镜像疗法结合循经按摩对脑梗死偏瘫患者上肢功能的疗效观察

目的观察镜像疗法结合循经按摩对脑梗死偏瘫患者上肢运动功能及日常生活活动能力的影响。方法将贵州中医药大学第二附属医院神经内科病房的60例脑梗死偏瘫患者随机分为镜像组、循经按摩组、结合组,每组20例。3组均采取常规治疗及康复,在此基础上,镜像组采用镜像视觉反馈康复训练,循经按摩组采用循上肢手阳明大肠经按摩,结合组在镜像视觉反馈的基础上结合循经按摩。于干预前及干预3周后,比较各组患者患侧上肢Fugl-Meyer运动功能(FMA)、改良Ashworth痉挛评定、改良Barthel指数(MBI)评分。结果3组患者干预前患侧上肢FMA、MBI评分及Ashworth痉挛评定比较,差异均无统计学意义(P>0.05);干预3周后,3组患者患侧上肢FMA、MBI评分均较干预前提高,差异有统计学意义(P<0.05);干预后结合组患侧上肢FMA、MBI得分较镜像组和循经按摩组更优(P<0.05);干预后镜像组Ashworth痉挛评定结果无明显差异(P>0.05),循经按摩组及结合组Ashworth痉挛评定级别均降低,差异有统计学意义(P<0.05);相比镜像组,干预后结合组Ashworth痉挛评定差异有统计学意义(P<0.05)。结论镜像疗法结合循经按摩可以有效降低脑梗死偏瘫患者肌张力,改善患侧上肢运动功能,提高日常生活活动能力,治疗效果优于单独使用镜像疗法和单独使用循经按摩。

Effect of mirror therapy combined with meridian massage on upper limb function in patients with cerebral infarction and hemiplegia

Objective To observe the effect of mirror therapy combined with meridian massage on upper limb motor function and daily life activity in patients with cerebral infarction and hemiplegia.Methods 60 patients with cerebral infarction and hemiplegia were randomly divided into mirror group,meridian massage group and combination group,with 20 patients in each group.All three groups received routine treatment and rehabilitation.On this basis,the mirror group received rehabilitation training with mirror visual feedback,the meridian massage group received massage with hand meridian Yangming large intestine,and the combination group received meridian massage with mirror visual feedback.The differences of fugl-meyer motor function(FMA),modified Ashworth spasm assessment,and modified Barthel index(MBI)scores of the affected upper limb were compared before and 3 weeks after intervention.Results Before intervention,there were no statistically significant differences(P>0.05)among the scores of FMA,MBI and Ashworth spasm of the affected upper limbs of the three groups.After 3 weeks of intervention,FMA and MBI scores of the affected upper limbs in the three groups were all improved compared with those before intervention,with statistically significant differences(P<0.05).After intervention,FMA and MBI scores of the affected upper limbs in the combination group were higher than those in the mirror group and the massage group(P<0.05).After intervention,there was no significant difference in the assessment results of Ashworth spasm in the mirror group(P>0.05),while the assessment level of Ashworth spasm in the meridian massage group and the combination group was reduced,with statistical significance(P<0.05).Compared with the mirror group,there was a statistically significant difference in the assessment of Ashworth spasm in the combination group after intervention(P<0.05).Conclusion Mirror therapy combined with meridian massage can effectively reduce the muscle tension of patients with cerebral infarction and hemiplegia,improve the upper limb motor function of the affected side,and improve the ability of daily life activities.The therapeutic effect is better than mirror therapy alone and meridian massage alone.