3.2 years) with ischemic post-stroke depression. It has been found that this drug possesses a multimodal action which is characterized by the decrease of the level of depression, widening of the range of social-environmental activity, improvement of the cerebral blood circulation and harmonization of the brain electrogenesis. In the patients with right versus left hemisphere stroke, the effect of Melitor on the functional state of the brain was more pronounced. Based on the results obtained in our study, we can recommend Melitor to use it in complex scheme of rehabilitation care of patients of the given nosological category.

Acupoint stimulation for post-stroke spasticity:a systematic review protocol

This systematic review is aim to comprehensively evaluate the efficacy of acupoint stimulation in managing of post-stroke spasticity. The eligible randomized controlled clinical trials （RCTs） and quasi-randomized controlled clinical trials （quasi-RCTs） will be searched from the following databases： the Cochrane Central Register of Controlled Trials （CENTRAL）, MEDLINE, EMBASE, China National Knowledge Infrastructure （CNKI）, Chinese Scientific Journal Database （VIP）, Wanfang Database, Chinese BioMedical Literature Database （CBM）. The Cochrane risk of bias tool will be used to assess the trials. No patients or their family will be bothered in this systematic review, so there is no need for the permission of institutional review board （IRB）. The completed systematic review will be published in a peer-reviewed journal.

Acupuncture for spastic hemiplegia after ischemic stroke: a systematic review

Objective:To systematically assess the effectiveness and safety of acupuncture for spastic hemiplegia after ischemic stroke.Methods:Randomized controlled trials(RCTs)of acupuncture treatment for spastic hemiplegia after ischemic stroke meeting the inclusion criteria in Cochrane Library,Medline,Excerpta Medica Database(EMBASE),PubMed,China National Knowledge Infrastructure(CNKI),SinoMed,Chongqing VIP Database(VIP),and Wanfang Data Knowledge Service Platform(Wanfang)published from each database’s inception to February 2023 were retrieved by computer.Two reviewers independently extracted data and evaluated the risk of bias using Cochrane’s risk of bias tool.Review Manager 5.4 was used for data analysis.Continuous data were evaluated using mean difference(MD)with a 95%confidence interval(CI),and dichotomous data were analyzed using risk ratio(RR).Results:A total of 24 trials,including 1970 participants,were included in the study.The meta-analysis of 7 trials showed that compared to the rehabilitation therapy,acupuncture therapy was more effective in improving the simplified Fugl-Meyer assessment score after 1-month treatments[MD=10.52,95%CI(7.81,13.23),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.18,95%CI(11.34,27.02),P<0.001],and the 6-month treatment course resulted in better outcomes than the 1-month course.The meta-analysis of 8 trials showed that acupuncture had a better improvement on the Barthel index score than rehabilitation therapy after 1-month treatments[MD=10.78,95%CI(8.91,12.64),P<0.001].The meta-analysis of 2 articles showed the same tendency after 6-month treatments[MD=19.94,95%CI(19.02,20.87),P<0.001],and the 6-month course was better than the 1-month course.The meta-analysis of 2 trials showed that the effective rate of the modified Ashworth scale score improvement was more notable in the acupuncture group after 1-month treatments[RR=1.20,95%CI(1.02,1.40),P=0.020].One trial reported no adverse event,and 1 trial reported 3 adverse events without severe influence.Conclusion:Acupuncture might be an effective and safe therapy for spastic hemiplegia after ischemic stroke,but more high-quality,large-sample objectively-evaluated RCTs are needed to validate the conclusion.

督脉排针法联合下肢智能反馈训练对缺血性脑卒中后下肢痉挛性瘫痪的疗效观察

目的探讨督脉排针法联合下肢智能反馈训练对缺血性脑卒中后下肢痉挛性瘫痪患者的治疗效果。方法选取2022年8月至2024年1月焦作市中医院接收的200例脑卒中后下肢痉挛性瘫痪患者临床资料,依据治疗方案不同分为对照组、联合组,各100例。对比分析两组临床疗效,治疗前后中医证候积分、脑血流动力学、临床痉挛指数量表(CSI)评分、Fugl-Meyer运动功能量表-下肢(FMA-LE)评分。结果治疗后联合组中医证候积分较对照组更低(P<0.05);与对照组相比,治疗后联合组峰流速(Vp)、平均流速(Vm)水平更高(P<0.05);联合组临床总有效率93.00%高于对照组84.00%(P<0.05);联合组治疗后CSI评分较对照组更低,FMA-LE评分较对照组更高(P<0.05)。结论督脉排针法联合下肢智能反馈训练治疗能有效改善缺血性脑卒中后下肢痉挛性瘫痪患者脑血流动力学,增强运动功能。

Clinical Study of Acupotomy Trinity Lysis Combined with Rehabilitation Training for Spastic Paralysis after Stroke

Objective:To study the clinical efficacy of acupotomy trinity lysis combined with rehabilitation training in the treatment of spastic paralysis after stroke,and to provide guidance for clinical diagnosis and treatment.Methods:From July 2019 to November 2020,119 patients with post-stroke spastic paralysis who were admitted to our hospital's encephalopathy department were selected as the research objects,and 61 patients were divided into acupuncture combined with rehabilitation training group as the observation group by random number table method.58 patients were divided into the rehabilitation training group as the control group.After 21 days of treatment,they passed the modified Ashworth Spasm Scale(MAS)grading scale score,Clinical Spasm Index(clinical spasm index,CSI)assessment,Fugl,Meyer exercise function scale(FMA)Score,Modified Barthel Index Score,and compare the clinical efficacy after treatment.Results:After treatment,the total effective rate of the observation group(95.08%)was higher than that of the control group(86.21%),and the difference was statistically significant(P<0.05);Before treatment,the contrast difference of MAS,FMA,CSI scores and modified Barthel index scores of the two groups of patients is not statistically significant;After treatment,the MAS scores and CSI scores of the elbow and knee joints of the observation group[(1.52±0.81)(1.46±0.83)(5.87±2.12)]were significantly lower than those of the control group[(2.17±0.68)(2.03±0.79)(8.36±2.41)];FMA upper limb and lower limb scores and modified Barthel index[(51.87±4.41)(30.21±5.05)(72.41±5.81)]of the observation group were significantly higher than those of the control group[(44.26±4.78)(28.45±4.23)(68.65±6.09)],the difference was statistically significant(P<0.05).Conclusion:Acupotomy trinity lysis combined with rehabilitation training is effective in treating patients with post-stroke spastic paralysis.It provides a safe,reliable and clinically effective new program,which is worthy of popularization and application.

参芪桃花四物汤合复遂汤联合针刺对气虚血瘀证缺血性脑梗死恢复期痉挛性瘫痪患者的临床疗效

目的探讨参芪桃花四物汤合复遂汤联合针刺对气虚血瘀证缺血性脑梗死恢复期痉挛性瘫痪患者的临床疗效。方法92例患者随机分为对照组和观察组,每组46例,2组采用常规治疗,同时对照组给予针刺,观察组在对照组基础上加用参芪桃花四物汤合复遂汤,疗程4周。检测临床疗效、中医证候评分、血清学指标(Glu、GABA、Glu/GABA、Gly、HCY、ASP)、神经功能指标(BDNF、NGF、NT-3)、NIHSS评分、FMA评分、MAS评分、Barthel评分、表面肌电信号(Hmax、Mmax、Hmax/Mmax)、不良反应发生率变化。结果观察组总有效率高于对照组(P<0.05)。治疗后,2组GABA、Gly、神经功能指标、FMA评分、Barthel评分升高(P<0.05),中医证候评分、Glu、Glu/GABA、HCY、ASP、NIHSS评分、MAS评分、表面肌电信号降低(P<0.05),以观察组更明显(P<0.05)。2组不良反应发生率比较,差异无统计学意义(P>0.05)。结论参芪桃花四物汤合复遂汤联合针刺可安全有效地改善气虚血瘀证缺血性脑梗死恢复期痉挛性瘫痪患者神经功能、运动功能、生活质量,降低中医证候评分、痉挛程度。

黄启辉辨治缺血性脑卒中后运动障碍经验介绍

介绍黄启辉教授治疗缺血性脑卒中后运动障碍的临床经验。黄启辉教授认为,临床上根据缺血性脑卒中后运动障碍的特点可分为硬瘫型、软瘫型。硬瘫型病机多为肝肾阴虚,肝阳上亢,内风旋动,气滞血瘀,治以滋补肝肾、平肝熄风、活血化瘀,常用天麻钩藤饮、六味地黄丸合桃红四物汤加减;软瘫型病机多为脾肾虚损,阳气失动,气滞血瘀,治以温肾助阳、益气健脾、活血通脉,以小续命汤加减。另外需重视药对的使用,根据临床辨证加减。

Network meta-analysis on different acupuncture therapies for post-stroke spastic hemiplegia

Objective:To perform a network meta-analysis on four commonly used acupuncture therapies(electroacupuncture,fire acupuncture,warm acupuncture,and filiform needling) and rehabilitation therapy in the treatment of post-stroke spastic hemiplegia so as to compare the differences in clinical therapeutic effect between acupuncture therapy and rehabilitation therapy as well as among different therapeutic methods of acupuncture.Methods:A computer-based retrieval was conducted in Chinese and English databases,i.e.CNKI,WanFang,VIP,SinoMed,PubMed,Embase,Web of Science and Cochrane library.The search period limit was from the database establishment to April 17,2020.Data analysis was performed through Revman 5.3,Gemtc 0.14.3 and Stata 14.2.Results:A total of 27 trials were finally eligible,including 1880 patients,943 patients of which were in observation group and 937 patients in control group.In terms of the improvement of effective rate,electroacupuncture,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,warm acupuncture was the highest in probability to be the optimal measure.Regarding the improvement in Fugl-Meyer Assessment(FMA) motor function score,fire needling,warm acupuncture and filiform needling methods were all better than rehabilitation therapy,and among which,fire needling method was the highest in probability to be the optimal measure.In view of the improvement of BI score,fire needling method was better than electroacupuncture and filiform needling method,while,warm acupuncture was better than electroacupuncture,thus,fire needling method may be the optimal measure.For the modified Ashworth muscular tension assessment,there was no significant differences in pairwise comparison among different interventions and warm acupuncture was probably the optimal measure.Conclusion:The overall therapeutic effect of 4 acupuncture therapies is better than rehabilitation therapy on post-stroke spastic hemiplegia,respectively,among which,the therapeutic effect of warm acupuncture and fire needling method is the best.However,because of a limitation of the varieties of acupuncturemoxibustion therapy and the number of included trials,it needs to conduct more rigorous and scientific randomized controlled trials so that this conclusion can be further confirmed.

Reduction of epinephrine in the lumbar spinal cord following repetitive blast-induced traumatic brain injury in rats

Traumatic brain inju ry-induced unfavorable outcomes in human patients have independently been associated with dysregulated levels of monoamines,especially epinephrine,although few preclinical studies have examined the epinephrine level in the central nervous system after traumatic brain injury.Epinephrine has been shown to regulate the activities of spinal motoneurons as well as increase the heart rate,blood pressure,and blood flow to the hindlimb muscles.Therefore,the purpose of the present study was to determine the impact of repeated blast-induced traumatic brain injury on the epinephrine levels in seve ral function-s pecific central nervous system regions in rats.Following three repeated blast injuries at 3-day intervals,the hippocampus,motor cortex,locus coeruleus,vestibular nuclei,and lumbar spinal cord were harvested at post-injury day eight and processed for epinephrine assays using a high-sensitive electrochemical detector cou pled with high-performance liquid chromatography.Our results showed that the epinephrine levels were significantly decreased in the lumbar spinal cord tissues of blast-induced traumatic brain injury animals compared to the levels detected in age-and sex-matched sham controls.In other function-specific central nervous system regions,although the epinephrine levels were slightly altered following blast-induced tra u matic brain injury,they were not statistically significant.These results suggest that blast injury-induced significant downregulation of epinephrine in the lumbar spinal cord could negatively impact the motor and cardiovascular function.This is the first repo rt to show altered epinephrine levels in the spinal cord following repetitive mild blast-induced traumatic brain injury.

醒脑开窍针刺联合穴位注射治疗缺血性卒中上肢痉挛性瘫痪气虚血瘀证的效果

目的研究醒脑开窍针刺联合穴位注射治疗缺血性卒中(IS)上肢痉挛性瘫痪气虚血瘀证患者的效果。方法本研究为随机对照试验。选取2021年12月至2023年9月安康市中医医院收治的100例IS上肢痉挛性瘫痪气虚血瘀证患者作为研究对象。采用随机数字表法,将患者分为观察组(50例)和对照组(50例)。观察组因2型糖尿病退出研究1例,因肺炎退出研究1例,对照组因高血压病退出研究1例,最终纳入97例。观察组男25例,女23例;年龄41~76(58.54±8.29)岁,病程(1.63±0.27)个月。对照组男22例,女27例;年龄40~74(57.06±8.73)岁,病程(1.52±0.31)个月。对照组采用规范化卒中康复治疗,观察组在对照组基础上采用醒脑开窍针刺联合穴位注射治疗。两组均治疗2周。比较两组临床疗效,治疗前后痉挛程度[改良Ashworth量表(MAS)]、运动功能[Fugl-Meyer运动功能评定量表(FMA)]和骨骼肌(肱二头肌、肱三头肌、肱桡肌)超声剪切波速度(SWV)。采用独立样本t检验、配对t检验和χ^(2)检验进行统计学分析。结果观察组治疗总有效率高于对照组[89.58%(43/48)比73.47%(36/49)](P<0.05)。治疗后,观察组MAS评分低于对照组,FMA评分高于对照组[(1.02±0.26)分比(1.44±0.25)分、(28.13±5.53)分比(20.29±5.01)分](均P<0.05);观察组肱二头肌、肱三头肌与肱桡肌SWV均低于对照组[(1.59±0.19)m/s比(1.93±0.22)m/s、(1.61±0.20)m/s比(1.97±0.19)m/s、(1.54±0.15)m/s比(1.86±0.22)m/s](均P<0.05)。结论醒脑开窍针刺联合穴位注射治疗可改善IS上肢痉挛性瘫痪气虚血瘀证患者临床症状,降低患肢痉挛程度,改善患肢活动度。

中医推拿联合康复训练治疗缺血性卒中后痉挛性偏瘫患者的效果

目的:观察中医推拿联合康复训练治疗缺血性卒中后痉挛性偏瘫患者的效果。方法:选取2021年1月至2024年1月该院收治的80例缺血性卒中后痉挛性偏瘫患者进行前瞻性研究,按照随机数字表法将其分为观察组与对照组各40例。对照组接受常规康复训练,观察组在对照组基础上实施中医推拿治疗。比较两组干预前后肢体痉挛程度[改良Ashworth量表(MAS)]及肌力[徒手肌力评定量表(MMT)]、四肢运动功能[Fugl-Meyer运动功能评定量表(FMA)]及日常生活自理能力[改良Barthel指数(MBI)]评分。结果:干预4周后,观察组肢体痉挛程度低于对照组,肱二头肌、股四头肌MMT评分,上、下肢FMA评分及MBI评分均高于对照组,差异有统计学意义(P<0.05)。结论:中医推拿治疗缺血性卒中后痉挛性偏瘫患者效果确切,可减轻其肢体痉挛程度,提高肌力,并进一步提升其肢体运动功能和日常生活自理能力,效果优于单用常规康复训练。

中药熏洗治疗脑梗死痉挛性瘫痪的效果

目的研究在张力平衡针法基础上联合中药熏洗治疗脑梗死痉挛性瘫痪的临床疗效与安全性。方法 2014年6月至2017年6月脑梗死痉挛性瘫痪患者258例,随机分为对照组(n=130)和观察组(n=128)。两组均给予常规治疗加张力平衡针法,观察组另予中药熏洗患肢,共6周。治疗前、治疗3周后、治疗6周后,采用改良Ashworth量表(MAS)、Fugl-Meyer评定量表(FMA)、改良Barthel指数(MBI)和神经功能缺损量表(NDS)对患者进行评定,记录不良反应发生情况。结果治疗3周后,两组患者FMA、MBI与NDS评分均无显著性差异(P>0.05)。治疗6周后,观察组MAS临床疗效明显优于对照组(χ~2=11.121,P=0.001);两组患者FMA、MBI与NDS评分均较治疗前改善(t>7.382,P<0.05),观察组FMA、MBI与NDS评分优于对照组(t>4.412,P<0.05);治疗后未出现明显不良反应。结论加用中药熏洗能改善脑梗死痉挛性瘫痪患者的肌张力、日常生活活动与运动功能。

针灸联合康复训练治疗缺血性中风后痉挛性偏瘫30例

目的:观察针灸联合康复训练治疗缺血性中风后痉挛性偏瘫的临床疗效。方法:将60例缺血性中风后痉挛性偏瘫患者随机分为两组。对照组30例采用康复训练治疗,治疗组30例在康复训练基础上给予针灸治疗,观察两组患者治疗前后痉挛指数变化情况。结果:针灸联合康复训练治疗后患者痉挛指数改善明显(P<0.05)。结论:针灸联合康复训练能有效改善缺血性中风后痉挛性偏瘫。

点穴疗法配合针刺治疗缺血性中风痉挛性偏瘫疗效观察

目的:研究点穴配合针刺疗法对缺血性中风患者痉挛性偏瘫状态的治疗效果。方法:将61例符合纳入标准的缺血性中风痉挛性偏瘫的患者随机分为治疗组和对照组。治疗组30例,对照组31例。2组均接受基础康复治疗和针刺治疗,治疗组在此基础上给予点穴疗法。经治疗2周后,分别运用临床神经功能缺损程度量表(NDS)和改良Ashworth量表评定2组患者神经功能缺损程度和肌张力痉挛程度。结果:2组患者治疗后的NDS和改良Ashworth量表评分结果均显著低于治疗前(P<0.05),且治疗后治疗组在上肢肩关节肌力、下肢肌力、步行能力和痉挛程度这4个层面均比对照组改善更明显(P<0.05)。结论:点穴疗法配合针刺能显著地缓解肢体的痉挛状态和改善缺血性中风痉挛性偏瘫患者的神经功能,提高患者的日常生活能力。

巨刺阳经法治疗缺血性脑卒中后上肢痉挛的临床观察

[目的]对巨刺阳经针刺法改善缺血性脑卒中患者的上肢痉挛状态进行疗效评价。[方法]将60例缺血性脑卒中患者随机分为观察组和对照组,每组各30例,两组均予相同的基础治疗,对照组应用传统针刺法治疗,观察组予巨刺阳经法治疗。在入院时及治疗2个疗程后均分别运用修订Ashworth痉挛评分、日常生活活动能力进行康复评定。[结果]观察组患者肌张力及日常生活活动能力均较对照组有明显改善(P<0.05)。[结论]巨刺阳经法可以明显缓解缺血性脑卒中后上肢痉挛性偏瘫,其疗效明显优于传统针刺法。

缺血性卒中后痉挛发生情况及预测因素分析

目的了解国人缺血性卒中6个月后肢体痉挛的发生情况与危险因素。方法连续选取2013年4月1日-7月31日在我院神经内科住院的新发缺血性卒中患者,在缺血性卒中后6个月时评估其痉挛情况。痉挛评定采用改良Ashworth痉挛量表（modified Ashworth Scale,MAS）,所有患者的痉挛评定均由同一人进行。结果纳入患者185例,完成随访114例,32例发生痉挛,上下肢均发生痉挛的有22例。最易受累的是肘关节（26例）,其次为踝关节（22例）、指关节（20例）、腕关节（19例）、膝关节（18例）、肩关节（15例）和髋关节（7例）。统计分析发现,入院时美国国立卫生研究院卒中量表（National Institutes of Health Stroke Scale,NIHSS）痉挛组（4.64,0-23分）显著高于无痉挛组（2.41,0-7分,P=0.001）;入院时NIHSS评分中瘫痪评分（3,2-6分）痉挛组明显高于无痉挛组（1,0-2分,P〈0.001）;出院时日常生活活动能力评分（Barthel Index,BI）痉挛组（71.2分,5-100分）明显低于无痉挛组（91.7分,45-100分,P〈0.001）。多因素回归分析后,发现入院时NIHSS评分中瘫痪评分及出院时BI评分与痉挛的发生存在相关性。结论缺血性卒中后,痉挛在上下肢同时发生最常见,上肢较下肢更易发生痉挛,其中肘关节最易受累,入院时NIHSS评分中瘫痪评分与出院时BI评分有助于预测痉挛的发生。

缺血性中风偏瘫痉挛状态对证候分布的影响

目的探讨缺血性中风偏瘫痉挛程度与证候分布的关系。方法纳入2014年6月—2015年12月北京中医药大学东直门医院、北京中医药大学东直门医院东区、北京市怀柔区中医医院、北京市中医医院顺义医院和北京市平谷区中医医院5家合作中心符合标准的病人82例,给予现代康复或中医康复训练,观察病人入组时和入组21 d改良的Ashworth分级和证候积分,进行性频数统计、聚类分析及相关性分析。结果 82例病人中,痉挛程度有效改善47例,无效35例。入组时主要以痰证、血瘀证和火热证为主;经康复治疗后,痉挛程度改善有效组病人气虚证和血瘀证为主要证候;无效组病人火热证、痰证和血瘀证以及证候组合中的火热+痰证为主,且各证候都"不符合"的病人比例最大。相关性分析显示入组时痉挛程度与火热证积分的显著负相关(r=-0.295,P=0.007);有效组中未显示出与各证候积分的显著相关性;但在无效组中,与痰证积分显著正相关(r=0.448,P=0.007)。结论中风病偏瘫痉挛病人发病早期以痰、瘀为重,痉挛程度改善后,逐渐转变为气虚血瘀为主;若无改善,则仍有实邪或者毒邪存在,病情较重。

腹针疗法治疗缺血性脑卒中恢复期痉挛状态腕手功能障碍的临床观察

目的观察腹针疗法治疗缺血性脑卒中恢复期痉挛状态腕手功能障碍的临床疗效及其安全性。方法将60例受试者按1:1随机分为治疗组与对照组,治疗组予腹针疗法,对照组予常规针刺,每周治疗5次,共治疗3周。观察两组治疗前后的简化Fugl-Meyer运动功能量表(FMA)腕手功能评分、改良Ashworth量表(MAS)分级,随访3个月后的Barthel指数评定量表分级,并记录是否有不良反应事件发生。结果治疗后两组FMA腕手功能评分均较治疗前升高(P<0.05),且治疗组优于对照组(P<0.05);治疗后两组MAS分级均较治疗前改善(P<0.05),但两组间差异无统计学意义(P>0.05);随访时两组Barthel分级无差异(P>0.05)。两组均未发生不良反应事件。结论腹针疗法能改善缺血性脑卒中恢复期患者的腕手功能,缓解痉挛状态,但对患者远期致残率的影响并不优于常规针刺。

针刺结合经筋推拿治疗缺血性卒中后患者上肢痉挛性瘫痪的疗效观察

[目的]探讨缺血性卒中后患者在针刺治疗的基础上应用经筋推拿改善上肢痉挛性瘫痪的效果观察。[方法]收集2018年1—6月在院的缺血性卒中后并伴有上肢痉挛性瘫痪患者60例,随机分为观察组30例和对照组30例。观察组在对照组的基础上,每日采用经筋推拿,6 d为1个疗程,休息1 d,8个疗程后,比较两组患者上肢痉挛改善的程度;对照组采取中风病一般护理常规及针刺治疗,疗程与观察组相同。[结果]观察组和对照组治疗前后比较临床痉挛量表(CSI)评分、Ashworth评分、神经功能缺损程度(NIHSS)评分、日常生活能力(MBI)评分、平衡评估量表(Fugl-Meyer)评分差异具有统计学意义(P<0.05);两组患者治疗后CSI评分、Ashworth评分、NIHSS评分、MBI评分比较,差异具有统计学意义(P<0.05);治疗后两组间患者Fugl-Meyer评分比较,差异不具有统计学意义(P>0.05)。[结论]运用针刺治疗配合经筋推拿可以有效地改善缺血性卒中患者上肢痉挛,同时降低了肌张力,提高了日常运动能力。