火针疗法联合温阳通络汤对中风后痉挛性偏瘫患者肢体功能的影响
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摘要
目的:探究火针疗法联合温阳通络汤对中风后痉挛性偏瘫患者肢体功能的影响。方法:选取中风后痉挛性偏瘫患者69例,按照随机数表法随机分为火针疗法组、温阳通络汤组和联合治疗组,每组各23例。火针疗法组采用火针针刺治疗,温阳通络组采用服用温阳通络汤治疗,联合治疗组采用火针疗法联合温阳通络汤治疗,6个疗程后观察3组患者的上下肢痉挛状况、肢体运动功能恢复状况和日常生活能力改善状况。结果:痉挛程度改善状况,火针疗法组的总有效率为65.2%,温阳通络组的总有效率为60.9%,联合治疗组的总有效率为87%,联合治疗组与其他两组比较差异具有统计学意义(P<0.05);3组患者的Fugl-Meyer运动功能评分较治疗前均有提高,但治疗后联合治疗组的评分明显大于其他两组,差异具有统计学意义(P<0.05);3组患者的Barthel评分较治疗前均有提高,但治疗后联合治疗组的评分明显大于其他两组,差异具有统计学意义(P<0.05)。结论:火针疗法联合温阳通络汤能够改善中风后痉挛性偏瘫患者的痉挛程度,并能够提高患者的肢体运动功能和日常生活能力。
Objective: To explore the effect of fire-needling combined with Wenyang Tongluo Decoction on limb function in patients with post-stroke spastic hemiplegia. Methods: 69 cases of spastic hemiplegia were randomly divided into the fire-needling group( n = 23),the Wenyang Tongluo Decoction group( n = 23) and the combined group( n = 23). The spasticity of upper and lower limbs,recovery of movement function,and improvement of daily life were observed in the three groups. Results: In terms of the effective rate of spasticity improvement,it was 65. 2% in the fire-needling group,60. 9% in the Wenyang Tongluo group,and 87% in the combined group,in which the combined group was the best( P < 0. 05). The Fugl-Meyer score was increased in the three groups after treatment,and it was significantly higher in the combined group than that in the other two groups( P < 0. 05). The Barthel score was also increased in the three groups after treatment,and it was significantly higher in the combined group than that in the other two groups( P < 0. 05). Conclusion: Fire-needling combined with Wenyang Tongluo Decoction can effectively improve spasticity of post-stroke hemiplegia,and it can improve motor function and daily activity of the patients.
Objective: To explore the effect of fire-needling combined with Wenyang Tongluo Decoction on limb function in patients with post-stroke spastic hemiplegia. Methods: 69 cases of spastic hemiplegia were randomly divided into the fire-needling group( n = 23),the Wenyang Tongluo Decoction group( n = 23) and the combined group( n = 23). The spasticity of upper and lower limbs,recovery of movement function,and improvement of daily life were observed in the three groups. Results: In terms of the effective rate of spasticity improvement,it was 65. 2% in the fire-needling group,60. 9% in the Wenyang Tongluo group,and 87% in the combined group,in which the combined group was the best( P < 0. 05). The Fugl-Meyer score was increased in the three groups after treatment,and it was significantly higher in the combined group than that in the other two groups( P < 0. 05). The Barthel score was also increased in the three groups after treatment,and it was significantly higher in the combined group than that in the other two groups( P < 0. 05). Conclusion: Fire-needling combined with Wenyang Tongluo Decoction can effectively improve spasticity of post-stroke hemiplegia,and it can improve motor function and daily activity of the patients.
引文
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[11]Jung Won Kwon,Sang Young Park,Sung Min Son,et al.Correlation between Assessments of Arm and Leg Ideomotor Apraxia in Hemiplegic Stroke Patients[J].Journal of physical therapy science,2012,24(2):187-190.
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[13]焦玉娟,孙培军,张连勇,等.自拟温阳化痰通络汤治疗卒中相关性肺炎(阳虚痰瘀阻络证)的临床观察[J].中国中医急症,2017,26(5):863-865.
[14]陆雯俊.温阳散寒益气通络法治疗类风湿关节炎临床研究[J].中医学报,2014,29(10):1525-1527.
[2]王宁,李志峰,吴海红,等.火针疗法治疗中风后痉挛性偏瘫的临床疗效观察[J].针刺研究,2015,40(4):304-308.
[3]王宁,李志峰.火针改善中风痉挛性偏瘫患者生存质量临床研究[J].中国针灸,2015,35(11):1105-1109.
[4]Kim YH,Jung SJ,Yang EJ,et al.Clinical and sonographic risk factors for hemiplegic shoulder pain:A longitudinal observational study[J].Journal of rehabilitation medicine:official journal of the UEMS European Board of Physical and Rehabilitation Medicine,2014,46(1 TN.6):81-87.
[5]刘小平,侯秀娟,朱跃兰,等.温阳散寒化痰通络法治疗类风湿关节炎伴发桥本氏甲状腺炎探讨[J].环球中医药,2017,10(7):727-729.
[6]李凤娣,陈焕红,欧阳秀珊,等.康复护理路径在脑卒中偏瘫患者肢体功能训练中的应用[J].现代临床护理,2015,14(3):62-65.
[7]Sheikh M,Olyaee GR,Abolfazli R,et al.Assessment of the Effects of Neurodevelopmental Treatment(NDT)and Botulinum Toxin Injection on Spastic Hemiplegic Patients[J].Occasional Publication,2006,14(4):377-413.
[8]周龙江,王苇,张新江,等.脑卒中偏瘫上肢早期被动运动时功能性磁共振成像对临床预后的判断价值[J].中华物理医学与康复杂志,2014,36(3):194-198.
[9]Morís G,Arias M,Terrero JM,et al.Ipsilateral reversible diaphragmatic paralysis after pons stroke[J].Journal of neurology,2012,259(5):966-968.
[10]唐新辉,尚淑梅,李春玲,等.肌电生物反馈联合针刺对脑卒中偏瘫患者上肢功能的影响[J].中西医结合心脑血管病杂志,2014(5):535-537.
[11]Jung Won Kwon,Sang Young Park,Sung Min Son,et al.Correlation between Assessments of Arm and Leg Ideomotor Apraxia in Hemiplegic Stroke Patients[J].Journal of physical therapy science,2012,24(2):187-190.
[12]张听雨,贾杰.电针对脑卒中后偏瘫患者手功能障碍的疗效[J].中国康复理论与实践,2017,23(1):14-18.
[13]焦玉娟,孙培军,张连勇,等.自拟温阳化痰通络汤治疗卒中相关性肺炎(阳虚痰瘀阻络证)的临床观察[J].中国中医急症,2017,26(5):863-865.
[14]陆雯俊.温阳散寒益气通络法治疗类风湿关节炎临床研究[J].中医学报,2014,29(10):1525-1527.