针刺联合隔药灸经筋结点法治疗脑卒中后上肢痉挛性瘫痪疗效观察

目的观察针刺联合隔药灸经筋结点法治疗脑卒中后上肢痉挛性瘫痪的临床疗效。方法 105例脑卒中后上肢痉挛性瘫痪患者随机分为观察组53例和对照组52例。对照组采用传统针刺治疗,观察组在对照组的基础上采用隔药灸经筋结点法治疗。比较两组治疗前后中医证候、改良Ashworth量表(MAS)、Fugl-Meyer评估法(FMA)、Barthel指数(BI)、健康调查简表(SF-36)评分和肌电图F波波幅、阈值及时限变化,并比较两组临床疗效。结果观察组总有效率为96.2%,显著高于对照组的82.7%(P<0.05)。观察组治疗后中医证候评分、MAS评分显著低于对照组,FMA、BI及SF-36评分显著高于对照组,肌电图F波波幅、阈值及时限变化显著优于对照组(P<0.05)。结论针刺联合隔药灸经筋结点法治疗脑卒中后上肢痉挛性瘫痪疗效确切,对于改善机体痉挛状态,促进肌力及患肢功能恢复,提高患者的生活质量有重要作用。

Therapeutic Observation of Acupuncture plus Herb-partitioned Moxibustion at Meridian Sinew Joints for Post-stroke Upper-limb Spastic Palsy

Objective To observe the clinical efficacy of acupuncture plus herb-partitioned moxibustion at meridian sinew joints in treating post-stroke upper-limb spastic palsy.Method A total of 105 patients with post-stroke upper-limb spastic palsy were randomized into an observation group of 53 cases and a control group of 52 cases.The control group was intervened by ordinary acupuncture,while the observation group was additionally given herbpartitioned moxibustion at meridian sinew joints.The traditional Chinese medicine(TCM)sign and symptom score,Modified Ashworth Scale(MAS)score,Fugl-Meyer Assessment(FMA)score,Barthel Index(BI)score,and 36-item Short-Form Health Survey(SF-36)score of the two groups were compared,as well as the changes in the amplitude,threshold and time limit of F wave on electroencephalogram(EEG).The clinical efficacies were also compared.Result The total effective rate was 96.2%in the observation group,significantly higher than 82.7%in the control group(P<0.05).After the treatment,the TCM sign and symptom score and MAS score in the observation group were significantly lower than those in the control group;the FMA,BI and SF-36 scores in the observation group were markedly higher than those in the control group;and the changes in the amplitude,threshold and time limit of wave F on EEG in the observation group were significantly superior to those in the control group(P<0.05).Conclusion Acupuncture plus herb-partitioned moxibustion at meridian sinew joints can produce valid efficacy in treating post-stroke upper-limb spastic palsy.It can significantly improve the spastic state,promote the recovery of muscle force and function of the affected limb,and enhance the patients’quality of life.