摘要
目的:观察针刺腰夹脊穴治疗脑卒中后下肢痉挛的临床疗效。
方法:本研究采用按入院顺序随机分组对照的方法,将60名符合纳入标准的患者,在康复训练的基础上随机分为治疗组(腰夹脊法)30例,对照组30例,分别进行针刺治疗,并采用国际通用的改良的Ashworth痉挛表、下肢临床痉挛指数(CSI)、FAC步行功能分级、Fug-Meyer下肢运动功能评价进行入院时、治疗中(1个月)及治疗后(3个月)的康复学评定,以评价治疗效果所以数据采用SPSS17.0统计软件进行分析。
结果:1.治疗组与对照组在入院时、治疗中、出院后MAS痉挛量表结果无统计学差异(p>0.05)。2.治疗组与对照组在入院时、治疗中下肢CSI结果无统计学差异,但在治疗后治疗组肌张力小于对照组(p<0.05)。3.治疗组与对照组在入院时FAC结果比较无统计学差异(p>0.05),但两组在治疗中及治疗后治疗组优于对照组(p<0.05)。4.治疗组与对照组在治疗中Fugl-Meyer下肢运动功能评定比较无统计学差异(p>0.05)。但在治疗后评定比较治疗组优于对照组(p<0.05)。
结论:腰夹脊法能降低脑卒中后患者的肌张力,缓解肌肉痉挛,从而改善患者的下肢功能的恢复,此方法疗效高于对照组针法,针刺腰夹脊穴是临床治疗脑卒中后下肢痉挛的有效方法之一。
Purpose: To assess therapeutic effect on acupuncture at Jiaji (EX-B) of waist for the treatment of lower extremity spasticity for stroke patients.
Method: This study adopts hospital order according to the method, randomized control. Choose 60 cases of lower extremity spastic paralysis after stroke were randomly divided into two groups which based on rehabilitation training.30cases in the treatment group were treated with acupuncture group at Jiaji acupoints of waist (therapy at Jiaji of waist).30cases in the control group were treated with traditional acupuncture therapy(traditional acupuncture therapy).The evaluation of the functional rehabilitation was carried out by the methods before the treatment and after,Which were improved internationally Ashworth spasms table, lower limb clinical spasms index CSI, FAC walking function classification, Meyer lower limb movement Fug - treatment function evaluation, so data analyzed by SPSS17.0 statistical software.
Result: 1, the treatment group and control group in admission, treatment and out of the hospital about MAS has not statistics significance .(P>0.05). 2, the treatment group and control group in admission and treatment has not statistics significance about CSI. But the treatment group muscle tension at discharge is less than the control group when out of hospital. (P < 0.05) . 3, In admission the treatment group and control group about FAC walking function classification comparison was not statistically significant (p > 0.05), two groups in treatment group than in control group treatment (p < 0.05), two groups in the hospital treatment group than in control group (p < 0.05). 4, Both the treatment group and control group in admission and treatment has not statistics significance about Fugl - treatment of lower extremities Meyer movement function (P>0.05). Compare therapeutic effect of two groups out of hospital, indicating that the treatment group was better than control group (p < 0.05).
Conclusion: Therapy at Jiaji of waist can alleviate spasticity, relieve muscle spasm, thus improving the lower extremity function and therapy at Jiaji of waist is superior to traditional acupuncture when there are serious spasms sufferer. This topic avoided the current clinical debate that the more acupuncturing antagonist muscle can aggravate the increased muscle tension seizures and provocation. Acupuncture waist at Jiaji is an effective method to treat the lower extremity spasticity for stroke patients, also superior to traditional acupuncture point.
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