电针结合屈伸肌交替刺激法改善脑卒中患者下肢功能障碍的疗效观察

目的:比较电针结合屈伸肌交替电刺激疗法与常规电针疗法对中风偏瘫患者下肢功能重建的影响,为临床脑卒中遗留下肢功能障碍的康复提供优化的治疗方案。方法:将符合本研究纳入标准的60例患者随机分为对照组与试验组,每组30例。本研究中患者均接受针灸科常规治疗,对照组患者给予电针治疗,选取患侧阳陵泉、足三里、悬钟和丘墟4个穴位,针刺得气后连接电针治疗仪,每日1次,治疗28 d;试验组接受电针结合屈伸肌交替电刺激干预,电针治疗取穴同对照组,低频电刺激取穴:患侧阳陵泉、悬钟、承山、昆仑,屈伸肌交替刺激,屈伸刺激比为(1∶2)。每日1次,治疗28 d。治疗前后采用RM Gait步态数据采集分析系统、Fugl-Meyer量表、Tinnetti平衡步态评分进行疗效判定。结果:治疗28 d后,两组患者患侧步态参数(步长、步速、步频、患侧单支撑相)、下肢Fulg-Meyer评分、Tinnetti平衡步态评分比疗前明显改善,组内比较差异具有统计学意义(P<0.05),组间治疗后比较差异具有统计学意义(P<0.05)。结论:电针结合屈伸肌交替刺激疗法与常规电针疗法均能够促进中风偏瘫患者下肢功能重建,治疗组疗效优于对照组。

Clinical Study of Electro-Acupuncture Combined with Flexor and Extensor Alternative Stimulation on Improving Dysfunction of Lower Limbs in Stroke Patients

Objective:To compare the effect of electro-acupuncture(EA)combined with flexor and extensor alternative stimulation and conventional EA on lower limb function in the treatment of post-stroke hemiplegia,and to provide an optimized treatment scheme for the rehabilitation of lower limb function in clinical practice.Methods:60 cases of post-stroke hemiplegia were randomly divided into the control group and the study group,with 30 cases in each group.Basic rehabilitation was applied in both groups.The control group was treated with electro-needling Yanglingquan(G34),Zusanli(ST36),Xuanzhong(GB39)and Qiuxu(GB40)on affected side,once a day,lasting 28 d;on which basis,the treatment group was also treated with flexor and extensor alternative stimulation,the low electric stimulation was on affected side of GB34,GB39,Chengshan(BL57)and Kunlun(BL60),flexor and extensor stimulation ratio is 1∶2,once a day,lasting 28 d.RM Lab&Gait analysis system,Fulg-Meyer score and Tinnetti Performance Oriented Mobility Assessment score were used to evaluate the treatment effects.SPSS23.0 was used for statistical analysis.Results:At the end of 28 d treatment,the gait parameters of patients(step length,step speed,step frequency,single supportive phase on the affected side)and the lower limb Fulg-Meyer score and the Tinnetti Performance Oriented Mobility Assessment score were significantly improved after the treatment compared to those before the treatment in the two groups;of which there were statistical differences between the two groups(P<0.05)and within the group(P<0.05).Conclusion:Effect of EA combined with flexor and extensor alternative stimulation is better than conventional EA treatment on improving the function of walking ability.