电芒针疗法对脑梗死患者上肢运动功能障碍的影响

目的:观察电芒针疗法对脑梗死患者上肢运动功能的影响。方法:100例脑梗死后上肢功能障碍患者随机分为常规针刺组和电芒针组,各50例。常规针刺组针刺患侧肩髃、极泉、手三里、尺泽、内关、合谷;电芒针组应用电芒针透刺肩髃与臂臑、手三里与外关,两组均每日治疗1次,每周治疗5次,2周为1个疗程,1个疗程后评价疗效。采用简式Wolf运动功能试验(WMFT)、Fugl-Meyer运动功能评分法(FMA)及三角肌表面肌电均方根(RMS)比值评定患者治疗前后的上肢运动功能。结果:两组患者治疗后WMFT评分、FMA评分及三角肌表面肌电RMS比值均优于治疗前(P0.01,P0.05);电芒针组治疗后WMFT评分、FMA评分及三角肌表面肌电RMS比值明显优于常规针刺组(P0.01)。结论:电芒针疗法可以显著改善脑梗死后患侧上肢运动功能,疗效优于常规针刺治疗。

Effect of Electroacupuncture Intervention on Rehabilitation of Upper Limb Motor Function in Patients with Ischemic Stroke

Objective To observe the effect of electro-elongated needle intervention on rehabilitation of upper limb motor function in patients with ischemic stroke.Methods A total of 100 ischemic stroke patients were equally and randomly divided into manual acupuncture group and electro-elongated needle group(n=50cases/group).For patients of the manual acupuncture group,filiform needles were respectively inserted into Jianyu(LI 15),Jiquan(HT 1),Shousanli(LI 10),Neiguan(PC 6)and Hegu(LI 4)on the affected side,manipulated with lifting-thrusting reinforcing or reducing method for 40 min,once daily for two weeks except the weekends,and for those of the electro-elongated needle group,elongated needles were repeatedly penetrated from LI 15 to Binao(LI 14),and from LI 10 to Waiguan(TE 5)on the affected side,followed by electrical stimulation for 40 min,once daily for two weeks except weekends.The therapeutic effect of manual acupuncture and electro-elongated needle for upper extremity rehabilitation was assessed according to the modified upper-extremity Fugl-Meyer Assessment(FMA)and Wolf Motor Function Test(WMFT)separately.The surface electromyogram(sEMG)of the deltoid muscle was recorded by using a Megawin Surface Electrogram System and the root mean square(RMS)of the amplitude of sEMG was used to evaluate the functional state of the deltoid muscle.Results After the treatment,the score of FMA and WMFT in both manual acupuncture and electro-elongated needle groups were significantly increased compared with pre-treatment in the same one group(P<0.01),suggesting an improvement of the motor function of the upper limbs,but RMS ratios of the amplitude of sEMG were evidently decreased in both groups(P<0.05,P<0.01),suggesting a relief of the abnormal muscular tension.The therapeutic effects of the electro-elongated needle were obviously superior to those of manual acupuncture in up-regulating FMA and WMFT scores and down-regulating RMS ratio(P<0.01).Conclusion Electro-elongated needle therapy can effectively improve the motor function of upper limb in ischemic stroke patients and has a better effect in comparison with simple manual acupuncture.