针刺外关、支沟穴治疗脑卒中手痉挛状态临床疗效观察

摘要

ObjectiveTo evaluate the clinical efficacy of acupuncture at Waiguan (TE5) and Zhigou (TE6) in treating post-stroke hand spasm.MethodSixty patients with post-stroke hand spasm graded≥Ⅰand≤Ⅲby the Modified Ashworth Scale (MAS) were randomized into a treatment group (30 cases) and a control group (30 cases). The treatment group was intervened by acupuncture at Waiguan and Zhigou plus rehabilitation training, while the control group was by dry rehabilitation training alone. The acupuncture and rehabilitation were performed once a day, 5 sessions a week, totally for 3 months. The change of hand spasm degree was observed by using MAS; the Fugl-Meyer Assessment (FMA) was adopted to observe the change of hand function; the Modified Barthel Index (MBI) was used to observe the change of the activities of daily living (ADL).ResultAfter treatment, there was a significant difference in comparing the MAS score between the two groups (P<0.05); there was a significant difference in comparing the FMA score between the two groups after treatment (P<0.05); after intervention, there was a significant difference in comparing the MBI score between the two groups (P<0.05).ConclusionAcupuncture at Waiguan and Zhigou can significantly improve the hand spasm sate after stroke; acupuncture plus rehabilitation can substantially improve the hand function and ADL of the patients, and can produce a more significant efficacy compared to dry rehabilitation training.%目的：评价针刺外关、支沟穴治疗脑卒中手痉挛状态的临床疗效。方法将脑卒中后手痉挛状态改良 Ashworth分级评价≥Ⅰ级且≤Ⅲ级的60例患者,随机分为治疗组(30例)和对照组(30例)。治疗组采用针刺外关、支沟穴结合康复治疗,对照组予单纯康复治疗,针刺治疗、康复治疗均每日1次,每星期5次,共观察3个月。通过改良Ashworth量表(Modified Ashworth Scale,MAS)对患者治疗前后手痉挛程度的动态改变进行评价；采用Fugl-Meyer(FMA)运动功能评分法观察治疗前后患者手功能的变化；采用改良Barthel指数(Modified Barthel Index,MBI)观察治疗前后患者日常生活自理能力的变化。结果治疗后两组患者MAS评定结果比较差异有统计学意义(P＜0.05)；治疗后两组Fugl-Meyer运动功能评分比较差异有统计学意义(P＜0.05)；治疗后两组患者MBI评分比较差异有统计学意义(P＜0.05)。结论外关配伍支沟针刺治疗可以明显改善脑卒中患者手痉挛状态；针刺结合康复训练可以明显改善患手运动功能,提高患者的日常生活自理能力,其效果优于单纯康复治疗。