中药熏蒸联合针灸治疗脑梗死后肌张力增高的临床观察

摘要

目的 观察中药熏蒸联合针灸治疗脑梗死后肌张力增高的临床观察.方法 将患者120例按随机数字表法分为对照组和观察组,各60例.两组患者均予基础治疗,并行康复治疗.对照组口服巴氯芬,观察组患者采用针灸治疗,同时配合中药熏蒸疗法,两组均治疗3个月.采用修订版Ashworth评分法(MAS)观察两组患者肢体肌张力改善程度并评价临床疗效,采用表面肌电图(sEMC)测定患者肌肉的肌张力,采用四肢简化Fugl-Meyer评分量表(FMA)评价患者治疗前后的运动功能以及生活自理能力Barthel指数(BI),记录治疗过程中不良反应的发生情况.结果 观察组总有效率为88.33％,高于对照组的80.00％ (P＜ 0.05).治疗后,两组患者的MAS评分以及RMS均显著下降,且观察组下降程度显著优于对照组(P＜0.05),治疗后,两组患者FMA及BI评分均显著升高,且观察组升高程度显著优于对照组(P＜0.05).观察组不良反应发生率显著低于对照组(P＜0.05).结论 中药熏蒸联合针灸治疗脑梗死后患者肌张力增高,疗效显著,可帮助患者恢复肢体运动功能,提高自理能力,且不良反应较少,安全性好.%Objective:To observe the clinical effects of Chinese herbal fumigation combined with acupuncture on hypermyotonia after cerebral infarction.Methods:120 patients were divided into the control group and the observation group by random number table,each with 60 cases.Two groups of patients were given basic treatment,parallel rehabilitation treatment.The control group took oral baclofen.The observation group was treated with acupuncture and the traditional Chinese medicine fumigation therapy.The two groups were treated for 3 months.The revised version of Ashworth scoring method (MAS) was used to observe the improvement of limb muscle tension in two groups and to evaluate the clinical efficacy.Surface electromyography (sEMG) was used to determine the muscle tone of the patients.Limbs simplified FMA was used to evaluate the motor function and self-care ability,Barthel index (BI) before and after the treatment,and the adverse reactions during the treatment were recorded.Results:The total effective rate of the observation group was 88.33％,higher than 80％ of the control group (P＜ 0.05).After treatment,the MAS score and RMS of the two groups decreased significantly,and the decrease rate of the observation group was significantly better than that of the control group(P＜ 0.05).After treatment,FMA and BI scores of the two groups were significantly higher,and the observation group was significantly higher than the control group (P＜ 0.05).Conclusion:Chinese herb fumigation combined with acupuncture has a significant effect on the increase of muscle tension after cerebral infarction,which can help the patients recover the limb movement function,improve their self-care ability,and have less adverse reactions and good safety.