通督调神针法结合夹脊穴治疗脑卒中后痉挛性瘫痪

目的 观察比较通督调神针法结合夹脊穴与单纯通督调神针法治疗脑卒中后痉挛性瘫痪的疗效差异。方法 将61例患者随机分为观察组（通督调神针法结合夹脊穴）31例和对照组（单纯通督调神针法）30例，两组患者均给予康复治疗，对照组针刺取督脉穴百会、风府、水沟、大椎、至阳、腰阳关为主穴；观察组在对照组基础上结合夹脊穴针刺，取颈2—7、腰1—5夹脊穴，双侧交替针刺，每日针刺1次，每次40 min，每周6次，共治疗4周。两组患者均采用简易Fugl- Meyer运动功能量表和修订的Barthel指数（Barthel index，BI）量表评定运动功能，比较两组的疗效差异。结果 治疗4周后，观察组肢体痉挛改善程度与对照组相当，差异无统计学意义（P>0.05）；两组治疗后Fugl- Meyer和BI评分均较治疗前显著升高（P<0.05），观察组治疗后Fugl- Meyer和BI评分较对照组升高更为显著（P＜0.05）。结论 通督调神针法结合夹脊穴在改善脑卒中后痉挛性瘫痪患者的痉挛状态方面与单纯通督调神针法疗效相当，但在提高肢体运动功能和日常生活活动能力方面，通督调神针法结合夹脊穴均优于单纯通督调神针法。

Clinical Effect of Tongdu Tiaoshen Acupuncture Combined with Jiaji Points in Treatment of Spastic Paralysis After Stroke

Objective To investigate the clinical effect of Tongdu Tiaoshen acupuncture combined with acupuncture at Jiaji points versus Tongdu Tiaoshen acupuncture alone in the treatment of spastic paralysis after stroke. Methods A total of 61 patients were randomly divided into observation group (31 patients treated with Tongdu Tiaoshen acupuncture combined with acupuncture at Jiaji points) and control group (30 patients treated with Tongdu Tiaoshen acupuncture alone). The patients in the control group were given rehabilitation treatment combined with acupuncture at Baihui, Fengfu, Shuigou, Dazhui, Zhiyang, and Yaoyangguan acupoints on the governor vessel, and those in the observation group were given acupuncture at bilateral neck 2- 7 and waist 1- 5 Jiaji points alternatively, with 40 minutes each time, once a day and 6 times each week for 4 weeks. The simplified Fugl- Meyer motor function assessment scale and the modified Barthel index (BI) scale were used for evaluation, and clinical outcome was compared between the two groups. Results After 4 weeks of treatment, there was no significant difference in the degree of improvement in limb spasm between the observation group and the control group (P>0.05). Both groups had significant increases in Fugl- Meyer and BI scores after treatment (P<0.05), and the observation group had significantly greater increases than the control group (P<0.05). Conclusion In the treatment of spastic paralysis after stroke, Tongdu Tiaoshen acupuncture combined with acupuncture at Jiaji points has a similar effect to Tongdu Tiaoshen acupuncture alone in improving spasticity in patients with spastic paralysis after stroke; however, such combination has a better effect in improving limb motor function and activities of daily living than Tongdu Tiaoshen acupuncture alone.