隔药灸联合按摩治疗缺血性脑卒中后肌痉挛临床观察
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摘要
目的观察隔药灸联合穴位按摩治疗缺血性脑卒中后肌痉挛的临床疗效。方法 80例缺血性脑卒中后肌痉挛患者随机分为治疗组和对照组,每组40例。两组均给予常规物理康复治疗,对照组给予口服巴氯芬片,治疗组给予隔药灸联合穴位按摩。观察两组治疗前后改良Ashworth量表(MAS)、Fugl-Meyer运动量表(FMMS)、Barthel指数(BI)评分变化,并比较两组临床疗效。结果治疗组治疗后MAS、FMMS、BI评分高于对照组(P<0.05)。治疗组总有效率为92.0%,明显高于对照组的75.0%,差异有统计学意义(P<0.05)。结论隔药灸联合穴位按摩可以明显改善脑卒中后肌痉挛患者的肌张力、肢体运动能力及日常生活能力,临床疗效显著。
Objective To observe the clinical efficacy of herb-partitioned moxibustion plus acupoint massage in treating myospasm after ischemic stroke. Method Eighty patients with myospasm after ischemic stroke were randomized into a treatment group and a control group, with 40 cases in each group. The two groups were both given conventional physical rehabilitation intervention. In addition, the control group was intervened by oral administration of baclofen tablets, while the treatment group was given herb-partitioned moxibustion plus acupoint massage. The Modified Ashworth Scale (MAS) score, Fugl-Meyer Motor Scale (FMMS) score and Barthel Index (BI) score in the two groups were observed before and after the treatment. The clinical efficacies were also compared. Result After the treatment, the MAS, FMMS and BI score in the treatment group were higher than those in the control group (P<0.05). The total effective rate was 92.0% in the treatment group, significantly higher than 75.0% in the control group (P<0.05). Conclusion Herb-partitioned moxibustion plus acupoint massage can obviously improve muscle tension, motor function of limbs and ADL in patients with post-stroke myospasm, and the clinical efficacy is significant.
Objective To observe the clinical efficacy of herb-partitioned moxibustion plus acupoint massage in treating myospasm after ischemic stroke. Method Eighty patients with myospasm after ischemic stroke were randomized into a treatment group and a control group, with 40 cases in each group. The two groups were both given conventional physical rehabilitation intervention. In addition, the control group was intervened by oral administration of baclofen tablets, while the treatment group was given herb-partitioned moxibustion plus acupoint massage. The Modified Ashworth Scale (MAS) score, Fugl-Meyer Motor Scale (FMMS) score and Barthel Index (BI) score in the two groups were observed before and after the treatment. The clinical efficacies were also compared. Result After the treatment, the MAS, FMMS and BI score in the treatment group were higher than those in the control group (P<0.05). The total effective rate was 92.0% in the treatment group, significantly higher than 75.0% in the control group (P<0.05). Conclusion Herb-partitioned moxibustion plus acupoint massage can obviously improve muscle tension, motor function of limbs and ADL in patients with post-stroke myospasm, and the clinical efficacy is significant.
引文
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[13]孟敏,杨翠翠,张丽,等.山茱萸环烯醚萜苷对血管性痴呆大鼠学习记忆能力及脑组织病理变化的影响[J].中国中医药信息杂志,2018,25(6):56-60.
[14]邓文伟,杨广禄,邓萌,等.山茱萸多糖对局灶性脑缺血-再灌注损伤神经胶质细胞的作用[J].黑龙江医药科学,2017,40(4):24-25.
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[16]张慧芳,姚碧文,陈坚波.山茱萸二氯甲烷部位对D-半乳糖致衰老小鼠脑组织中NO、NOS及p53、pRB蛋白表达的影响[J].中医药导报,2016,22(4):27-29.
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[19]吴非,黎红华,陈文军.脑缺血再灌注损伤后一氧化氮合酶表达变化及知母总皂苷对其影响[J].中华神经医学杂志,2006,5(8):757-760.
[20]吴非,郭胜蓝,程玉芳,等.知母总皂苷对大鼠脑缺血及再灌注损伤的保护作用[J].中国药学杂志,2006,41(9):668-671.
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[23]徐英姿,韩向东.关于活络效灵丹的浅析[J].四川中医,2014,32(9):28-30.
[24]金竹青.活络效灵丹通过抑制脑组织炎症反应对缺血性脑损伤的保护作用[J].浙江中医药大学学报,2013,37(9):1099-1102,1107.
[25]王舰,王惠敏,叶艺茹.针刺阴阳跷脉治疗脑卒中后下肢平衡功能障碍40例[J].中国针灸,2016,36(7):750.
[26]李旗,田福玲.“烧山火、透天凉”补泻跷脉法对缺血性中风恢复期患者下肢痉挛的影响研究[J].中国全科医学,2013,16(7):826-827,831.
[2]胡英华,王燕,蒋雪玲,等.平衡阴阳针刺法早期干预对卒中急性期患者肢体痉挛状态的影响[J].中国中医急症,2017,26(10):1870-1872.
[3]宋高坡,王世民,赵英,等.神经肌肉电刺激联合巴氯芬治疗脑卒中后肌痉挛的疗效及安全性[J].中国康复医学杂志,2014,29(10):978-980.
[4]李青松,谢道俊,周磊.脑卒中后痉挛状态的中西医诊治[J].中医药临床杂志,2015,27(2):163-165.
[5]中华医学会神经病学分会脑血管病学组急性缺血性脑卒中诊治指南撰写组.中国急性缺血性脑卒中诊治指南2010[J].中国全科医学,2011,14(35):4013-4017.
[6]卓大宏.中国康复医学[M].第2版.北京:华夏出版社,2003:667-675.
[7]于兑生.康复医学评价手册[M].北京:华夏出版社,1993:178-180.
[8]王玉龙.康复评定[M].北京:人民卫生出版社,2000:290-2992.
[9]马震震,胡军,徐亭亭,等.脑卒中后肌痉挛的治疗进展[J].中华中医药学刊,2015,33(7):1617-1621.
[10]赵然,任秀云.巴氯芬结合头针及康复训练治疗颅脑损伤后痉挛性瘫痪的临床观察[J].中国药物与临床,2011,11(2):201-203.
[11]袁秀娜,高其芳.中医药治疗脑卒中后痉挛性瘫痪研究进展[J].河南中医,2013,33(12):2111-2113.
[12]秦劭晨,雒晓东,郑春叶,等.借鉴张锡纯经验浅析山萸肉在脑病治疗中的运用[J].四川中医,2015,33(6):34-35.
[13]孟敏,杨翠翠,张丽,等.山茱萸环烯醚萜苷对血管性痴呆大鼠学习记忆能力及脑组织病理变化的影响[J].中国中医药信息杂志,2018,25(6):56-60.
[14]邓文伟,杨广禄,邓萌,等.山茱萸多糖对局灶性脑缺血-再灌注损伤神经胶质细胞的作用[J].黑龙江医药科学,2017,40(4):24-25.
[15]李永格.山茱萸多糖对血管性痴呆大鼠海马BDNF和NGF表达的影响[J].中医临床研究,2016,8(24):146-148.
[16]张慧芳,姚碧文,陈坚波.山茱萸二氯甲烷部位对D-半乳糖致衰老小鼠脑组织中NO、NOS及p53、pRB蛋白表达的影响[J].中医药导报,2016,22(4):27-29.
[17]赵春草,吴飞,张继全,等.知母的药理作用研究进展[J].中国新药与临床杂志,2015,34(12):898-902.
[18]吴非,钟雷,程玉芳,等.知母总皂苷对脑缺血再灌注损伤的保护机制[J].中国临床康复,2006,10(31):22-24.
[19]吴非,黎红华,陈文军.脑缺血再灌注损伤后一氧化氮合酶表达变化及知母总皂苷对其影响[J].中华神经医学杂志,2006,5(8):757-760.
[20]吴非,郭胜蓝,程玉芳,等.知母总皂苷对大鼠脑缺血及再灌注损伤的保护作用[J].中国药学杂志,2006,41(9):668-671.
[21]张会文,张前.活络效灵丹异病同治瘀血阻络[J].实用中医内科杂志,2017,31(1):59-61.
[22]刘启明.活络效灵丹对腰椎间盘突出症患者的临床疗效观察[J].世界最新医学信息文摘,2016,16(2):136.
[23]徐英姿,韩向东.关于活络效灵丹的浅析[J].四川中医,2014,32(9):28-30.
[24]金竹青.活络效灵丹通过抑制脑组织炎症反应对缺血性脑损伤的保护作用[J].浙江中医药大学学报,2013,37(9):1099-1102,1107.
[25]王舰,王惠敏,叶艺茹.针刺阴阳跷脉治疗脑卒中后下肢平衡功能障碍40例[J].中国针灸,2016,36(7):750.
[26]李旗,田福玲.“烧山火、透天凉”补泻跷脉法对缺血性中风恢复期患者下肢痉挛的影响研究[J].中国全科医学,2013,16(7):826-827,831.