TREATMENT OF 33 CASES OF APOPLETIC HEMIPLEGIA BY COMBINED ACUPUNCTURE THERAPIES

In the present study,33 cases of apopletic hemiplegia were treated with combinedtherapies of scalp-,body-acupuncture and restoring consciousness needling;besides,electroacupuncture（EA）stimulation was added.The treatment was given once daily,six days constitutea therapeutic course with an interval of 1—2 days between courses.After 5 courses of treatment,10cases（30.30％）were cured,15（45.45％）markedly effective,7（21.21％）effective and 1（3.03％）was ineffective.The total effective rate was 96.96％.

Hemiplegia Patients Treatment Should Combine Acupuncture with Rehabilitation Treatment

The acupuncturetherapy for hemiplegiapatients is popular insome Asian countries,and it has been graduallyaccepted in the rehabili-tative medical field ofsome developed countries.Although numer-ous clinical and experimental studies have beendone,many doctors usu-

Latest Advances in the Treatment of Post-stroke Limb Spasm with Botulinum Neurotoxin

Objective: To describe the latest progress in the use of botulinum neurotoxin for post-stroke limb spasm. Methods: This paper looks up the relevant research literatures in recent years in PubMed, Web of Science, Springer, Ovid, CNKI, WanFang databases and summarizes them. Results: The latest progress in the use of botulinum neurotoxin for post-stroke limb spasm was studied from the following aspects: the action mechanism of botulinum neurotoxin;efficacy evaluation;injection dose;target muscle selection;guiding technology;combination therapy. Conclusion: Botulinum neurotoxin is the first-line treatment for post-stroke limb spasm. We need to make continuous improvement and progress from the treatment period, injection dose, target muscle selection, guiding technology and efficacy evaluation to improve the quality of life of the majority of post-stroke survivors in China.

Effectiveness on post-stroke hemiplegia in patients:electroacupuncture plus cycling vs electroacupuncture alone

OBJECTIVE:To evaluate the effectiveness of cycling in combination with electroacupuncture in treatment of poststroke hemiplegia patients at National Hospital of Acupuncture,Vietnam.METHODS:The study was designed as a single-centre,outcome-assessor-blinded parallel randomised controlled trial with 120 post-stroke hemiplegia patients randomly assigned into two groups:electroacupuncture plus cycling(CT group) and electroacupuncture(AT group).Patients were assessed before and after the treatment(using muscle grading,modified Rankin,Barthel,Orgorozo scores and electromyography).Statistical Man–Whitney U test,and Fisher’s exact tests were used to compare between CT and AT groups.RESULTS:The results reported statistically significant improvement in motor function in patients suffering from hemiplegia following ischemic stroke in both CT and AT groups.Patients in CT group experienced a greater improvement compared to those in AT group including better muscle contraction(increased frequency and amplitude of electromyography and increased muscle grading scale);increased recovery(Orgogozo scale),increased independency(Barthel scale) and decreased disability(Modified Rankin scale)(P < 0.01).CONCLUSIONS:Combination with cycling training significantly improves the recovery of post-stroke patients treated with electroacupuncture.

吴灵芝教授治疗脑瘫足内翻(脾虚肝亢证)经验

吴灵芝教授认为,脑瘫足内翻(脾虚肝亢证)主要见于痉挛型四肢瘫、痉挛型双瘫以及痉挛型偏瘫,其病机为脾虚生痰、血少筋强、阴急阳缓,宜从肝脾论治;临床治疗上针药并用,辅以肌内效贴加强疗效,诸法并用以达健脾化痰、养血柔筋、平衡阴阳之效,可有效降低踝部内侧肌张力,促进踝部内、外侧肌张力平衡,改善足内翻角度。

脑卒中偏瘫患者身体运动功能目标指向性变异组合训练实验研究

在中医针灸、现代康复技术联合运动康复对脑卒中偏瘫患者身体运动功能康复效果得到了广泛认可的前提下,本研究将现代运动训练理论中的周期理论、负荷理论以及训练手段理论等引入到脑卒中偏瘫患者康复过程中来,设计了一套目标指向性变异组合训练计划,并针对处于软瘫期的15名脑卒中偏瘫患者进行了三周的实验。结果显示,与传统康复疗法相比,医疗康复结合目标指向性变异组合训练康复疗效更加显著,这对于继续深入摸索脑卒中偏瘫患者运动康复的思路、路径、方法、手段等问题有很高的指导意义。

针灸辅助治疗急性缺血性脑卒中后偏瘫的临床价值

目的探讨针灸辅助治疗急性缺血性脑卒中(CIS)后偏瘫的临床疗效及安全性。方法选取2019年3月至2021年3月我院收治的CIS偏瘫患者79例,按照随机数字表法分为观察组(温针灸联合通络扶正汤治疗)42例和对照组(通络扶正汤治疗)37例。比较两组治疗后临床疗效、血清学指标环磷酸腺苷(cAMP)、环磷酸鸟苷(cGMP)、肢体功能、神经功能及生活能力,并分析治疗安全性。结果治疗后,观察组临床疗效优于对照组(P<0.05);两组cAMP水平较治疗前上升,cGMP水平较治疗前下降,且观察组变化程度显著高于对照组(P<0.05);治疗后观察组肢体功能、神经功能及生活能力评分均优于对照组(P<0.05);两组治疗期间及治疗后不良反应比较差异无统计学意义(P>0.05)。结论温针灸辅助治疗急性缺血性脑卒中后偏瘫疗效更佳,更有利于促进患者神经功能及运功能康复。

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.

中医针灸联合经颅磁刺激治疗脑胶质瘤术后偏瘫的临床研究

目的观察中医针灸联合经颅磁刺激技术(TMS)对改善脑胶质瘤术后偏瘫患者认知功能、肢体功能的效果。方法选择2021年1月至2022年1月南阳市中心医院收治的82例脑胶质瘤术后偏瘫患者为研究对象,采用抽签法将其均分为联合组和对照组,每组41例,两组患者均接受常规治疗+经颅磁刺激治疗,联合组采用中医针灸配合治疗,比较两组患者的脑神经功能、脑血液流变学、认知功能、肢体功能及治疗后不良事件发生情况。结果治疗前,两组患者的脑神经功能、脑血液流变学、认知及肢体功能差异无统计学意义(P>0.05);治疗7 d、14 d、30 d后,联合组的脑源性神经营养因子(BDNF)水平均高于对照组;治疗后,联合组的脑组织血浆黏度(PSV)、全血高切黏度(HSV)、全血低切黏度(LSV)低于对照组,简易精神状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)评分高于对照组,Fugl-Meyer运动功能评分量表(FMA)上肢、下肢功能评分高于对照组,不良事件发生率7.32%(3/41)低于对照组24.39%(10/41),P<0.05。结论采用中医针灸联合TMS技术治疗脑胶质瘤术后偏瘫可显著改善患者脑神经功能及脑血流动力学,对促进其认知功能、肢体功能恢复并降低不良事件发生风险均有积极意义。

护士危机意识教育联合下肢抗血栓压力泵预防脑卒中后合并偏瘫患者下肢深静脉血栓形成的效果分析

目的:探讨护士危机意识教育联合下肢抗血栓压力泵预防脑卒中后合并偏瘫患者下肢深静脉血栓形成的效果。方法:选取2018年4月—2020年9月驻马店市中心医院收治的96例脑卒中后合并偏瘫患者作为研究对象。随机分为对照组46例和观察组50例。其中,对照组给予常规护理干预,观察组在对照组的基础上给予护士危机意识教育联合下肢抗血栓压力泵干预。干预2周后,对比两组患者下肢静脉血栓发生率、并发症总发生率、干预前后双下肢股静脉血流速度及总疗效情况。结果:观察组下肢静脉血栓发生率显著低于对照组,差异有统计学意义(χ^(2)=4.604,P<0.05)。观察组并发症总发生率显著低于对照组,差异有统计学意义(χ^(2)=4.031,P<0.05)。干预后,两组患者双下肢股静脉血流速度均有所改善,且观察组改善优于对照组,差异有统计学意义(t=3.450、3.068,P<0.05)。观察组总有效率显著高于对照组,差异有统计学意义(χ^(2)=4.601,P<0.05)。结论:护士危机意识教育联合下肢抗血栓压力泵的干预能够有效地降低脑卒中后合并偏瘫患者下肢深静脉血栓形成的发生率,降低其并发症的发生率,从而提高其治疗效果。

动静结合针法对中风后偏瘫患者运动功能及步态的影响

目的 观察动静结合针法对中风后痉挛性偏瘫患者的步态改善情况。方法 将纳入研究的60例中风后痉挛性偏瘫患者按照随机数字表法分为试验组和对照组,试验组使用动静结合针法治疗,对照组采用普通电针治疗,观察治疗前后2组的三维步态分析时空参数、改良Ashworth量表分级、tinetti步态量表分值。结果 2组患者治疗后的三维步态分析时空参数(步行周期、步幅、步宽、步频、摆动时相及总支撑时相)、tinetti步态量表分值较治疗前均有显著差异(P <0.05),且试验组治疗后三维步态分析时空参数改善情况显著优于对照组。结论 动静结合针法及普通电针均对中风后痉挛性偏瘫患者的步态有显著的改善效果,且动静结合针法效果明显优于普通电针。

Observation on the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke

Objective To evaluate the therapeutic effect of scalp acupuncture and body acupuncture in combination with rehabilitation exercise for hemiplegia and shoulder pain after stroke. Methods Sixty cases were randomly divided into an acupuncture rehabilitation group （33 cases） and a routine treatment group （27 cases）. Both two groups received rehabilitation exercise, acupuncture rehabilitation group was treated with scalp acupuncture and body acupuncture, and in body acupuncture, Pishu（脾俞 BL 20）, Weishu （胃俞 BE 21）, Zusanli （足三里 ST 36）, Fenglong （丰隆 ST 40）, Xuehai （血海 SP 10）, and accompanying points according to the symptoms were selected; in scalp acupuncture, Baihui （百会 GV 20）, Sishencong （四神聪EX-HN 1）, motor area, vascular dilation and constriction area were selected. Routine treatment group was treated with western drugs, including dehydration with mannitol to reduce intracranial pressure, control blood pressure, and brain cell protective agent was given, triamcinolone acetate solution for shoulder pain or cortisone acetate solution for blocking treatment. The treatment was given once a day, four weeks were one course, and four courses were given in all. The hemorheological indices and the clinical effect of two groups were compared. Results The effective rate of acupuncture rehabilitation group was 90.9% （30/33）, better than that of 70.4% （19/27） in routine treatment group （P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment became lowered than those before the treatment in acupuncture rehabilitation group （all P〈0.05）; whole blood viscosity and plasma viscosity after the treatment was also lowered than those before the treatment in routine treatment group （both P〈0.05）; whole blood viscosity low shear and middle shear, plasma viscosity and hematocrit after the treatment in acupuncture rehabilitation group were obviously lowered than those of routine treatment group （all P〈0.05）. Conclusion With good therapeutic effect and better efficacy than routine medical treatment, scalp acupuncture and body acupuncture in combination with rehabilitation exercise can improve the movement, sensation and hemorheology of extremities of patients with hemiplegia and shoulder pain after stroke.

针刺结合镜像疗法治疗卒中后偏瘫上肢功能障碍的疗效观察

目的评价针刺结合镜像疗法治疗脑卒中后偏瘫患者上肢功能障碍的临床疗效。方法将90例脑卒中后偏瘫患者随机分为治疗组和对照组,每组45例。两组患者均接受西医基础治疗和常规康复训练,治疗组采用针刺结合镜像疗法,对照组采用镜像疗法。每星期5次,4星期为1个疗程。观察两组治疗前后上肢Fugle-Meyer运动功能评定量表(FMA)评分、简易上肢机能检查(STEF)评分及改良Barthel指数(MBI)评分变化,并比较两组临床疗效。结果两组治疗后FMA、MBI、STEF评分均高于同组治疗前(P<0.01);治疗组治疗后FMA评分、STEF评分及MBI评分均高于对照组(P<0.01);治疗组治疗前后FMA评分、STEF评分及MBI评分的差值均高于对照组(P<0.01)。治疗组总有效率为88.9%,对照组为68.9%,治疗组总有效率显著高于对照组(P<0.05)。结论在西医基础治疗和常规康复训练的基础上,针刺结合镜像疗法和镜像疗法均有助于脑卒中后偏瘫患者上肢功能的恢复,针刺结合镜像疗法效果更为显著。

“气机升降调脾胃”配穴法针刺治疗脑卒中后偏瘫临床研究

目的:观察"气机升降调脾胃"配穴法针刺治疗脑卒中后偏瘫的临床疗效。方法:采用随机数字表,将60例脑卒中后偏瘫患者随机分成治疗组和对照组,各30例。对照组采用常规取穴针刺,只针患侧,治疗组在对照组基础上,配以"气机升降调脾胃"组穴(中脘、气海、双天枢、左足三里、右阳陵泉)治疗。治疗4个疗程后评价疗效。结果:两组临床疗效对比,差异无统计学意义(P>0.05);在患者肢体运动功能评分(FMA)、日常生活活动能力评分(MBI)的升高程度上,治疗组明显优于对照组(P<0.01);在中医证候积分的升高程度上,治疗组相比对照组差异有统计学意义(P<0.05)。结论:"气机升降调脾胃"配穴法针刺治疗脑卒中后偏瘫与常规针刺比较,在改善患者肢体运动功能、日常生活活动能力方面均具有明显优势;在改善患者临床症状方面,有一定优势;在患者临床疗效的比较上,两组未见明显差异。

药棒叩击综合疗法治疗中风后偏瘫临床观察

目的观察药棒叩击综合疗法治疗中风后偏瘫的临床疗效。方法将200例中风后偏瘫患者随机分为治疗组与对照组,每组100例。对照组予针灸治疗,治疗组在对照组治疗措施基础上加用药棒叩击等疗法。两组疗程均为21天,观察中风病疗效评定标准量表评分、NIHSS评分、Barthel指数及分级情况。结果 1治疗前后组内比较,两组中风病疗效评定标准量表评分、NIHSS评分、Barthel指数差异均有统计学意义(P<0.05);组间治疗前后各评分及指数的差值比较,差异均有统计学意义(P<0.05)。2组间治疗后比较,Barthel指数分级分布差异有统计学意义(P<0.05)。结论药棒叩击综合疗法治疗中风后偏瘫,可促进患肢功能恢复,消除肿胀、麻木症状,改善神经功能。

通督调神针刺联合腕踝针治疗脑卒中偏瘫临床观察

目的:观察评估通督调神针刺联合腕踝针与单纯通督调神针刺治疗脑卒中偏瘫的临床疗效。方法:将42例脑卒中患者随机分为治疗组(21例)和对照组(21例),两组在基础治疗的同时,对照组予以通督调神针刺(水沟、神庭、百会、风府、至阳、腰阳关、命门)为主穴,治疗组在对照组的基础上加以腕踝针取患侧上4、5及下4、5。治疗周为14天,比较两组患者临床疗效及治疗前后美国国立卫生研究院卒中量表(National Institute of Health stoke scale,NIHSS)、运动功能Fugl-Meyer评分法及改良Barthel指数(MBI)评定量表的评分结果评价两组的临床疗效。结果:两组患者治疗后NIHSS、Fugl-Meyer及MBI评分均较治疗前显著降低(P<0.01),治疗组NIHSS、Fugl-Meyer及MBI评分差值与对照组比较,差异均有统计学意义(P<0.05)。两组临床疗效分布比较,差异无统计学意义(P>0.05)。结论:通督调神针刺法联合腕踝针在治疗脑卒中偏瘫的临床疗效方面与单纯通督调神针刺法相当,但通督调神针刺联合腕踝针可明显改善患者的肢体运动功能及提高日常生活能力。

康复训练联合针刺对卒中后中重度偏瘫患者运动功能恢复及日常生活能力的影响

目的 观察康复训练联合针刺对卒中后中重度偏瘫患者运动功能恢复及日常生活能力的影响。方法 将92例卒中后中重度偏瘫患者随机分为2组,均予早期药物对症治疗。对照组46例予康复训练,治疗组46例在对照组治疗基础上予针刺治疗,2组均10 d为1个疗程,每个疗程间隔1-2 d,共治疗6个疗程。比较2组治疗前后美国国立卫生院神经功能缺损评分（NIHSS）、肢体Fugl-Meyer评分及Barthel（BI）指数评分。结果 2组治疗后NIHSS评分均较本组治疗前下降（P〈0.05）,且治疗组治疗后NIHSS评分较对照组下降明显（P〈0.05）。2组治疗后肢体Fugl-Meyer评分、BI指数评分均较本组治疗前升高（P〈0.05）,且治疗组治疗后肢体Fugl-Meyer评分、BI指数评分较对照组升高明显（P〈0.05）。结论 康复训练联合针刺治疗卒中后中重度偏瘫,有利于患者神经功能康复和肢体运动功能提高,改善患者日常生活能力及预后。

针刺联合隔药灸经筋结点法治疗脑卒中后上肢痉挛性瘫痪疗效观察

目的观察针刺联合隔药灸经筋结点法治疗脑卒中后上肢痉挛性瘫痪的临床疗效。方法 105例脑卒中后上肢痉挛性瘫痪患者随机分为观察组53例和对照组52例。对照组采用传统针刺治疗,观察组在对照组的基础上采用隔药灸经筋结点法治疗。比较两组治疗前后中医证候、改良Ashworth量表(MAS)、Fugl-Meyer评估法(FMA)、Barthel指数(BI)、健康调查简表(SF-36)评分和肌电图F波波幅、阈值及时限变化,并比较两组临床疗效。结果观察组总有效率为96.2%,显著高于对照组的82.7%(P<0.05)。观察组治疗后中医证候评分、MAS评分显著低于对照组,FMA、BI及SF-36评分显著高于对照组,肌电图F波波幅、阈值及时限变化显著优于对照组(P<0.05)。结论针刺联合隔药灸经筋结点法治疗脑卒中后上肢痉挛性瘫痪疗效确切,对于改善机体痉挛状态,促进肌力及患肢功能恢复,提高患者的生活质量有重要作用。

巨刺运动疗法对偏瘫患者患侧上肢痉挛的影响

目的观察巨刺运动疗法治疗偏瘫患者患侧上肢屈肌痉挛的临床疗效。方法将 63例偏瘫上肢屈肌痉挛患者随机分为治疗组 (应用巨刺运动疗法 )与对照组 (应用单纯运动疗法 ) ,比较两组患者的疗效。结果治疗组有效率 90 .6% ,对照组有效率64 .5 2 % ,两者有显著性差异 (P <0 .0 5 )。结论巨刺运动疗法治疗偏瘫患者患侧上肢屈肌痉挛疗效显著且优于单纯运动疗法。

针刺五脏俞联合康复训练治疗脑血管意外后偏瘫临床研究

目的:探讨针刺五脏俞联合康复训练治疗脑血管意外后偏瘫的临床效果。方法:选取2013年8月至2015年8月在我院接受治疗的130例脑血管意外后偏瘫患者为研究对象,按就诊编号分为对照组(n=65)和研究组(n=65),对照组患者接受常规康复疗法及复方血栓通胶囊治疗,研究组患者在对照组的基础上接受针刺五脏俞治疗。将两组治疗前、后的神经功能缺损评分(NIHSS)、牛津残障评分(OHS)、抑郁自评量表(SDS)评分、焦虑自评量表(SAS)评分、日常生活能力评分(ADL)、Fugl-Meyer运动功能评分、中医症候积分、Berg平衡量表评分变化情况进行比较分析。结果:与治疗前比较,治疗后对照组、研究组患者的NIHSS评分、OHS评分、SDS评分、SAS评分及中医症候积分均明显下降,而ADL评分、Fugl-Meyer运动功能评分及Berg平衡量表评分均明显上升,差异具有统计学意义(P<0.05);治疗后,研究组患者的NIHSS评分、OHS评分、SDS评分、SAS评分及中医症候积分均明显低于对照组,而ADL评分、Fugl-Meyer运动功能评分及Berg平衡量表评分均明显高于对照组,差异具有统计学意义(P<0.05)。结论:对脑血管意外后偏瘫患者应用针刺五脏俞联合康复训练进行治疗,可有效缓解临床症状,提高治疗效果,促进患者身体恢复,可进一步推广。