腹针、腕踝针配合康复疗法治疗缺血性脑卒中偏瘫临床观察

摘要

目的 观察腹针、腕踝针配合康复疗法对缺血性脑卒中偏瘫患者肢体运动功能障碍的功能以及神经康复的作用,并与单纯康复治疗方案相比较,以优化临床治疗方案.方法 采用随机对照的临床研究方法,将100例确诊为缺血性脑卒中且肢体偏瘫的患者按就诊先后顺序随机分为治疗组(50例)和对照组(50例).所有患者在试验前均结合患者具体病情给予控制血压、改善脑循环、稳定生命体征以及预防并发症等基础治疗.治疗组在常规针刺的基础上再结合腹针、腕踝针,并结合康复运动疗法;对照组采用单纯康复治疗.两组均治疗2个疗程后观察疗效.于治疗前后采用国际通用运动功能Fugl-Meyer(FMA)、临床神经功能缺损程度评分(CSS)以及Berg平衡量表评定其功能情况,并检测其同型半胱氨酸(Hcy)水平.结果 两组治疗前后FMA、CSS以及Berg评分比较差异均有统计学意义(P<0.05),治疗组治疗后FMA、CSS以及Berg评分与对照组比较差异有统计学意义(P<0.05),两组治疗前后FMA、CSS以及Berg评分差值比较差异有统计学意义(P<0.05).两组治疗后,均可以降低Hcy水平,治疗组Hcy水平为(11.68±4.53)μmol/L,对照组为(13.53±4.01)μmol/L,两组差值比较差异有统计学意义(P<0.05).结论 腹针、腕踝针配合康复疗法治疗缺血性脑卒中偏瘫的疗效较单纯康复治疗更明显.%Objective By taking rehabilitation as the control, to observe the effect of abdominal and wrist-ankle acupuncture plus rehabilitation in restoring the motor and neurological function in hemiplegia due to ischemic cerebral stroke, and to optimize the treatment protocol. Method By adopting a randomized controlled clinical design, a hundred patients diagnosed with hemiplegia after ischemic cerebral stroke were randomized into a treatment group (50 cases) and a control group (50 cases) regarding their visiting sequence. The patients all received basic symptomatic treatment to control blood pressure, improve cerebral circulation, stabilize vital signs and prevent complications. In addition, the treatment group received abdominal and wrist-ankle acupuncture plus kinesiotherapy; the control group received rehabilitation training. The two groups were evaluated for therapeutic efficacy after 2 courses of treatment. Before and after the intervention, the recruited patients were tested by Fugl-Meyer Assessment (FMA), China Stroke Scale (CSS) and Berg Balance Scale (BBS), and the level of homocysteine (Hcy) was also detected. Result The FMA, CSS and BBS scores all showed significant changes after the intervention in the two groups (P<0.05); after the treatment, the FMA, CSS and BSS scores in the treatment group were significantly different from those in the control group (P<0.05), and there were significant between-group differences in comparing the score differences of FMA,CSS and BBS (P<0.05). The two groups both showed decrease of Hcy, (11.68±4.53)μmol/L in the treatment group versus (13.53±4.01)μmol/L in the control group, and the between-group difference was statistically significant (P<0.05). Conclusion Compared to rehabilitation alone, abdominal and wrist-ankle acupuncture plus kinesiotherapy can produce a more significant efficacy in treating hemiplegia due to ischemic cerebral stroke.