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头针久留结合Brunnstrom不同分期电针不同穴位对卒中后下肢运动及平衡障碍的影响
引用本文:包烨华,陈飞宇,刘小平,楚佳梅,史红丽,王延武,徐珊珊. 头针久留结合Brunnstrom不同分期电针不同穴位对卒中后下肢运动及平衡障碍的影响[J]. 中华全科医学, 2019, 17(2): 280-283. DOI: 10.16766/j.cnki.issn.1674-4152.000661
作者姓名:包烨华  陈飞宇  刘小平  楚佳梅  史红丽  王延武  徐珊珊
作者单位:1. 杭州市中医院针灸康复科, 浙江 杭州 310007;
基金项目:浙江省中医药科技计划项目(2014ZB092)
摘    要:目的探讨头穴久留针结合在Brunnstrom不同分期的理论基础上电针不同穴位对脑卒中后下肢运动及平衡障碍的影响。方法将2014年10月—2016年5月杭州市中医院收治的符合纳入标准的100例患者经随机数表法随机分为对照组(普通针刺配合康复治疗)和治疗组(头穴久留针结合Brunnstrom不同分期电针不同穴位配合康复治疗),每组50例。评估2组患者在治疗前、治疗4周后及8周后Berg平衡评分(BBS)、下肢简化FuglMeyer评分(SFMA)和Holden功能步行分类(Holden FAC)的变化。所有患者均住院治疗,针刺及康复疗程均为:每日1次,每周治疗5次,双休日不治疗,连续8周;患者均评估3次,分别在治疗前、治疗4周、8周时。结果治疗4周和8周较治疗前及治疗8周较治疗4周时,2组组内BBS均有升高(均P<0.05)、SFMA亦有升高(均P<0.05)和Holden FAC的等级均提高(均P<0.05),差异有统计学意义;治疗4周及治疗8周时,均同一时点比较,治疗组BBS、SFMA和Holden FAC较对照组均有明显改善,差异有统计学意义(均P<0.05)。结论在常规康复训练的基础上,头穴长时间久留针,同时依据Brunnstrom不同分期患者肢体功能的不同状态电针不同穴位,这种综合疗法能更有效地提高卒中后的偏瘫患者站立平衡的功能,同时可改善其步行能力。

关 键 词:头针久留  Brunnstrom分期  电针  不同穴位  脑卒中  下肢运动功能  平衡功能
收稿时间:2018-01-26

The influence of long-term scalp acupuncture combined with different acpoints with electroacupuncture in different brunnstromon stage on the lower extremity motor function and balance function after stroke
Affiliation:Department of Acupuncture and Moxibustion, Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou, Zhejiang 310007, China
Abstract:Objective To explore the effects of long-term scalp acupuncture combined with different acpoints with electroacupunctrue in different brunnstromon stage on the lower extremity motor function and balance function after stroke. Methods One hundred cases met the inclusion criteria were randomly divided into control group (traditional acupuncture + rehabilitation) and treatment group (long-term scalp acupuncture + using different acpoints with electroacupunctrue in different brunnstromon stage + rehabilitation), 50 cases in each group with the therapy of each group.Berg Balance Scale (BBS), simplified Fugl-Meyer assessment mark (SFMA) and Holden functional ambulation classification (Holden FAC) were observed before and after 4 and 8 weeks' treatment, respectively. Each case was treated on the ward. Treatment course of acupuncture and rehabilitation was once per day, 5 times a week, resting at weekends, treated for 8 weeks. Results BBS, SFMA and Holden FAC were improved in same group after 4 and 8 weeks' treatment, compared with before (all P<0.05), and the indexes after 4 weeks' treatment is superior to that after 4 weeks' treatment (all P<0.05). After 4 weeks' treatment, BBS, SFMA and Holden FAC of treatment group were better than control group, and the same outcome after 8 weeks' treatment. Conclusion With the basic treatment of routine rehabilitation training, long-term scalp acupuncture combined with different acpoints with electroacupunctrue in di fferent brunnstromon stage is more beneficial to improve low limb dysfunction and balance dysfunction than traditional acupuncture. 
Keywords:Long-term scalp acupuncture  Brunnstromon stage  Electroacupunctrue  Different acpoints  Stroke  Lower extremity motor function  Balance function
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