巨刺结合经筋刺针法在脑卒中患者康复期的应用价值
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摘要
目的探讨巨刺结合经筋刺针法对脑卒中患者功能康复的影响。方法选取康复科2016年6月-2017年6月收治的120例脑卒中患者为研究对象,随机分为两组,对照组60例采用常规针刺治疗,研究组60例采用巨刺结合经筋刺针法,比较两组患者治疗前后神经功能缺损程度(NIHSS)、运动能力(FMA)、日常生活活动能力(MBI)、肌张力(MAS)情况。结果两组病例治疗后NIHSS评分均低于本组治疗前,FMA评分、MBI评分均高于本组治疗前(P <0. 05),差异有统计学意义,研究组治疗后NIHSS、FMA和MBI评分改善明显优于对照组(P<0. 05),差异均有统计学意义。两组治疗后MAS均低于本组治疗前(P <0. 05),差异有统计学意义,且研究组治疗后MAS改善情况明显优于对照组(P <0. 05),差异有统计学意义。研究组临床治疗总有效率为86. 7%,高于对照组的71. 7%(P <0. 05),差异有统计学意义。结论巨刺结合经筋刺针法在脑卒中患者康复期的治疗中,能够改善脑卒中患者的神经功能恢复、肢体运动能力、有助于恢复日常生活功能,缓解偏瘫患者的痉挛状态。
Objective To explore the effects of contralateral needling and meridian-muscle-region needling in the patients with stroke at recovery stage. Methods From June 2016 to June 2017,120 stroke patients were collected from the Department of Rehabilitation as the subjects and randomized into two groups. In the control group,the routine acupuncture was used. In the treatment group,the contralateral needling and meridian-muscle-region needling were combined in treatment. NIHSS,MFA,MBI and MAS were compared before and after treatment in the two groups. Results NIHSS score after treatment was lower than the score before treatment in the two groups,and FMA score and MBI were higher than the levels before treatment,indicating the significant differences(P < 0. 05). The improvements in the scores in the treatment group were obviously better than the control group,indicating the statistical significance(P < 0. 05). After treatment,MAS was lower than the score before treatment in the two groups,indicating the statistical significance(P < 0. 05). The improvements in the treatment group were obviously better than the control group,indicating the statistical significance(P < 0. 05).The total effective rate was 86. 7% in the treatment group,higher than 71. 7% in the control group,indicating the statistical significance(P < 0. 05). Conclusion The contralateral needling combined with meridian-muscle-region needling improves the nerve function recovery and the motor function of extremities,contributes to the recovery of quality of life and relieves hemiplegic spasticity in the patients with stroke at recovery stage.
Objective To explore the effects of contralateral needling and meridian-muscle-region needling in the patients with stroke at recovery stage. Methods From June 2016 to June 2017,120 stroke patients were collected from the Department of Rehabilitation as the subjects and randomized into two groups. In the control group,the routine acupuncture was used. In the treatment group,the contralateral needling and meridian-muscle-region needling were combined in treatment. NIHSS,MFA,MBI and MAS were compared before and after treatment in the two groups. Results NIHSS score after treatment was lower than the score before treatment in the two groups,and FMA score and MBI were higher than the levels before treatment,indicating the significant differences(P < 0. 05). The improvements in the scores in the treatment group were obviously better than the control group,indicating the statistical significance(P < 0. 05). After treatment,MAS was lower than the score before treatment in the two groups,indicating the statistical significance(P < 0. 05). The improvements in the treatment group were obviously better than the control group,indicating the statistical significance(P < 0. 05).The total effective rate was 86. 7% in the treatment group,higher than 71. 7% in the control group,indicating the statistical significance(P < 0. 05). Conclusion The contralateral needling combined with meridian-muscle-region needling improves the nerve function recovery and the motor function of extremities,contributes to the recovery of quality of life and relieves hemiplegic spasticity in the patients with stroke at recovery stage.
引文
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[13]林梅琴,柳维林.针灸治疗脑卒中患者偏瘫步态疗效的系统评价[J].康复学报,2015,25(1):54-62.
[14]陈瑛玲,陈立典.脑卒中后肢体痉挛的康复研究进展[J].世界中医药,2013(1):110-112.
[15]詹明明,韦丹.“缪刺”与“巨刺”之浅析[J].中医外治杂志,2017,26(4):55-56.
[16]马培锋,刘静.巨刺法在神经科疾病中的临床应用进展[J].中国中医药现代远程教育,2017,15(6):142-144.
[17]姜劲峰,王欣君,张建斌.巨刺法治疗偏瘫的神经生理机制及其临床应用策略探讨[J].中国康复理论与实践,2011,17(12):1198-1200.
[18]马健芸,纪哲.经筋疗法联合神经功能重建系统治疗脑梗死后痉挛性瘫痪的临床观察[J].天津中医药,2014,31(9):542-544.
[19]谢占清,王玉双.经筋疗法的源流、理论和临床研究概述[J].环球中医药,2014,7(1):35-36.
[20]王春雷,刘保延,黄福开.经筋疗法相关研究与展望[J].中医杂志,2013,54(5):438-441.
[2]吴毅.脑卒中康复的精准评定[J].康复学报,2016,26(5):1-7.
[3]张艳,刘国成,王金宇,等.巨刺配合康复训练治疗脑卒中后痉挛性偏瘫疗效观察[J].上海针灸杂志,2012,31(9):631-633.
[4]周学德.经筋针刺治疗脑卒中后痉挛性瘫痪随机平行对照研究[J].实用中医内科杂志,2015,29(6):152-153.
[5]各类脑血管疾病诊断要点[J].中华神经外科杂志,1997(1):6-8.
[6]赵建国,高长玉,顼宝玉,等.脑梗死和脑出血中西医结合诊断标准(试行)[J].中国中西医结合杂志,2006(10):948-949.
[7]Jeyaseelan RD,Vargo MM,Chae J.National Institutes of Health Stroke Scale(NIHSS)as an early predictor of poststroke dysphagia[J].PM&R,2015,7(6):593-598.
[8]许光旭,高晓阳,陈文红.Fugl-Meyer运动功能评分的敏感性及实用性[J].中国康复,2001(1):18-19.
[9]李小峰,陈敏.改良Barthel指数评定量表的设计与应用[J].护理研究,2015,29(13):1657-1658.
[10]郭铁成,卫小梅,陈小红.改良Ashworth量表用于痉挛评定的信度研究[J].中国康复医学杂志,2008(10):906-909.
[11]张艳宏,刘保延,赵宏,等.脑卒中痉挛性瘫痪特点及其评定进展[J].中国康复理论与实践,2008(2):110-112.
[12]林成杰,梁娟.脑卒中痉挛状态的康复治疗[J].中国康复医学杂志,2009,24(2):179-182.
[13]林梅琴,柳维林.针灸治疗脑卒中患者偏瘫步态疗效的系统评价[J].康复学报,2015,25(1):54-62.
[14]陈瑛玲,陈立典.脑卒中后肢体痉挛的康复研究进展[J].世界中医药,2013(1):110-112.
[15]詹明明,韦丹.“缪刺”与“巨刺”之浅析[J].中医外治杂志,2017,26(4):55-56.
[16]马培锋,刘静.巨刺法在神经科疾病中的临床应用进展[J].中国中医药现代远程教育,2017,15(6):142-144.
[17]姜劲峰,王欣君,张建斌.巨刺法治疗偏瘫的神经生理机制及其临床应用策略探讨[J].中国康复理论与实践,2011,17(12):1198-1200.
[18]马健芸,纪哲.经筋疗法联合神经功能重建系统治疗脑梗死后痉挛性瘫痪的临床观察[J].天津中医药,2014,31(9):542-544.
[19]谢占清,王玉双.经筋疗法的源流、理论和临床研究概述[J].环球中医药,2014,7(1):35-36.
[20]王春雷,刘保延,黄福开.经筋疗法相关研究与展望[J].中医杂志,2013,54(5):438-441.