摘要
目的:研究穴位不同针刺方式促进缺血性脑卒中手功能障碍的恢复。方法:将120例缺血性脑卒中手功能障碍的患者随机分为手针(AC)组、电针(EA)组、神经肌肉电刺激(NMES)组和假穴位刺激(Sham)组4组,每组各30例,所有的病例均接受常规的康复训练,手针组在此基础上增加手法针刺治疗,电针组则增加电刺激治疗,神经肌肉电刺激组则增加肌电刺激,治疗假穴位刺激组则接受假刺激治疗,穴位统一选择"曲池"和"外关"两穴,1次/d,30min/次,5d/周,共4周。所有的患者均于治疗前后采用简式Fugl-Meyer上肢运动功能评价表(FMU)、改良Barthel指数评定(MBI)对患者患侧上肢运动功能及日常生活活动能力进行评价。结果:治疗前4组患者的FMU评分和MBI评分差异无显著性意义(P>0.05),治疗后4组患者FMU和MBI评分均有提高(P<0.05)。组间比较,治疗后,手针组、电针组、神经肌肉电刺激组和假穴位刺激组相比,三组疗效指标FMU和MBI的前后变化值明显优于假穴位刺激组(P<0.05)。神经肌肉电刺激组比电针组、手针组在改善上肢运动功能疗效指标FMU值更明显(P<0.01),而电针组和手针组相比较,电针组比手针组改善上肢运动功能疗效指标FMU值更显著(P<0.05)。神经肌肉电刺激、手针和电针三组在改善患者ADL能力疗效指标MBI评分上差异不显著(P>0.05)。结论:三种穴位不同针刺方式均可改善缺血性脑卒中手功能障碍的运动功能和促进ADL能力的恢复,神经肌肉电刺激结合了电刺激和患者主动运动模式,比针刺刺激更有利于脑卒中后手功能的恢复。
Objective： To investigate the different acupuncture ways on the recovery of ischemic stroke patients＇ hand dysfunction. Method： One hundred and twenty patients with hand dysfunction caused by ischemic stroke were randomly divided into 4 groups： acuptmcture（AC） group, electric acupuncture（EA） group, neuromuscular electric stimulation （NMES） group and control（Sham） group, each group 30 cases. All patients received regular rehabilitation training. At the same time,except the Sham group received Sham stimulation with no output the three treatment groups accepted acupuncture, EA and NMES stimulation therapy. Acupuncture points stimulation were at＂Quchi＂ （LEll） and ＂Waiguan＂（ST5）,30min/d, 5 times/week for 4 weeks. Before and after 4 weeks of treatment, simplified Fugl-Meyer upper limb function scale （FMU） and modified Barthel index （MBI） were used to access upper limb motor function and ability of activities of daily living（ADL） of all patients of 4 groups. Result： Before training and treatment, FMU scores and MBI scores of four groups had no significant difference （P〉 0.05）.After 4 weeks training and treatment the FMU and MBI scores improved in four groups （P〈0.05）, especially in the three treatment groups compared with the control group, the difference was statistically significant （P〈0.05）.As far as in three treatment groups, the FMU other two groups, the difference was statistically significant much better than that in acupuncture group（P〈0.05）. But in provement of ADL（MBI） were not significant （P〉0.05） Conclusion： The treatments of three different acupuncture of hand dysfunction caused by ischemic stroke in recovery scores of NMES group improved better than the （P〈0.01）,while in EA group the FMU score was the three treatment groups the differences of imways were helpful for promoting the improvement of upper limb motor function and ADL ability,especially in NMES combined with active movement.
出处
《中国康复医学杂志》
CAS
CSCD
北大核心
2015年第5期467-471,共5页
Chinese Journal of Rehabilitation Medicine
基金
国家自然科学基金资助项目(81173317)
关键词
穴位
针刺
脑卒中
手功能
康复
different acupuncture way
stroke
hand function
recovery
