摘要
目的:比较利多卡因局部阻滞结合针康法与常规针康法治疗脑卒中患者上肢痉挛的临床疗效。方法:选取2017年6月—2020年6月在黑龙江中医药大学附属第二医院就诊的符合纳入条件的脑卒中后上肢痉挛患者60例,采用随机数字表法分为观察组和对照组各30例。对照组给予针康法治疗,每周6次,连续治疗4周;观察组在针康法基础上给予利多卡因注射液局部阻滞治疗,每周3次,连续治疗4周。采用改良Ashworth肌张力评定量表(MAS)、上肢简化Fugl-Meyer运动功能评定表(FMA-UE)、改良Barthel指数(MBI)评定量表、主动关节活动度量表(AROM)分别评定患者上肢的肌肉痉挛程度、运动功能、日常生活能力、肘关节活动度的变化。结果:2组治疗前MAS分级、FMA-UE、MBI、AROM评分比较,差异均无统计学意义(P>0.05),具有可比性。2组治疗后MAS分级、FMA-UE、MBI、AROM评分均较治疗前提高,差异具有统计学意义(P<0.01)。与对照组比较,治疗后观察组MAS评分具有实质性改善(P<0.01);治疗前后观察组和对照组FMA-UE评分差值分别为(14.7±3.7)分、(9.7±2.5)分,观察组FMA-UE评分比对照组有实质性改善,差异有统计学意义(P<0.05);治疗前后观察组和对照组MBI评分差值分别为(28.3±5.1)分、(20.3±5.1)分,观察组MBI评分比对照组有实质性改善,差异有统计学意义(P<0.05);治疗前后观察组和对照组AROM评分差值分别为(42.0±34.5)分、(25.5±18.7)分,观察组AROM评分比对照组有实质性改善,差异有统计学意义(P<0.05)。结论:利多卡因局部阻滞结合针康法治疗对脑卒中后上肢痉挛患者具有较好的疗效,能有效减轻患者的肌痉挛,改善肘关节活动能力,增强运动功能及日常活动能力。
Objective:To compare the clinical efficacy of Lidocaine local block combined with acupuncture-rehabilitation method and conventional acupuncture-rehabilitation method in the treatment of upper limb spasticity among post-stroke patients.Methods:Sixty cases of post-stroke upper limb spasticity patients who met the inclusion criteria in our hospital from June 2017 to June 2020,were selected.All the patients were randomly divided into observation group and control group,with 30 cases in each group.The control group was treated with conventional acupuncture-rehabilitation therapy,6 times a week,for 4 weeks;the observation group was given Lidocaine local block therapy,3 times a week,for 4 weeks.The Modified Ashworth Scale(MAS),Fugl-Meyer Assessment Upper Extremity(FMA-UE),Modified Barthel Index(MBI),and Active Range of Motion(AROM)scales were used to evaluate the changes of spasticity,motor function,activities of daily living,and elbow joint active range of motion.Results:There were no significant differences in MAS grade,FMA-UE,MBI,and AROM scores between the two groups before treatment(P>0.05),validating the comparisons between the two groups.The MAS grade,FMA-UE,MBI,and AROM scores of the two groups improved significantly after treatment compared with those before treatment,as the differences were statistically significant(P<0.01).In addition,MAS grade in the observation group exhibited a substantial improvement compared with the control group after treatment(P<0.01).The differences of FMA-UE scores before and after treatment in the observation and control groups were(14.7±3.7)and(9.7±2.5)points,respectively.The differences of MBI scores in the observation and control groups were(28.3±5.1)and(20.3±5.1)points,respectively.The differences of AROM scores in the observation and control groups were(42.0±34.5)and(25.5±18.7)points in the observation and control groups,respectively.Compared with the control group after treatment,the observation group showed substantial improvements in FMA-UE,MBI,and AROM scores,and th
作者
李季
张立
关莹
王璐
辛贵乐
邢艳丽
唐强
LI Ji;ZHANG Li;GUAN Ying;WANG Lu;XIN Guile;XING Yanli;TANG Qiang(The Second Affiliated Hospital of Heilongjiang University of Traditional Chinese Medicine,Harbin,Heilongjiang 150001,China)
出处
《康复学报》
CSCD
2021年第3期215-221,共7页
Rehabilitation Medicine
基金
黑龙江省中医药科研项目(ZHY18-078)
第六批全国名老中医药专家学术经验继承项目
国家重点研发计划项目(2018YFC1706000)。
关键词
上肢痉挛
肌张力
针康法
利多卡因
局部阻滞
upper limb spasticity
muscle tone
acupuncture-rehabilitation
Lidocaine
local block
