巨刺针法治疗中风恢复期手功能障碍37例临床观察

目的 比较巨刺针法与传统患侧针法治疗缺血性中风手功能障碍的临床疗效. 方法 将84例缺血性中风手运动功能障碍患者随机分为治疗组和对照组各42例.治疗组取健侧手阳溪、阳谷、合谷、后溪,行针时配合患侧手腕关节的运动；对照组取患侧手相同穴位.两组每次均留针30min,每隔10min行针1次,每穴行针1min.每周各治疗3次,隔日1次.总疗程共8周.根据改良的Ashworth分级量表评定法、Fugl-Meyer评价量表、Lindmark运动功能评定法、Barthel指数观察两组患者治疗前后功能障碍手肌张力分级、手平衡功能、运动功能、日常生活活动能力的变化和临床疗效. 结果 两组患者治疗后,肌张力Ashworth分级量表评分、Fugl-Meyer运动平衡评分、Lindmark运动功能评分、Barthel指数较治疗前均明显改善(P＜0.01).治疗组在肌张力Ashworth分级量表评分、Fugl-Meyer运动评分、Lindmark运动功能评分、Barthel指数改善方面均明显优于对照组(P＜0.05或P＜0.01).治疗组总有效明显优于对照组(P＜0.05). 结论 巨刺针法可有效促进缺血性中风恢复期患者手运动功能障碍的恢复,改善手运动功能,提高患者日常生活活动能力.

Clinical Observation on Opposing Needling for 37 Cases of Hand Dysfunction in Stroke Recovery

Objective To compare the therapeutic effects of opposing needling and routine needling on hand dysfunction in stroke recovery.Methods Eighty-four patients with hand dysfunction in stroke recovery were randomized into treatment group and control group,with 42 in each.Yangxi(LI 5),Yanggu(SI 5),Hegu(LI 4) and Houxi(SI 3) were selected in both groups.Points on the healthy side were selected for the treatment group and those on the affected side were selected for the control group,needling for 30 minutes each time.Needling manipulation was given once every 10 minutes,and 1 minute per point each time.The treatment was administrated every other day,three times a week.Dystonia grading dysfunctioned hand,hand balancing function,motor function and activities of daily life were observed in both groups before and after treatment according to Ashworth grading scale assessment method,Fugl-Meyer sports balanced scoring,Lindmark motor function assessment method and Barthel Index.Results Both groups were significantly improved after treatment in Ashworth grading scale assessment method,Fugl-Meyer sports balanced scoring,Lindmark motor function assessment method and Barthel Index(P<0.05),especially the treatment group(P<0.05 or P<0.01).The total effective rate of the treatment group was superior to that of the control group(P<0.05).Conclusion The opposing needling for hand dysfunction in ischemic stroke recovery could obviously promote the recovery of hand motor dysfunction,improve the movement of hand and raise activities of daily life.