井穴刺络放血配合巨刺法治疗脑卒中恢复期上肢痉挛疗效及对患者肌肉、运动功能的影响

目的:探讨井穴刺络放血配合巨刺法治疗脑卒中恢复期上肢痉挛的疗效,并分析对肌肉、运动功能的影响。方法:采用随机数字表法将100例急性缺血性脑卒中患者分为治疗组和对照组各50例,对照组予以西医常规治疗,治疗组在对照组的基础上采用手十二井穴刺络放血联合巨刺法,在治疗4周后分析疗效并探讨对患者肌肉、运动功能的影响。结果:治疗组疗效92.00%显著高于对照组74.00%(P<0.05); 治疗后两组改良Barthel指数(MBI)、肢体功能评分(FMA)均显著升高,肌肉痉挛评分(MAS)降低,且治疗组MBI、FMA评分高于对照组,MAS评分低于对照组(P<0.05); 治疗后两组疼痛、关节僵硬、痉挛、疲劳评分均显著降低,且治疗组以上评分明显低于对照组(P<0.05); 治疗后两组Klotho、成纤维生长因子(FGF23)、G蛋白耦联受体APJ内源性配体(Apelin-13)水平均显著降低,且治疗组以上指标均明显低于对照组(P<0.05); 治疗后两组高密度脂蛋白(HDL)水平显著升高,低密度脂蛋白(LDL)、总胆固醇(TC)、甘油三酯(TG)水平降低,且治疗组HDL高于对照组,LDL、TC、TG水平低于对照组(均P<0.05); 治疗后两组认知功能评分(MMSE)水平显著升高,卒中状态评分(NIHSS)、神经功能缺损评分(NDF)降低,且治疗组MMSE评分高于对照组,NIHSS、NDF评分低于对照组(均P<0.05)。结论:井穴刺络放血配合巨刺法治疗脑卒中恢复期上肢痉挛效果较佳,可显著改善患者卒中状态、认知功能、上肢运功功能及活动度,降低血脂水平及对神经功能的损伤,在脑卒中恢复期治疗中具有指导意义。

Curative effect of bloodletting puncture at Jing points combined with opposing needling on upper limb spasm during stroke recovery and the influence on muscle and motor function

Objective:To explore the curative effect of bloodletting puncture at Jing points combined with opposing needling on upper limb spasm during stroke recovery,and analyze the influence on muscle and motor function.Methods:A total of 100 patients with acute ischemic stroke were divided into treatment group(n=50)and control group(n=50)by random number table method.Patients in the control group were treated with routine western medicine,while patients in treatment group were treated with bloodletting puncture at Jing points combined with opposing needling based on the treatment of control group.After 4 weeks of treatment,the curative effect was analyzed,and the influence on muscle and motor function was explored.Results:The response rate of treatment group was significantly higher than that of control group(92.00% vs 74.00%,P<0.05).After treatment,the modified Barthel index(MBI)and Fugl-Meyer assessment(FMA)scores were significantly increased,while modified Ashworth scale(MAS)scores were decreased in the two groups.The treatment group had higher MBI and FMA scores and lower MAS scores than the control group(P<0.05).After treatment,the scores of pain,joint stiffness,spasm and fatigue were significantly decreased in the two groups,and treatment group had significantly lower scores than the control group(P<0.05).After treatment,the levels of Klotho,fibroblast growth factor 23(FGF23),G protein-coupled receptor APJ endogenous ligand(Apelin-13)were significantly decreased in the two groups,which were significantly lower in treatment group than in control group(P<0.05).After treatment,the levels of high-density lipoprotein(HDL)were significantly increased,while the levels of low-density lipoprotein(LDL),total cholesterol(TC)and triglyceride(TG)were decreased in the two groups.HDL in treatment group was higher than that in control group,while the levels of LDL,TC and TG were lower than those in control group(all P<0.05).After treatment,the mini-mental state examination(MMSE)scores were significantly increased,while the National institutes of health stroke scale(NIHSS)scores and neurological deficit scale(NDF)scores were decreased.The treatment group had higher MMSE scores and lower NIHSS and NDF scores than the control group(all P<0.05).Conclusion:Bloodletting puncture at Jing points combined with opposing needling is effective in the treatment of upper limb spasm during stroke recovery.It can significantly improve stroke status,cognitive function,upper limb motor function and range of motion,reduce blood lipid level and damage to nerve function,which is of certain guidance significance in the treatment of stroke during recovery.