温针结合抗痉挛支具治疗痉挛性偏瘫的疗效

摘要

目的:探索温针结合抗痉挛支具以及常规康复训练治疗痉挛性偏瘫的疗效.方法:选取2016年7月至2017年6月接受治疗的100例痉挛性偏瘫患者为研究对象,按照随机数表分成2组,其中50例应用温针结合抗痉挛支具联合治疗痉挛性偏瘫的患者为观察组,其余50例应用常规康复训练治疗的患者为对照组.对患者治疗前、治疗后2周、4周、2个月、3个月时分别评价日常生活能力(BI)、Berg平衡量表、最大步行速度(MWS)、步行功能(Holden)进行评分.使用肌电图仅对患者进行H反射测量.结果:观察组患者接受温针结合抗痉挛支具治疗痉挛性偏瘫效果更为明显,治疗前2组患者各项评分差异无统计学意义(P＞0.05).治疗后观察组患者日常生活能力(BI)评分、Berg平衡评分、步行功能评分均较对照组高,且步行功能(Holden)分级结果显示观察组患者步行功能恢复良好,差异有统计学意义(P＜0.05),疗效较对照组明显.对照组患者H反射亢进,潜伏期时间有所缩短至,肌电图波峰增高,说明上运动神经元病变,而观察组患者H反射潜伏期缩短较小,差异无统计学意义(P＞0.05),肌电图波峰没有增高现象,说明患者H反射情况较好.结论:温针结合抗痉挛支具治疗痉挛性偏瘫较常规康复训练疗效更为显著.%Objective:To explore the curative efficacy of warm acupuncture combined with anti-spasm brace and conventional rehabilitation training in the treatment of spastic hemiplegia.Methods:A total of 100 patients with spastic hemiplegia who were treated from July 2016 to June 2017 in our hospital were selected as the research object and divided into observation group and control group according to random number table,with 50 patients in each group.The observation group was treated with warm acupuncture combined with anti-spasm brace,and the control group was treated with routine rehabilitation training.Before treatment,the Barthel Index (BI),Berg balance scale,maximum walking speed (MWS),walking function (Holden) score at 2 weeks,4 weeks,2 months,3 months after treatment were measured.H reflex in patients was determined with electromyography.Results:Warm acupuncture combined with anti-spasm brace had more significant curative efficacy in the treatment of spastic hemiplegia.The differences between 2 groups were not statistically significant before treatment (P ＞ 0.05).After treatment,BI,Berg balance score,walking function scores in the treatment group were higher than the control group,and walking function (Holden) classification results showed that walking function of the patients in the treatment group recovered well.And the difference was statistically significant (P ＜ 0.05),and the clinical efficacy was significant when compared with the control group.H hyperreflexia,incubation time was shortened,and the peak of EMG increased in control group,indicating upper motor neuron lesion.And H reflex latency shortened less in the treatment group,with no significant difference (P ＞ 0.05).No wave EMG increased indicated that patients with better H reflecting.Conclusion:Warm acupuncture combined with anti-spasm brace treatment of spastic hemiplegia has more significant curative efficacy than routine rehabilitation training.