天柱傍针刺结合平衡区电针对脑卒中患者站立平衡功能的影响

目的:探讨天柱傍针刺结合平衡区电针对脑卒中患者站立平衡功能的影响。方法:将脑卒中患者145例随机分为康复组、传统针刺组和傍针刺组。康复组采用平衡训练及常规康复训练,传统针刺组采用头针运动区、足运感区及体针结合平衡训练及常规康复训练,傍针刺组采用天柱傍针刺平衡区配合头针运动区、足运感区及体针结合平衡训练及常规康复训练。治疗每日1次,每周5次,治疗4周为1个疗程,连续治疗2个疗程。分别于治疗前、治疗4周及结束后,用Berg平衡评分量表(Berg balance scale,BBS)、Sheikh躯干评分、Fugl-Meyer下肢运动评分、10m步行时间及Holden功能步行分级对各组患者进行站立平衡功能的评定。结果:4周后3组BBS、Sheikh、Fugl-Meyer、10m步行时间及Holden功能步行分级均较治疗前有明显提高(P0.01),傍针刺组的BBS、Sheikh、Fugl-Meyer、10m步行时间及Holden功能步行分级均优于康复组及传统针刺组(P0.05),8周后3组BBS、Sheikh、Fugl-Meyer评分、10m步行时间及Holden功能步行分级均较治疗前明显提高(P0.01)。结论:在常规康复训练的基础上,配合天柱傍针刺结合平衡区电针,能有效地提高脑卒中偏瘫患者的站立平衡功能,改善步行能力,缩短病程。

Effects of Acupuncture Intervention Combined with Rehabilitation on Standing-balance-walking Ability in Stroke Patients

Objective To observe the influence of acupuncture stimulation of lateral side of Tianzhu(para-BL 10),electroacupuncture(EA)stimulation of scalp-point Balance Area(MS 14),Motor Area(MS 6)and body acupoints combined with rehabilitation training on standing-balance and walking ability in stroke patients.Methods A total of 145 stroke inpatients were randomly assigned to rehabilitation group(n=48),routine acupuncture group(n=49)and para-BL10group(n=48).Patients of the rehabilitation group received balance training and routine rehabilitation training treatment,those of the routine acupuncture group received acupuncture stimulation of scalp-points(MS 14,MS 6),body acupoints,balance training and routine rehabilitation training,and those of the para-BL10 group received acupuncture stimulation of lateral side of BL 10 combined with scalp-points of MS 14 and MS 6and body acupoints,and balance training and routine rehabilitation training.The treatment was conducted once daily,5times per week,8weeks altogether.The patients' balancing function,lower-limb motor function and walking ability were assessed using Berg Balance Scale(BBS),Sheikh Trunk Control Ability Scale(STCAS),Fugl-Meyer Assessment Scale(FMAS),and Holden Functional Ambulation Classification(FAC),respectively.Results After 4and 8weeks' treatment,the scores of BBS,STCAS,FMAS and FAC in patients of the rehabilitation,routine acupuncture and para-BL10 groups were significantly increased and 10meters-walking time obviously reduced in comparison with pre-treatment in the same one group(P<0.01).The effects of acupuncture stimulation of para-BL 10 were considerably better than both rehabilitation and routine acupuncture groups in raising BBS,STCAS,FMAS and FAC scores and in reducing 10m-walking time(P<0.05).Conclusion Acupuncture stimulation of lateral side of BL 10 combined with scalp-points has a significant benefit for stroke patients in standing-balance ability and walking ability.