推拿点穴联合康复治疗对脑卒中偏瘫患者上肢功能恢复的影响

摘要

目的 探讨推拿点穴联合常规康复治疗对老年脑卒中偏瘫患者上肢功能及痉挛模式的影响.方法 首发脑卒中患者87例,按住院号单双随机分为推拿点穴组46例和对照组41例,推拿点穴组采用常规康复治疗联合推拿点穴,对照组仅接受常规康复治疗.于治疗前及治疗3个月后采用Fugl-Meyer运动功能评分对偏瘫上肢功能进行评定,采用改良Ashworth痉挛量表对肩内旋肌、肘屈肌及屈腕肌张力水平进行评定.结果 治疗前两组FMA上肢功能积分比较,差异无统计学意义(P＞0.05);治疗后推拿点穴组FMA上肢功能积分明显高于对照组(P＜0.05).推拿点穴组总有效率为52.17%(24/46),高于对照组的29.27%(12/41)(P＜0.05).治疗前两组患者肩内旋肌、屈肘肌、腕屈肌MAS评级比较,差异均无统计学意义(P＞0.05);治疗后推拿点穴组肩内旋肌、屈肘肌、腕屈肌MAS评级低于对照组(P＜0.05).结论 推拿点穴联合常规康复治疗可抑制痉挛模式的形成,帮助患者顺利度过痉挛期,能显著改善脑卒中患者肢体痉挛及运动功能.%Objective To explore the influence of acupoint masssage combined with rehabilitation therapy on the recovery of upper limb function in elderly stroke patients with hemiplegia. Methods A total of 87 subjects with stroke were recruited for the study,the patients were randomly divided into two groups according to the hospital number,the experimental group with single number was consisted of 46 patients with acupoint massage combined with rehabilitation therapy ,and the rest 41 patients were in the control group with only regular rehabilitation therapy. Before treatment and 3 months after treatment, Fugl-Meyer assessment( FMA ) was used to evaluate upper limb function of hemiplegia patient, and modified Ashworth scale( MAS ) for assessment of shoulder internal rotation muscle tension, elbow flexion muscle tension and wrist flexor muscle tension. Results There was no significant difference in FMA score of upper limb function between two groups before treatment (P >0. 05 ); After the treatment,the FMA score of upper limb function of acupoint massage group was significantly higher than that of control group( P <0.05 );Total effective rate of acupoint massage group was 52. 17%( 24/46 ),higher than that of control group[ 29. 27%( 12/41 ),P <0. 05 ]. There was no significant difference in the MAS rating of shoulder internal rotation muscle tension, elbow flexion muscle tension, wrist flexor muscle tension between two groups before treatment( P >0. 0 ); After treatment, MAS rating of shoulder internal rotation muscle tension, elbow flexion muscle tension, wrist flexor muscle tension of acupoint massage group was lower than that of control group( P <0.05 ). Conclusion Acupoint massage combined with rehabilitation therapy is able to inhibit the spasms mode in elderly stroke patients, help them spend their spastic stage smoothly, and improve their motor function effectively.