针灸联合中药湿热敷治疗脑卒中后肢体痉挛临床研究

目的:探讨针灸联合中药湿热敷治疗脑卒中后肢体痉挛的临床效果及其对患者血清谷氨酸(Glu)、γ-氨基丁酸(GABA)水平的影响。方法:选取126例脑卒中后肢体痉挛患者,按随机数字表法分为观察组和对照组各63例。对照组给予针灸治疗,观察组在对照组基础上加用中药湿热敷治疗。比较2组治疗前后肢体痉挛状态、肢体运动功能、日常生活活动能力(ADL)与血清Glu、GABA水平的变化及临床疗效。结果:观察组总有效率为92.06%,高于对照组74.60%(P<0.05)。治疗后,2组上肢痉挛、下肢痉挛状态评分较治疗前下降(P<0.05),且观察组上肢痉挛、下肢痉挛状态评分低于对照组(P<0.05)。治疗后,2组Fugl-Meyer、ADL评分较治疗前升高(P<0.05),且观察组Fugl-Meyer、ADL评分高于对照组(P<0.05)。治疗后,2组血清Glu水平较治疗前降低,GABA水平较治疗前升高;且观察组Glu水平低于对照组,GABA水平高于对照组;差异均有统计学意义(P<0.05)。结论:针灸联合中药湿热敷治疗脑卒中后肢体痉挛疗效显著,可明显改善患者肢体痉挛状态与肢体运动功能,提高日常生活活动能力,其作用机制可能与针灸联合中药湿热敷可有效调节血清Glu、GABA水平有关。

Clinical Study on Acupuncture and Moxibustion Combined with Chinese Herbal Hotwet Compression for Limb Spasticity after Stroke

Objective: To discuss the therapeutic effect of the therapy of acupuncture and moxibustion combined with Chinese herbal hot-wet compression for limb spasticity after stroke and its effect on the levels of serum glutamic acid(Glu)and γ-aminobutyric acid(GABA). Methods:A total of 126 patients with limb spasticity after stroke were selected and divided into the observation group and the control group according to random number table method, 63 cases in each group. The control group was treated with acupuncture and moxibustion, and the observation group was additionally treated with Chinese herbal hot-wet compression. Before and after treatment, the changes of limb spasmodic status, limb motor function,activities of daily living(ADL) and levels of serum Glu and GABA,and the clinical effect were compared between the two groups. Results:The total effective rate was 92.06% in the observation group,higher than that of 74.60% in the control group(P<0.05). After treatment, the scores of upper limb and lower spasmodic status in the two groups were decreased when compared with those before treatment(P<0.05),and the above scores in the observation group were lower than those in the control group(P<0.05). After treatment,the scores of Fugl-Meyer and ADL in the two groups were increased when compared with those before treatment(P<0.05),and the above scores in the observation group were higher than those in the control group(P<0.05). After treatment, the Glu levels in serum in the two groups were decreased when compared with those before treatment,and GABA levels were increased;the Glu level in the observation group was lower than that in the control group,and GABA level was higher;differences were significant(P<0.05). Conclusion:The therapy of acupuncture and moxibustion combined with Chinese herbal hot-wet compression has significant therapeutic effect in treating limb spasticity after stroke,which can obviously improve the limb spasmodic status,limb motor function and the activities of daily living,whose mechanism may be related to the effective regulation of Glu and GABA levels in serum.