子午流注纳甲法针刺治疗脑卒中后痉挛性偏瘫临床研究

摘要

目的 观察应用表面肌电图(sEMG)评价子午流注纳甲法针刺治疗脑卒中后痉挛性偏瘫的临床疗效.方法 将52例脑卒中后痉挛性偏瘫患者随机分为治疗组和对照组,每组26例.两组均采用常规康复训练治疗,治疗组在此基础上采用子午流注纳甲法针刺治疗,对照组采用常规循经取穴针刺治疗.两组均每日治疗1次,15次为1个疗程.治疗2个疗程后,分别对两组治疗前后步行能力、肌张力、临床神经功能缺损程度、下肢运动功能及平衡功能进行评定,并采集与分析表面肌电图信号.结果 两组治疗后Holden功能步行分级和改良Ashworth分级与同组治疗前比较,差异均具有统计学意义(P<0.01).治疗组治疗后Holden功能步行分级和改良Ashworth分级与对照组比较,差异均具有统计学意义(P<0.05).两组治疗后NDS、FMA、BBS评分与同组治疗前比较,差异均具有统计学意义(P<0.05).且治疗组治疗后NDS、FMA、BBS评分与对照组比较,差异均具有统计学意义(P<0.05).治疗组治疗后sEMG中H/M max指标与对照组比较,差异具有统计学意义(P<0.01).结论 子午流注纳甲法针刺配合康复训练能明显缓解脑卒中后痉挛性偏瘫患者的肌张力,提高患者日常生活活动能力.%Objective To evaluate the clinical efficacy ofZi Wu Liu Zhu Na Jia needling (acupuncture based on midnight-noon ebb-flow theory) in treating spastic hemiplegia after cerebral stroke by using surface electromyography (sEMG).Method Fifty-two patients with spastic hemiplegia due to cerebral stroke were randomized into a treatment group and a control group, 26 cases each. The two groups were both intervened by conventional rehabilitation training. In addition, the treatment group was givenZi Wu Liu Zhu Na Jia needling and the control group was given ordinary acupuncture. The two groups were treated once a day, 15 sessions as a course. The ambulation ability, muscle tension, neurological deficit score (NDS), Fugl-Meyer Assessment Scale (FMA), and Berg Balance Scale (BBS) were evaluated before the intervention and after 2 treatment courses, and the sEMG signals were also collected and analyzed.Result The Holden's Functional Ambulation Classification (FAC) and Modified Ashworth Scale scores were significantly changed in the two groups after the intervention (P<0.01). After the intervention, the FAC and MAS scores in the treatment group were significantly different from those in the control group (P<0.05). The NDS, FMA and BBS scores were significantly changed in the two groups after the treatment (P<0.05). The NDS, FMA and BBS scores in the treatment group were significantly different from those in the control group after the treatment (P<0.05). Of the sEMG signals, H/M max in the treatment group was significantly different from that in the control group after the intervention (P<0.01).Zi Wu Liu Zhu Na Jia needling with rehabilitation training can significantly mitigate the muscle tension and promote the activities of daily living in patients with spastic hemiplegia after cerebral stroke.