摘要
【目的】观察头针联合任务导向训练治疗脑卒中弛缓性瘫痪的临床疗效。【方法】将80例脑卒中弛缓性瘫痪患者随机分为观察组和对照组,每组各40例。对照组采用任务导向训练治疗,观察组在对照组的基础上给予头针针刺治疗。连续治疗4周。治疗4周后,评价2组患者的临床疗效,观察2组患者治疗前后简式Fugl-Meyer运动功能评分(FMA)、巴塞尔指数(BI)评分、Berg平衡量表评分以及生存质量测定量表(QOL-BREF)评分的变化情况,比较2组患者治疗前后屈伸最大等长收缩(MIVC)状态下腓肠肌和胫前肌的积分肌电值(iEMG)、均方根值(RMS)及足背伸协同收缩率(CR)的变化情况。【结果】(1)观察组总有效率为95.00%(38/40),对照组为77.50%(31/40)。观察组疗效优于对照组,差异有统计学意义(P<0.05)。(2)治疗后,2组患者的FMA、BI及Berg评分均明显改善(P<0.05),且观察组在改善FMA、BI及Berg评分方面明显优于对照组,差异有统计学意义(P<0.05)。(3)治疗后,2组患者的腓肠肌iEMG、RMS,胫前肌iEMG、RMS及CR均明显改善(P<0.05),且观察组在改善腓肠肌iEMG、RMS,胫前肌iEMG、RMS及CR方面明显优于对照组,差异有统计学意义(P<0.05)。(4)治疗后,2组患者的生存质量评分生理、心理、社会、环境方面均明显改善(P<0.05),且观察组在改善生存质量评分生理、心理、社会、环境方面明显优于对照组,差异有统计学意义(P<0.05)。【结论】头针联合任务导向训练治疗脑卒中弛缓性瘫痪,能够有效改善患者表面肌电参数,提高患者运动功能、平衡能力、日常生活能力,从而提高患者生活质量,临床疗效显著。
Objective To observe the clinical efficacy of scalp acupuncture combined with task-oriented training for the treatment of post-stroke flaccid paralysis. Methods A total of 80 patients with post-stroke flaccid paralysis were randomly divided into observation group and control group,40 cases in each group. The two groups received task-oriented training,additionally,the observation group received scalp acupuncture treatment,the treatment lasting 4 continuous weeks. After 4 weeks of treatment,the clinical efficacy of the two groups was evaluated,the changes in Fugl-Meyer motor assessment(FMA),Basel index(BI)score and Berg balance scale score,Quality of Life BREF(QOL-BREF)score were observed in the two groups before and after treatment,the changes in the integrated electromyogram(iEMG)and root mean square(RMS)of musculus gastrocnemius and tibialis anterior muscles, and synergistic contraction rate(CR)of foot dorsiflexion in maximum isometric voluntary contraction(MIVC)state were compared between the two groups. Results(1)The total effective rate in the observation group was 95.00%(38/40),and that in the control group was 77.50%(31/40). The clinical efficacy of the observation group was superior to that of the control group,the difference being statistically significant(P < 0.05).(2)After treatment, the FMA, BI, Berg scores were significantly improved in the two groups(P < 0.05), and the improvement in FMA,BI,Berg balance scores of the observation group was significantly superior to that of the control group,the difference being statistically significant(P < 0.05).(3)After treatment,the iEMG,RMS of musculus gastrocnemius and iEMG,RMS,CR of tibialis anterior muscles were significantly improved in the two groups(P < 0.05),and the improvement in iEMG,RMS of musculus gastrocnemius and iEMG,RMS,CR of tibialis anterior muscles of the observation group was significantly superior to that of the control group, the difference being statistically significant(P < 0.05).(4)After treatment,the scores of physiology,psychology,society
作者
陈立霞
李承家
杨傲然
CHEN Li-Xia;LI Cheng-Jia;YANG Ao-Ran(Affiliated Beijing Rehabilitation Hospital of Capital Medical University,Beijing 100144,China)
出处
《广州中医药大学学报》
CAS
2021年第5期941-946,共6页
Journal of Guangzhou University of Traditional Chinese Medicine
基金
北京市中医管理局中医康复体系建设专项资助项目。
关键词
头针
任务导向训练
脑卒中弛缓性瘫痪
运动功能
表面肌电
临床疗效
scalp acupuncture
task-oriented training
post-stroke flaccid paralysis
motor function
surface electromyography
clinical efficacy
