电针刺激伸肌结合辨证取穴治疗卒中偏瘫腕踝关节痉挛的临床研究
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摘要
目的:观察电针刺激伸肌结合辨证取穴对卒中偏瘫患者腕踝关节康复的临床效果。方法:卒中偏瘫患者168例随机分为对照组84例和观察组84例。两组均接受西医内科药物及康复治疗,在此基础上对照组予辨证取穴进行电针治疗,观察组采用电针刺激伸肌结合辨证取穴治疗,疗程两个月,观察日常生活能力(ADL、Barthel指数评分)、患侧肢体痉挛程度(改良Ashworth分级)的变化。结果:治疗后两组Barthel指数评分有显著差异(P <0. 05),治疗后观察组改良Ashworth分级较治疗前有显著差异(P <0. 05)。结论:电针刺激伸肌结合辨证取穴可改善卒中偏瘫患者关节活动度、提高日常生活能力。
Objective: To observe the improvements of wrist-ankle activity of hemiplegic paralysis treated by electro-needling extensor and points of syndrome differentiation. Methods: 168 patients with hemiplegic paralysis were randomly divided into the control group( n = 84) and the observation group( n = 84). Internal medication and rehabilitation were applied to the both groups; also,the control group was treated with electro-needling points of syndrome differentiation,on which basis,the observation group was also treated with electro-needling extensor. Activity of daily living( ADL),Barthel Index scores,and changes of Modified Ashworth classification were observed after two months of the treatment. Results: There were significant difference in Barthel Index scores between the two groups after the treatment( P < 0. 05). The difference of Modified Ashworth classification was significant in the observation group between before and after the treatment( P <0. 05). Conclusion: Electro-needling extensor and points of syndrome differentiation can improve joint range of motion and ADL of the patients.
Objective: To observe the improvements of wrist-ankle activity of hemiplegic paralysis treated by electro-needling extensor and points of syndrome differentiation. Methods: 168 patients with hemiplegic paralysis were randomly divided into the control group( n = 84) and the observation group( n = 84). Internal medication and rehabilitation were applied to the both groups; also,the control group was treated with electro-needling points of syndrome differentiation,on which basis,the observation group was also treated with electro-needling extensor. Activity of daily living( ADL),Barthel Index scores,and changes of Modified Ashworth classification were observed after two months of the treatment. Results: There were significant difference in Barthel Index scores between the two groups after the treatment( P < 0. 05). The difference of Modified Ashworth classification was significant in the observation group between before and after the treatment( P <0. 05). Conclusion: Electro-needling extensor and points of syndrome differentiation can improve joint range of motion and ADL of the patients.
引文
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[14]唐容达,欧阳八四.恢刺配合康复训练治疗脑卒中后足下垂疗效观察[J].上海针灸杂志,2015,34(4):300-302.
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[16]张自茂,冯崇廉,皮周凯,等.针刺治疗脑卒中后上肢痉挛疗效观察[J].中国针灸,2008,28(4):257-260.
[17]杨翊,周光涛,刘经星,等.头针配合电针治疗脑卒中痉挛性偏瘫124例[J].上海针灸杂志,2012,31(3):171-172.
[18]许淑芬,方颖.温针疗法缓解偏瘫后肢体痉挛的疗效分析[J].中国医疗前沿,2012,7(23):59-60.
[2]中华医学会.临床诊疗指南:物理医学与康复分册[M].北京:人民卫生出版社,2005:11-14.
[3]上海市卫生局.上海市中医病症诊疗常规[M]. 2版.上海:中医药大学出版社,2003:75-76.
[4]窦祖林.痉挛-评估与治疗[M].北京:人民卫生出版社,2004:41-42.
[5]缪鸿石,朱镛连.脑卒中的康复评定和治疗[M].北京:华夏出版社,1996:9.
[6]吕瑛,石向东,王洁,等.辨证取穴结合电针刺激伸肌对脑卒中后偏瘫患者腕踝关节活动的影响[J].上海针灸杂志,2017,36(7):776-780.
[7]王国祥,刘殿玉.针刺对痉挛性偏瘫患者脊髓筼筜神经元兴奋性的影响[J].中国运动医学杂志,2005,24(2):222-224.
[8]王桂芳.火针针刺拮抗肌治疗脑血管病肌痉挛疗效分析[J].中国康复医学杂志,2008,23(2):163-164.
[9]孙陶,邹兆华.电针拮抗肌腧穴联合Bobath技术治疗脑卒中后下肢痉挛的临床观察[J].中医临床研究,2016,8(29):35-36.
[10]宗涛.针刺在脑卒中后偏瘫不同康复时期的应用体会[J].辽宁医学杂志,2005,19(4):201-202.
[11]游真,车德亚.针药结合治疗脑卒中后肌痉挛的临床疗效[J].检验医学与临床,2018,15(2):170-172.
[12]马元.《灵枢·官针》刺法探析[J].山东中医学院学报,2009,33(5):404-405.
[13]李肖荷,甘君学.恢刺经筋结点治疗中风后痉挛性偏瘫的疗效观察[J].中西医结合心脑血管病杂志,2017,15(7):858-860.
[14]唐容达,欧阳八四.恢刺配合康复训练治疗脑卒中后足下垂疗效观察[J].上海针灸杂志,2015,34(4):300-302.
[15]姜桂美,贾超.针刺拮抗肌与主动肌治疗中风后痉挛性偏瘫的临床疗效观察[J].中西医结合心脑血管疾病杂志,2007,5(9):812-813.
[16]张自茂,冯崇廉,皮周凯,等.针刺治疗脑卒中后上肢痉挛疗效观察[J].中国针灸,2008,28(4):257-260.
[17]杨翊,周光涛,刘经星,等.头针配合电针治疗脑卒中痉挛性偏瘫124例[J].上海针灸杂志,2012,31(3):171-172.
[18]许淑芬,方颖.温针疗法缓解偏瘫后肢体痉挛的疗效分析[J].中国医疗前沿,2012,7(23):59-60.