肌肉关键点穴位埋线治疗脑卒中后上肢痉挛性瘫痪临床研究

目的:观察肌肉关键点穴位埋线治疗脑卒中后上肢痉挛性瘫痪的临床疗效。方法:将符合标准的85例脑卒中后上肢痉挛性瘫痪患者随机分为普通针刺组(42例)和穴位埋线组(43例)。2组均接受常规康复治疗,普通针刺组加用针刺治疗,穴位埋线组加用肌肉关键点穴位埋线疗法,共治疗4周。观察患者治疗前后改良Ashworth痉挛分级(modified Ashworth scale,MAS)、Fugl-Meyer运动功能评分(Fugl-Meyer assessment,FMA)、日常生活活动能力巴氏指数(Barthel index,BI)的变化。结果:治疗前2组患者MAS、FMA及BI评分均无明显差异(P>0.05)。治疗1周后,穴位埋线组患者MAS评分均较治疗前明显降低(P<0.05),FMA、BI评分均明显升高(P<0.05),而普通针刺组较治疗前相比无明显差异(P>0.05)。治疗4周后,2组患者的MAS评分均较治疗前明显降低(P<0.05),FMA、BI评分均明显升高(P<0.05),且与普通针刺组相比,穴位埋线MAS降低及FMA、BI升高更明显(P<0.05)。此外,穴位埋线组治疗1周后的各项评分与普通针刺组治疗4周后的相比无明显差异(P>0.05)。整个治疗过程2组患者均无不良事件发生。结论:普通针刺及穴位埋线治疗脑卒中后上肢痉挛性瘫痪均具有较好的疗效及安全性,而穴位埋线治疗起效更快、频次更少、作用时间长、疗效持久。

Clinical Observation on Treating Spastic Upper Limb Paralysis after Stroke by Acupoint Catgut Embedding at Muscle Key Points

Objective:To observe the clinical effect of catgut embedding at key points of muscles for treatment of spastic paralysis of upper limbs after stroke.Methods:Eighty-five patients with spastic paralysis of upper limbs after stroke were randomly divided into normal acupuncture group (42 cases) and acupoint embedding group (43 cases).Both groups received conventional rehabilitation treatment.The normal acupuncture group was treated with acupuncture,and the acupoint embedding group was treated with acupuncture at key points of the muscle for a total of 4 weeks.The changes of modified Ashworth scale (MAS),Fugl-Meyer motor function score (Fugl-Meyer assessment,FMA),and Barthel index (BI) before and after treatment were observed.Results:There was no significant difference in MAS,FMA and BI scores between the two groups before treatment (P>0.05).After 1 week of treatment,the MAS scores of the acupoint catgut embedding group were significantly lower than before treatment (P<0.05),and the FMA and BI scores were significantly increased (P<0.05),while the ordinary acupuncture group was not significantly compared to before treatment Difference (P>0.05).After 4 weeks of treatment,the MAS scores of the two groups were significantly lower than those before treatment (P<0.05),and the FMA and BI scores were significantly increased (P<0.05).Compared with the ordinary acupuncture group,the MAS scores of acupoint embedding The decrease and the increase of FMA and BI were more obvious (P<0.05).In addition,the scores of the acupoint embedding group after 1 week of treatment were not significantly different from those of the ordinary acupuncture group after 4 weeks of treatment (P>0.05).There were no unhealthy incidents in the two groups of patients throughout the treatment.Conclusion:Ordinary acupuncture and acupoint embedding have good efficacy and safety in treating spastic paralysis of upper limbs after stroke,while acupoint embedding has a faster effect,less frequency,longer action time and lasting effect.