等力测时法对肢体痉挛的评估与经筋刺法针灸治疗肢体痉挛

背景针灸治疗偏瘫的痉挛状态疗效明显差于治疗弛缓状态,究其原因,主要忽视了对两种状态治疗差异的理解.目的探讨有关肢体痉挛状态有效的针灸疗法及效果评定方法.设计随机对照研究.单位湖南中医学院针灸推拿系,湖南中医学院附属第一医院针灸科.对象2002-01/2003-12湖南中医学院第一附属医院针灸科病房住院的肢体痉挛患者72例,分为治疗组40例,对照组32例.方法治疗组自拟经筋刺法治疗40例.对照组独取阳明法治疗32例.采用康复医学SIAS法,Ashworth法及自拟等力测时法对痉挛状态的肢体进行功能康复评定.主要观察指标①SIAS积分变化.②两组疗效比较.③两组痉挛状态Ashworth分析比较.④两组患者等力测时法量化评定痉挛状态比较.结果根据康复评定的结果,其中SIAS积分治疗组治疗前后分别为(6.79±3.58),(11.68±3.24)分,对照组分别为(6.68±3.36),(8.97±3.48)分,差异有显著性意义(P＜0.01),治疗组痊愈、显效、有效、无效的例数分别为10,23,5,2例,对照组则分别为4,8,16,4例,两组相比差异有显著性意义(P＜0.01).两组痉挛状态Ashworth分析及等力测时法量化评定痉挛状态比较也有统计学意义.结论①研究证实了经筋刺法治疗肢体痉挛状态疗效确实.②提出了有关痉挛状态的量化评定方法等力测时法.

Evaluation with isodynamic time-measuring method and acupuncture treatment with muscle-region needling for limb spasm

BACKGROUND: Acupuncture treatment for hemiplegia spasticity is remarkably worse than that for flaccidity, which roots from the neglect of the recognition of differences in treatments of two states.OBJECTIVE: To probe into relevant effective acupuncture therapy and evaluation method of therapeutic results for limb spasticity.DESIGN: A randomized and controlled trial.SETTING: Department of Acupuncture-Moxibustion and Massage of Hunan College of Chinese Medicine and Department of Acupuncture-Moxibustion of First Affiliated Hospital of Hunan College of Chinese Medicine.PARTICIPANTS: A total of 72 inpatients of limb spasm were collected from the ward of Department of Acupuncture-Moxibustion of First Affiliated Hospital of Hunan College of Chinese Medicine from January 2002 to December 2003, which was divided into treatment group(40 patients) and control group(32 patients).METHODS: In treatment group, 40 patients were treated by the self-designed needling method on muscle region. In the control, 32 patients were treated with the points only from Yangming meridians. Evaluation of functional rehabilitation for spasticity of limbs was carried on with SIAS methods, Ashworth methods and self-designed isodynamic time-measuring methods.parison of quantitative evaluation on spasticity with isodynamic time-measuring method in two groups.RESULTS: According to the results of rehabilitation evaluation, SIAS integrals were(6.79 ± 3.58), (11.68 ± 3.24) before and after treatment respectively in treatment group, were(6.68 ± 3.36), (8.97 ± 3.48) respectively in the control, indicating significant difference ( P ＜ 0. 01 ) . Patients of curing, remarkable effect, being effective and no effect in treatment group were 10, 23, 5 and 5 successively in treatment group, were 4, 8, 16 and 4successively in the control, indicating significant differences by the comparison of two groups( P ＜ 0.01 ). The statistical significance also presented in the comparisons of Ashworth analysis and quantitative evaluation with isodynamic time-measuring method on spasticity in two groups.tative evaluation methods for spasticity were proposed forward, named as isodynamic time-measuring method.