调和阴阳经刺法联合上肢机器人在脑卒中后上肢功能障碍患者中的应用观察
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摘要
目的观察调和阴阳经刺法联合上肢机器人在脑卒中后上肢功能障碍患者中的应用效果。方法将60例脑卒中后上肢功能障碍患者随机分为2组,对照组30例给予上肢机器人治疗,研究组30例在对照组治疗基础上加用调和阴阳经刺法,2组均持续治疗4周。比较2组治疗后临床疗效,记录2组治疗前后Fugl-Meyer运动功能(FMA)评分、改良Barthel指数(MBI)评分、肘关节屈伸处于最大等长收缩时肱二头肌和肱三头肌肌电积分值(IEMG)评分,比较2组治疗期间不良反应发生情况。结果治疗后,研究组治疗总有效率明显高于对照组(P<0.05);2组FMA评分和MBI评分均明显升高(P均<0.05),且研究组均明显高于对照组(P均<0.05);2组患侧肱二头肌和肱三头肌最大等长收缩时IEMG评分均明显升高(P均<0.05),且研究组均明显高于对照组(P均<0.05)。治疗期间2组不良反应发生率比较差异无统计学意义(P>0.05)。结论脑卒中后上肢功能障碍患者给予调和阴阳经刺法联合上肢机器人治疗,疗效显著,值得临床推广应用。
Objective It is to observe the effect of acupuncture of regulating Yin and Yang combined with upper limb robot in upper limb dysfunction in patients after stroke. Methods 60 patients with upper limb dysfunction after stroke were randomly divided into 2 groups,30 cases in the control group were treated with upper limb robot,and the other 30 cases in the study group were treated with acupuncture of regulating Yin and Yang combined with upper limb robot. The 2 groups were treated continuously for 4 weeks. The clinical curative effect of the 2 groups after treatment was compared; the Fugl-Meyer assessment( FMA) score,modified Barthel index( MBI) score,elbow flexion and extension in the maximum isometric contraction of the biceps and triceps EMG( IEMG) score were recorded before and after treatment in the 2 groups; the adverse reactions were compared between the 2 groups during the treatment. Results After treatment,the total effective rate of the treatment group was significantly higher than that of the control group( P < 0. 05); the FMA and MBI scores in the 2 groups were significantly higher( all P < 0. 05),but those of the study group was significantly higher than the control group( all P < 0. 05); the IEMG scores of both sides of the ipsilateral biceps brachii and triceps brachii were increased significantly in the both groups( all P <0. 05),and the score of the study group was significantly higher than that of the control group( P < 0. 05). During the treatment,there was no significant difference in the incidence of adverse reactions between the 2 groups( P > 0. 05). Conclusion The clinical curative effect of acupuncture of regulating Yin and Yang combined with upper limb robot in the treatment of upper limb dysfunction after stroke was remarkable,it is worthy of clinical application.
Objective It is to observe the effect of acupuncture of regulating Yin and Yang combined with upper limb robot in upper limb dysfunction in patients after stroke. Methods 60 patients with upper limb dysfunction after stroke were randomly divided into 2 groups,30 cases in the control group were treated with upper limb robot,and the other 30 cases in the study group were treated with acupuncture of regulating Yin and Yang combined with upper limb robot. The 2 groups were treated continuously for 4 weeks. The clinical curative effect of the 2 groups after treatment was compared; the Fugl-Meyer assessment( FMA) score,modified Barthel index( MBI) score,elbow flexion and extension in the maximum isometric contraction of the biceps and triceps EMG( IEMG) score were recorded before and after treatment in the 2 groups; the adverse reactions were compared between the 2 groups during the treatment. Results After treatment,the total effective rate of the treatment group was significantly higher than that of the control group( P < 0. 05); the FMA and MBI scores in the 2 groups were significantly higher( all P < 0. 05),but those of the study group was significantly higher than the control group( all P < 0. 05); the IEMG scores of both sides of the ipsilateral biceps brachii and triceps brachii were increased significantly in the both groups( all P <0. 05),and the score of the study group was significantly higher than that of the control group( P < 0. 05). During the treatment,there was no significant difference in the incidence of adverse reactions between the 2 groups( P > 0. 05). Conclusion The clinical curative effect of acupuncture of regulating Yin and Yang combined with upper limb robot in the treatment of upper limb dysfunction after stroke was remarkable,it is worthy of clinical application.
引文
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[12]喻腾云,吴艳华,孙寒静,等.缺血性脑卒中中医病因病机的层次关系[J].吉林中医药,2016,36(4):328-331
[13]查天柱,陈思宇,唐素珍.穴位注射联合中医综合理疗治疗脑卒中后上肢运动功能障碍的临床观察[J].陕西中医,2016,37(1):105-106
[14]李佩岚.脑卒中后上肢功能障碍针刺疗法进展[J].医学信息,2015,28(34):388
[15]赖耀铭.调和阴阳经刺法治疗缺血性中风痉挛性偏瘫的临床研究[D].广州:广州中医药大学,2012
[2]赵先伟,田庆涛,杜怡峰,等.早期康复治疗对脑卒中患者认知功能障碍及日常生活活动能力的影响[J].中华老年心脑血管病杂志,2014,16(7):740-742
[3]林强,陈安亮,程凯,等.针刺疗法对脑卒中患者的运动功能、平衡功能及日常生活活动能力的影响[J].中国康复医学杂志,2015,30(9):898-901
[4]饶明俐.中国脑血管病防治指南[M].北京:人民卫生出版社,2007:3-39
[5]国家中医药管理局脑病急症协作组.中风病诊断与疗效评定标准[J].北京中医药大学学报,1996,19(1):55-56
[6]国家中医药管理局.中药新药临床研究指导原则[S].北京:中国医药科技出版社,2002:69
[7]恽晓平.康复疗法评定学[M].北京:华夏出版社,2005:393-396
[8]Orakdogen M,Emon ST,Somay H,et al.Decompressive craniectomy for treatment of malignant middle cerebral artery ischemic stroke:surgical results in 34 cases[J].J Neurol Sci Turk,2016,33(2):352-360
[9]Thomas K,Kessler C.New antiplatelet agents prescribed to patients with ischemic heart disease:implications for treatment of stroke[J].Curr Treat Options Neurol,2014,16(5):1-7
[10]杨改清,董志强,杜金刚.上肢康复机器人治疗脑卒中后上肢运动功能障碍新进展[J].中国康复,2014,29(6):462-464
[11]陈四芳,韩为.针刺治疗卒中后肢体运动功能障碍研究概况[J].中医药临床杂志,2016,28(2):158-161
[12]喻腾云,吴艳华,孙寒静,等.缺血性脑卒中中医病因病机的层次关系[J].吉林中医药,2016,36(4):328-331
[13]查天柱,陈思宇,唐素珍.穴位注射联合中医综合理疗治疗脑卒中后上肢运动功能障碍的临床观察[J].陕西中医,2016,37(1):105-106
[14]李佩岚.脑卒中后上肢功能障碍针刺疗法进展[J].医学信息,2015,28(34):388
[15]赖耀铭.调和阴阳经刺法治疗缺血性中风痉挛性偏瘫的临床研究[D].广州:广州中医药大学,2012