头针留针、康复训练联合西医综合治疗脑卒中后偏瘫步态随机平行对照研究

目的]观察头针留针康复训练联合西医综合治疗脑卒中后偏瘫步态疗效。方法]使用随机平行对照方法,将40例患者按就诊顺序随机分为两组,对照组20例常规治疗(早期护理、避免患侧输液,常规药物对症、支持治疗,消除脑水肿,减轻颅内压,抗感染,维持水电平衡,改善脑循环等)同时步行康复训练。治疗组20例,在对照组基础上增加头针(选穴:选取顶中线、偏瘫对侧顶颖前斜线的上1/5,顶旁1线、双侧枕下旁线。)留针、康复训练。均连续治疗2周为1疗程。观测定量步态参数,平衡、步行功能,日常生活自理能力。连续治疗3个疗程,判定疗效。结果]治疗组步态各参数、下肢运动功能FAC、FMA评分、平衡BBS评分、MBI指数等方面的改善优于对照组(P<0.01)。结论]头针留针、康复训练联合西医综合治疗脑卒中后偏瘫步态疗效满意。

A Randomized Parallel Controlled Trial of the Comprehensive Treatment of Retaining Scalp Needle,Rehabilitation Training and Western Medication for Hemiparalysis Gait after Stroke

Objective]To observe the therapeutic effect of retaining scalp needle,rehabilitation training and western medication in treating hemiparalysis gait after stroke.Method] Randomized parallel controlled trial was applied.40 eligible patients were recruited and randomized assigned to two groups.20 patients in control group received routine treatments(nursery,vein infusion in affected side,routine western medication for symptoms and support,hydrocephalus elimination,intracranial hypertention relief,anti-infection,water-salt and electrolyte balance maintaining,cerebral blood circulation improvement,etc.) combined with rehabilitation training.20 patients in treatment group received additional scalp needling(middle vertex line,upper 1/5 anterior oblique line of vertex-temporal on the non-affected side,1st lateral vertex line,both lower-lateral occiput lines).One treatment course will last for continual two weeks.The outcome measurements are rational Gait Index,Balance and Walking Ability,Activities of Daily Living.After three treatment courses,effect will be assessed.Results] The treatment group demonstrates better effect regarding to improvement of rational Gait Index,scores of FAC,FMA of low limbs,scores of BBS,MBI(P<0.01).Conclusion] the Comprehensive Treatment of retaining scalp needle,rehabilitation training and western medication shows satisfactory effect in treating hemiparalysis gait after stroke