互动式头针结合PNF技术对缺血性卒中痉挛性偏瘫上肢功能的影响

目的:在内科基础治疗的基础上,探讨互动式头针治疗、头针后配合本体感觉神经肌肉促进法(proprioceptive neuromuscular facilitation,PNF)康复治疗及单用PNF康复治疗对缺血性脑卒中痉挛性偏瘫患者上肢运动功能的影响。方法:将90例脑卒中痉挛性偏瘫患者随机分为PNF组、互动式头针组与头针组,每组30例,各组均采用内科基础治疗与PNF康复治疗。互动式头针组于头针治疗期间进行肢体PNF康复训练,头针组于头针治疗结束后行PNF康复训练。头针穴取病灶同侧(肢体偏瘫对侧)顶颞前斜线上1/5、中2/5,顶颞后斜线上1/5、中2/5,每日1次,1个月为一疗程,连续干预6个月。于治疗前,治疗2周、1个月、3个月、6个月后记录患者改良Ashworth痉挛量表(MAS)分级、简式Fugl-Meyer运动功能(FMA)评分、Barthel指数(BI)评分。结果:治疗1个月、3个月及6个月后,各组患者上肢MAS分级均较治疗前改善(均P0.05),且互动式头针组上肢MAS分级优于PNF组与头针组(均P0.05);治疗1个月、3个月、6个月后,各组患者FMA及BI评分均高于治疗前(均P0.05),且互动式头针组FMA及治疗3个月、6个月后BI评分均高于PNF组与头针组(均P0.05)。结论:互动式头针可有效改善缺血性卒中后痉挛性偏瘫患者上肢痉挛状态,改善患者肢体功能,提高患者生活质量,优于头针后采用PNF及单用PNF康复治疗者。     

华心素颗粒治疗充血性心力衰竭多中心双盲双模拟临床应用

目的评价华心素颗粒治疗充血性心力衰竭的有效性和安全性.方法120例患者,随机分治疗组(华心素颗粒组)59例,对照组(地高辛组)61例.采用多中心、双盲、双模拟设计.观察治疗前后纽约心功能分级、西医症候计分、中医症候计分、生活质量计分及安全性指标的改变.结果经治疗后两组纽约心功能分级、西医症候计分、中医症候计分、生活质量计分均有显著改善,两组间差异无统计学意义.安全性指标无显著性改变.结论华心素颗粒可有效、安全地治疗充血性心力衰竭,效果与地高辛相当.     

药物穴位注射配合雷火灸治疗膝关节骨关节炎60例临床观察

目的:观察药物穴位注射配合雷火灸治疗膝关节骨关节炎的临床疗效。方法:将确诊的膝关节骨关节炎90例随机分为两组,治疗组60例用正清风痛宁注射液作穴位注射并配合雷火灸治疗;对照组仅用上述药物作穴位注射治疗。结果:两组总有效率治疗组为95%,对照组为86.7%,两组比较,差异有显著性意义(P<0.01)。治疗组疗效优于对照组。结论:药物穴位注射配合雷火灸治疗膝关节骨关节炎有较好的临床疗效。     

关刺温针法复合易化技术治疗缺血性卒中痉挛性偏瘫运动功能的临床观察

目的:观察关刺温针法结合康复技术对卒中痉挛性偏瘫患者运动功能的影响。方法:90例脑卒中痉挛性偏瘫患者,随机分为康复组30例,采用Bobath康复技术治疗;关刺温针组30例,采用关刺温针法治疗;关刺温针结合康复组30例,针刺后采用Bobath康复技术治疗,共治疗6个月,治疗前与治疗后2周、1个月、3个月、6个月各时点分别采用上肢MAS评分评估上肢抗痉挛疗效,FMA功能活动评分评估运动功能能力,BI评分评估日常生活活动能力。结果:治疗1个月后各时间点关刺温针组结合康复组在FMA评分、上肢MAS评分方面显著优于单用康复或关刺温针组,有显著性意义(P0.05)。治疗3个月与治疗6个月关刺温针组结合康复组在BI评分方面显著优于单用康复或关刺温针组相,有显著性意义(P0.05)。结论:关刺温针法结合Bobath康复技术可有效改善卒中后痉挛期偏瘫患者上肢痉挛状态,改善患者肢体功能,提高患者生存质量。     

Effect of warm joint needling plus rehabilitation on the balance function and quality of life of patients with spastic hemiplegia after ischemic cerebral stroke

Objective

To observe the effect of warm joint needling plus rehabilitation techniques on the balance function and quality of life (QOL) of patients with spastic hemiplegia after ischemic cerebral stroke.

Methods

Ninety patients with spastic hemiplegia after ischemic cerebral stroke were randomized into a rehabilitation group, a warm joint needling group and an observation group, with 30 cases in each group. The rehabilitation group was intervened by Bobath therapy, the warm joint needling group was treated with joint needling on the affected side plus warm needling, and the observation group was given the same rehabilitation treatment as the rehabilitation group together with the same warm joint needling as the warm joint needling group. The three groups were treated once another day, 1 month as a treatment course for 6 months. Before the treatment, and respectively after 2-week, 1-month, 3-month, and 6-month treatment, the modified Ashworth scale (MAS) was used to measure the anti-spasm ability of the lower limb, the Berg balance scale (BBS) was adopted to evaluate the balance function, and the stroke-specific quality of life scale (SS-QOL) was employed to estimate the QOL.

Results

After 3-month and 6-month treatment, the lower-limb MAS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). After 1-month, 3-month and 6-month treatment, the BBS scores in the observation group were significantly better than those in the rehabilitation group and the warm joint needling group (all P<0.05). After 2-week, 1-month, 3-month and 6-month treatment, the SS-QOL scores in the observation group were markedly better than those in the rehabilitation group and the warm joint needling group (all P<0.05).

Conclusion

Warm joint needling plus rehabilitation can effectively improve the lower‐limb spasticity state, balance function and QOL in patients with spastic hemiplegia after ischemic cerebral stroke.

     

综合治疗与单纯牵引治疗对腰椎间盘突出患者的疗效

目的：比较单纯牵引与综合物理疗法治疗腰椎间盘突出症的疗效。方法：116例腰椎间盘突出症患者分为观察组62例和对照组54例,均采用腰椎间歇牵引治疗;观察组同时配合微波及温热式低周波疗法。结果：治疗1个月后,观察组治愈显效率明显优于对照组（77．4％与50．0％,P〈0．05）,总有效率,2组比较差异无显著性意义（91．9％与90．7％）。结论：综合物理治疗更能显著提高腰椎间盘突出症的临床疗效。