刺络拔罐治疗卒中患者上肢痉挛的疗效观察

目的观察刺络拔罐疗法对卒中患者上肢痉挛的疗效。方法 90例卒中上肢痉挛患者随机分为传统电针组、刺络拔罐组和联合组,每组30例。3组在基础治疗的基础上分别采用传统电针、刺络拔罐、刺络拔罐联合传统电针3种疗法治疗。观察3组治疗前后上肢功能Fugl-Meyer评定(FMA)评分和肌电图H反射最大H波与M波比(Hmax/Mmax)变化,并比较临床疗效。结果传统电针组总有效率为60.0%,刺络拔罐组总有效率为100.0%,联合组总有效率为100.0%。刺络拔罐组和联合组总有效率高于传统电针组(P<0.05)。3组治疗后FMA评分与同组治疗前比较,差异有统计学意义(P<0.05)。联合组和刺络拔罐组治疗后FMA评分高于传统电针组(P<0.05)。联合组治疗后FMA评分高于刺络拔罐组(P<0.05)。3组治疗后正中神经、尺神经、桡神经Hmax/Mmax比值与同组治疗前比较,差异有统计学意义(P<0.05)。联合组和刺络拔罐组治疗后正中神经、尺神经、桡神经Hmax/Mmax比值优于传统电针组(P<0.05)。结论刺络拔罐治疗卒中患者上肢痉挛疗效显著,刺络拔罐能有效降低肌张力,刺络拔罐联合传统电针能更好改善上肢的自主运动功能。

Therapeutic Observation of Collateral-pricking Cupping for Upper-limb Spasm in Patients with Cerebral Stroke

Objective To observe the efficacy of collateral-pricking cupping in treating upper-limb spasm in cerebral stroke. Method Ninety patients with upper-limb spasm due to cerebral stroke were randomized into a conventional electroacupuncture group, a collateral-pricking cupping group and an integrated group, with 30 cases in each group. In addition to the basic intervention, the three groups received conventional electroacupuncture, collateral-pricking cupping, and collateral-pricking cupping plus conventional electroacupuncture treatment, respectively. Before and after treatment, for the three groups, the change of upper-limb function was assessed by Fugl-Meyer Assessment (FMA) and electromyogram was detected to see the change in Hmax/Mmax. The clinical efficacies were also compared. Result The total effective rate was 60.0% in the conventional electroacupuncture group, 100.0% in the collateral-pricking cupping group and 100.0% in the integrated group. The collateral-pricking cupping group and integrated group were both higher than the conventional electroacupuncture group comparing the total effective rate (P<0.05). After treatment, the FMA score changed significantly in the three groups (P<0.05). The integrated group and collateral-pricking cupping group had a higher FMA score compared with the conventional electroacupuncture group after treatment (P<0.05). The integrated group was higher than the collateral-pricking cupping group comparing the FMA score after treatment (P<0.05). The Hmax/Mmax values of median nerve,ulnar nerve and radial nerve changed significantly after treatment in the three groups (P<0.05). The integrated group and collateral-pricking cupping group were better than the conventional electroacupuncture group comparing the Hmax/Mmax values of median nerve, ulnar nerve and radial nerve after the intervention (P<0.05). Conclusion Collateral-pricking cupping can produce significant efficacy in treating upper-limb spasm due to cerebral stroke, and it can effectively reduce muscle tension. Collateral-pricking cupping plus conventional electroacupuncture can better improve the autonomic movement of upper limb.