摘要
目的观察温针灸联合体外冲击波和康复训练综合治疗卒中后患者肢体痉挛的疗效。方法将114例卒中后肢体痉挛患者按照随机数字表法分为3组,3组均在临床治疗基础上进行常规康复训练,对照A组38例联合温针灸治疗,对照B组38例联合体外冲击波治疗,联合组38例采用温针灸、体外冲击波治疗。3组均治疗2个月。比较2组治疗前后改良Ashworth量表(MAS)评分、日常生活活动能力量表(ADL)评分、Fugl-Meyer运动功能量表(FMA)评分及神经递质[甘氨酸(Gly)、γ-氨基丁酸(GABA)]水平,并统计3组疗效。结果联合组总有效率92.11%(35/38),对照A组总有效率71.05%(27/38),对照B组总有效率68.42%(26/38),联合组临床疗效优于对照A组、对照B组(P<0.05)。3组治疗后上肢、下肢、整体MAS评分均较本组治疗前降低(P<0.05),且联合组治疗后均低于对照A、B组(P<0.05)。3组治疗后ADL、FMA评分均较本组治疗前升高(P<0.05),且联合组治疗后均高于对照组(P<0.05)。3组治疗后Gly、GABA水平均较本组治疗前升高(P<0.05),且联合组治疗后均高于对照组(P<0.05)。结论温针灸联合体外冲击波和康复训练综合疗法能进一步调节神经递质,改善患者肢体痉挛状态,提高卒中后肢体痉挛患者日常生活能力及运动能力,疗效显著。
Objective To investigate the efficacy of warm acupuncture combined with extracorporeal shock wave and rehabilitation training on post-stroke limb spasticity.Methods Totally 114 patients with post-stroke limb spasm were randomly in 1∶1∶1 matching allocated to 3 groups.Based on conventional rehabilitation training,control group A were treated with warm acupuncture,control group B with extracorporeal shock wave,and the combined group with warm acupuncture and extracorporeal shock wave,the efficacy was observed after 2 months of treatment.The scores of modified Ashworth scale(MAS),activities of daily living(ADL),motor function assessment scale(FMA),and the levels of neurotransmitter(glycine[Gly],gamma-aminobutyric acid[GABA])in the three groups were assessed.Results After treatment,the total effective rate in the combined group was higher than that in control A and B groups(92.11%[35/38]vs 71.05%[27/38]vs 68.42%[26/38],P<0.05,respectively).The MAS scores of upper limbs,lower limbs and the whole body in the three groups were lower than those before treatment(P<0.05),which were lower in the combined group than in the control groups(P<0.05).The scores of ADL and FMA and the levels of Gly and GABA in the three groups were higher than those before treatment(all P<0.05),and the combined group was superior to the control groups(all P<0.05).Conclusion For patients with post-stroke limb spasticity,the combined therapy can further regulate neurotransmitters,improve patients'limb spasticity,and improve daily living ability and exercise capacity,with significant efficacy.
作者
朱慧
周林冲
卫炜
吴赛艇
杨煜
ZHU Hui;ZHOU Linchong;WEI Wei;WU Saiting;YANG Yu(Qidong People's Hospital/Qidong Liver Cancer Institute/Department of Pharmacy,Qidong Hospital Affiliated to Nantong University,Nantong,Jiangsu 226200;Qidong People's Hospital/Qidong Liver Cancer Institute/Department of Rehabilitation,Qidong Hospital Affiliated to Nantong University,Nantong,Jiangsu 226200)
出处
《河北中医》
2023年第2期271-275,共5页
Hebei Journal of Traditional Chinese Medicine
基金
南通市科技计划项目(编号:MSZ18184)。
关键词
卒中
痉挛
温针疗法
体外冲击波疗法
Stroke
Spasm
Warm acupuncture therapy
Extracorporeal shock wave therapy
