头针结合镜像疗法治疗脑卒中后上肢痉挛性瘫痪临床研究
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摘要
目的:观察头针结合镜像疗法治疗脑卒中后上肢痉挛性瘫痪的临床疗效。方法:将40例脑卒中患者随机分为治疗组(头针+镜像疗法+常规康复治疗)与对照组(镜像疗法+常规康复治疗)各20例,治疗4周后应用Fugl-Meyer量表评价上肢运动功能,改良Ashworth痉挛评定量表评价痉挛情况,改良Bathel指数评价日常生活活动能力。结果:治疗后,2组上肢Ashworth评分均较治疗前明显降低(P <0.05),且治疗组Ashworth评分低于对照组(P <0.05)。治疗后,2组Fugl-Meyer、Bathel指数评分均较治疗前明显升高(P <0.05),且治疗组上述2项评分高于对照组(P <0.05)。结论:头针结合镜像疗法能有效改善脑卒中上肢功能及生活自理能力,疗效优于单纯镜像治疗。
Objective: To observe the clinical effect of scalp acupuncture combined with mirror therapy for spastic paralysis of upper limbs due to stroke. Methods:A total of 40 patients with stroke were randomly divided into the treatment group, in which patients were treated with scalp acupuncture combined with mirror therapy and normal rehabilitation treatment, and the control group, in which patients received mirror therapy and normal rehabilitation treatment,with 20 cases in each group. Four weeks after the treatment, Fugl-Meyer scale was applied to evaluate motor function of upper limbs,modified Ashworth scale was adopted to evaluate spasm,and modified Bathel index was used to evaluate the ability of activities of daily living. Results:After treatment,scores of Ashworth of upper limbs in the two groups were decreased significantly when compared with those before treatment(P < 0.05),and the one in the treatment group was lower than that in the control group(P < 0.05). After treatment,scores of Fugl-Meyer and Bathel index in the two groups were increased significantly when compared with those before treatment(P < 0.05),and the ones in the treatment group were higher than those in the control group(P < 0.05). Conclusion: The therapy of scalp acupuncture combined with mirror therapy can effectively improve the upper limb function and self-care ability of daily living of patients with stroke,whose therapeutic effect is superior to that of the simple mirror therapy.
Objective: To observe the clinical effect of scalp acupuncture combined with mirror therapy for spastic paralysis of upper limbs due to stroke. Methods:A total of 40 patients with stroke were randomly divided into the treatment group, in which patients were treated with scalp acupuncture combined with mirror therapy and normal rehabilitation treatment, and the control group, in which patients received mirror therapy and normal rehabilitation treatment,with 20 cases in each group. Four weeks after the treatment, Fugl-Meyer scale was applied to evaluate motor function of upper limbs,modified Ashworth scale was adopted to evaluate spasm,and modified Bathel index was used to evaluate the ability of activities of daily living. Results:After treatment,scores of Ashworth of upper limbs in the two groups were decreased significantly when compared with those before treatment(P < 0.05),and the one in the treatment group was lower than that in the control group(P < 0.05). After treatment,scores of Fugl-Meyer and Bathel index in the two groups were increased significantly when compared with those before treatment(P < 0.05),and the ones in the treatment group were higher than those in the control group(P < 0.05). Conclusion: The therapy of scalp acupuncture combined with mirror therapy can effectively improve the upper limb function and self-care ability of daily living of patients with stroke,whose therapeutic effect is superior to that of the simple mirror therapy.
引文
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[2]Ohman A,Kull L,Andersson J,et al.Radiation doses in examination of lower Third molars with computed to mography and conventional radiography[J].Dentomaxillofac Radiol,2008,37(8):445-452.
[3]Wissel J,Schelosky LD,Scott J,et al.Early development of sp asticity following stroke:a prospective,observational trial[J].J Neurol,2010,257:1067-1072.
[4]李宁,滕飞,陈玉辉,等.缺血性卒中后痉挛发生情况及预测因素分析[J].中国卒中杂志,2016,11(6):443-448.
[5]向云,王辉,倪俊杰,等.基于肌电、肌动信号评估不同频率电针对脑卒中患者上肢痉挛的干预作用[J].中西医结合心脑血管病杂志,2017,15(5):541-546.
[6]刘欣,王彩娟,袁坤,等.化痰通络解痉汤熏洗治疗脑卒中痉挛性瘫痪82例临床观察[J].世界中西医结合杂志,2016,11(12):1684-1687.
[7]任媛媛,赵卫峰,朱秀莲.不同频率电针治疗脑卒中后上肢痉挛性瘫痪疗效观察[J].陕西中医,2014,35(10):1404-1405.
[8]魏冰,李岩.电针治疗脑卒中后上肢痉挛性瘫痪32例[J].针灸临床杂志,2010,26(6):40-41.
[9]白钟飞,张子未,王惠芳,等.镜像疗法改善脑卒中后上肢运动功能和日常生活活动的Meta分析[J].中国康复理论与实践,2016,22(12):1384-1394.
[10]董继革.镜像疗法结合运动想象对脑卒中后单侧忽略症的临床疗效观察[C]//国际数字医学会数字中医药分会成立大会暨首届数字中医药学术交流会论文集,[出版地、出版者不详],2016:2.
[11]李冰.针灸配合中药湿热敷治疗脑卒中偏瘫44例[J].中国现代医生,2010,48(4):79.
[12]王丽菊,陈立早,欧艺,等.镜像视觉反馈和肌电生物反馈对脑卒中偏瘫患者上肢功能的影响[J].中国康复理论与实践,2015,21(2):202-206.
[13]Kim JH,Lee BH.Mirror therapy combined with biofeedback functionalelectrical stimulation for motor recovery of upper extremities after stroke:a pilot randomized controlled trial[J].Occup Ther Int,2015,22(2):51-60.
[14]Rensink M,Schuurmans M,Lindeman E,et al.Task-oriented training in rehabilitation after stroke:Systematic review[J].J Adv Nurs,2009,65(4):737-754.
[15]李军,郑斌.早期头针结合现代康复技术对脑卒中后偏瘫康复疗效观察[J].上海针灸杂志,2009,28(7):380-382.