热补针法结合康复训练对缺血性脑卒中偏瘫患者早期运动功能的影响

目的:探讨热补针法结合康复训练对缺血性脑卒中偏瘫患者早期运动功能(Fugl-Meyer)的影响。方法:将80例缺血性脑卒中患者随机分为康复组40例、针刺结合康复组40例,康复组患者接受内科常规治疗的同时采用康复训练进行治疗,针刺结合康复组患者接受内科常规治疗的同时采用热补针法结合康复训练进行治疗。针刺治疗取穴肩髃、曲池、合谷、阳陵泉、阴陵泉、足三里、三阴交,施热补针法,留针20min,每日1次,共治疗3周。同时在治疗前和治疗3周后分别采用脑卒中患者临床神经功能缺损程度评分和Fugl-Meyer评定量表进行评估。结果:针刺结合康复组显著进步、进步、无变化分别为17(42.5%)、18(45.0%)、5(12.5%),康复组显著进步、进步、无变化分别为10(25.0%)、17(42.5%)、13(32.5%),总有效率分别为87.5%和67.5%,针刺结合康复治疗组的疗效显著优于单纯康复治疗组(P<0.05)。两组治疗后比较神经功能缺损程度和Fugl-Meyer评分差异均有统计学意义,针刺结合康复组神经功能缺损程度评分明显减少(P<0.05)、Fugl-Meyer评分明显增加(P<0.01)。结论:热补针法结合康复训练对脑卒中神经功能缺损程度和Fugl-Meyer的改善作用明显优于单纯康复治疗方法。

Effect of Heat-reinforcing Needling Combined with Rehabilitation Training on the Motor Function of Ischemic Stroke Patients

Objective To observe the therapeutic effect of heat-reinforcing needling combined with modem rehabilitation training on the motor function of ischemic stroke patients.Methods Fifty cases of ischemic stroke patients were randomly divided into rehabilitation(Rehab,n=40)and acupuncture(Acup)+ Rehab(n=40)groups.Heat-reinforcing needling was applied to Jianyu(LI 15),Quchi(LI 11),Hegu(LI 14),Zusanli(ST 36),Yanglingquan(GB 34),Yinlingquan(SP 9)and Sanyinjiao (SP 6),once daily for 3 weeks.Rehabilitation training including healthy limb and joint movement was conducted,once daily for 3 weeks.The patient's neurological impairment degree and the motor function(Fugl-Meyer index)were evaluated before and after the treatment.Results After the treatment,of the each 40 cases in Rehab and Acup + Rehab groups,10(25.0%)and 17(42.5 %)experienced marked improvement in their symptoms,17(42.5 %)and 18(45.0 %)had improvement,13(32.5 %)and 5(12.5%)failed,with the effective rates being 67.5% and 87.5% respectively.The therapeutic effect of Acup+ Rehab group was markedly superior to that of Rehab group(P＜0.05).Comparison between two groups showed no significant differences in the scores of clinical neurological impairment degree and the scores of Fugl-Meyer index before the treatment(P＞0.05).After the treatment,the scores of neurological impairment degree of two groups both decreased significantly(P＜0.05),and the scores of the Fugl-Meyer index of the upper and lower limbs increased significantly in two groups(P%0.05).The score of neurological impairment degree of Acup+Rehab group was significantly lower than that of Rehab group(P＜0.05),while the scores of the Fugl-Meyer index of two limbs of Acup+ Rehab group were obviously higher than those of Rehab group(P＜0.01).Conclusion The therapy of heat-reinforcing needling combined with rehabilitation training is significantly superior to that of simple rehabilitation training in improving neurological impairment and motor function of ischemic stroke patients.