麦粒灸联合康复训练治疗卒中后偏身麻木临床观察*

目的：观察麦粒灸联合康复训练治疗卒中后偏身麻木的临床疗效。方法：将60例卒中后偏身麻木患者按随机数字表法分为对照组和观察组各30例，对照组采用常规康复训练，观察组则在此基础上联合麦粒灸治疗，每天1次，连续灸6天后休息 1 天，治疗 2 周后比较两组治疗前后感觉障碍评定积分（改进 Fugl-Meyer 及 Lind-mark 评分）、数字麻木感视觉模拟评分 （Visual Analogue Score, VAS）、卒中神经缺损量表（NIH Stroke Scale, NIHSS）、改良 Barthel指数（Modified Barthel Index, MBI） 及患侧肢体肱动脉、桡动脉、尺动脉、股动脉、胫前动脉的收缩期峰值流速（peak systolic velocity, PSV）和搏动指数（pulsatility index, PI），评估临床疗效。结果：观察组总有效率为 93.33%，对照组总有效率为 53.33%，观察组总有效率高于对照组（P＜ 0.05）。组内比较：治疗 2 周后，两组患者 VAS 麻木感评分和 NIHSS 评分较治疗前均显著下降（P＜0.05）；对照组治疗后改进 Fugl-Meyer 及 Lind-mark 评分和 MBI 评分则较治疗前差异无统计学意义（P＞0.05）。观察组治疗后改进 Fugl-Meyer 及 Lindmark评分和MBI评分较治疗前显著上升（P＜0.05）。两组患者治疗后肱动脉、桡动脉、尺动脉、股动脉、胫前动脉PSV较治疗前均显著升高，PI均显著降低，差异均有统计学意义（P＜0.05）。组间比较：治疗 2 周后，观察组改进 Fugl-Meyer及 Lind-mark 评分、VAS麻木感评分、NIHSS评分、MBI评分和尺动脉 PI与对照组比较，差异均有统计学意义（P＜0.05）。差值比较：两组治疗前后改进 Fugl-Meyer及 Lind-mark评分、VAS麻木感评分、NIHSS评分、MBI评分，肱动脉、桡动脉、尺动脉、股动脉 PSV，肱动脉、尺动脉、股动脉、胫前动脉 PI的差值比较，差异均有统计学意义（P＜0.05）。结论：麦粒灸治疗联合康复训练能有效改善卒中后偏身麻木症状，促进肢体感觉功能的恢复。

Clinical Efficacy of Moxibustion with Grain-Sized Moxa Cone Combined with Rehabilitation Training on Post-Stroke Hemiparalysis with Numbness

Objective: To observe the clinical efficacy of moxibustion with grain-sized moxa cone combined with rehabilitation training in the treatment of post-stroke hemiparalysis with numbness. Methods: 60 patients with post-stroke hemiparalysis with numbness were randomly divided into control group (n=30) and observation group (n=30), the control group received conventional rehabilitation training, while observation group received moxibustion with grain-sized moxa cone on the basis of control group, once daily for 6 consecutive days followed by a 1-day rest. After 2 weeks of treatment, the sensory impairment assessment score (improved Fugl-Meyer and Lind-mark score), Visual Analogue Score (VAS) for numbness, NIH Stroke Scale (NIHSS), Modified Barthel Index (MBI), peak systolic velocity (PSV), and pulsatility index (PI) of the brachial artery, radial artery, ulnar artery, femoral artery, and anterior tibial artery on the affected side were compared between the two groups to evaluate the clinical efficacy. Results: The overall response rate of observation group was 93.33%, which was better than 53.33% that of control group (P＜0.05). Within-group comparison: after 2 weeks of treatment, both groups showed significant decreases in VAS scores and NIHSS scores compared with those before treatment, with significant differences (P＜0.05). However, there was no significant difference in the improved Fugl-Meyer and Lind-mark scores and MBI scores between the control group after treatment compared with those before treatment (P＞0.05). The improved Fugl-Meyer and Lind-mark scores and MBI scores of observation group after treatment showed significant increases compared with those before treatment (P＜0.05). Both groups showed significant increases in PSV of the brachial artery, radial artery, ulnar artery, femoral artery, and anterior tibial artery after treatment compared with those before treatment, while PI showed significant decreases, with significant differences (P＜0.05). Between-group comparison: after 2 weeks of treatment, the improved Fugl-Meyer and Lind-mark scores, VAS numbness scores, NIHSS scores, MBI scores, and ulnar PI of the observation group showed significant differences compared with those of the control group (P＜0.05). Comparison of differences: the differences of the modified Fugl-Meyer and Lind-mark scores, VAS numbness scores, NIHSS scores, MBI scores, PSV of the brachial artery, radial artery, ulnar artery and femoral artery, PI of the brachial artery, ulnar artery, femoral artery and anterior tibial artery of the two groups before and after treatment were significant (P＜0.05). Conclusion: Moxibustion with grain-sized moxa cone combined with rehabilitation training can effectively improve the numbness symptoms of post-stroke hemiparalysis and promote the recovery of limb sensory function.