头体针巨刺法联合本体感觉神经肌肉促进技术治疗脑卒中后偏瘫临床研究
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R743.3;R246.6

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2019年度河南省医学科技攻关计划联合共建项目(LHGJ20191459)


Clinical Study on Scalp-Body Acupuncture and Contralateral Meridian Needling Method Combined with Proprioceptive Neuromuscular Facilitation Technique for Hemiplegia After Stroke
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    摘要:

    目的:观察头体针巨刺法联合本体感觉神经肌肉促进技术(PNF) 对脑卒中后偏瘫患者肢体功能 及体感诱发电位的影响。方法:选取150 例脑卒中后偏瘫患者为研究对象,按随机数字表法分为3 组各 50 例。对照1 组予PNF 治疗,对照2 组予头体针巨刺法治疗,观察组予PNF 联合头体针巨刺法治疗。比较 3 组临床疗效,并比较3 组神经功能缺损评分(NFD)、改良Barthel 指数(MBI) 评分、Fugl-Meyer 运动功能 量表(FMA) 评分、Berg 平衡量表(BBS) 评分、正中神经体感诱发电位及脑卒中专门化生活质量量 表(SS-QOL) 评分。结果: 治疗后, 观察组总有效率92.00%, 高于对照1 组70.00%及对照2 组 72.00% (P<0.05)。治疗1 个月、3 个月,3 组NFD 评分均逐渐降低(P<0.05),MBI 指数评分均逐渐升 高(P<0.05),且观察组NFD 评分低于同期对照1 组、对照2 组(P<0.05),MBI 评分高于同期对照1 组、 对照2 组(P<0.05)。治疗1 个月、3 个月,3 组FMA 上肢评分、下肢评分均逐渐升高(P<0.05),且观察组 FMA 上肢评分、下肢评分均高于同期对照1 组、对照2 组(P<0.05)。治疗1 个月、3 个月,3 组BBS 评分均 逐渐升高(P<0.05),且观察组高于同期对照1 组、对照2 组(P<0.05)。治疗1 个月、3 个月,3 组正中神 经N20 潜伏期均逐渐缩短(P<0.05),且观察组短于同期对照1 组、对照2 组(P<0.05),3 组正中神经 N20-P25 波峰振幅均逐渐增大(P<0.05),且观察组大于同期对照1 组、对照2 组(P<0.05)。治疗1 个月、 3 个月,3 组SS-QOL 评分均逐渐升高(P<0.05),且观察组高于同期对照1 组、对照2 组(P<0.05)。结 论:头体针巨刺法联合PNF 技术治疗脑卒中后偏瘫,疗效确切,能改善患者神经功能及平衡能力,减轻肢体 障碍程度,促进正中神经体感诱发电位恢复,提高患者生活能力及生活质量。

    Abstract:

    Abstract: Objective: To observe the effects of scalp- body acupuncture and contralateral meridian needling method combined with proprioceptive neuromuscular facilitation technique (PNF) on limb function and somatosensory evoked potential in patients with hemiplegia after stroke. Methods:A total of 150 cases of patients with hemiplegia after stroke were selected as the study objects and divided into three groups according to the random number table method, with 50 cases in each group. The control group 1 was treated with PNF,the control group 2 was treated with scalp-body acupuncture and contralateral meridian needling method,and the observation group was treated with PNF combined with scalp-body acupuncture and contralateral meridian needling method. The clinical effects were compared among the three groups; the scores of Neurological Function Defect (NFD),Modified Barthel Index (MBI),Fugl-Meyer Assessment (FMA), Berg Balance Scale (BBS), somatoceptive evoked potential in median nerve and Stroke- specific Quality of Life (SS- QOL) were compared among the three groups. Results: After treatment, the total effective rate was 92.00% in the observation group,higher than that of 70.00% in the control group 1 and 72.00% in the control group 2 (P<0.05). After 1 month and 3 months of treatment,the NFD scores in the three groups were gradually decreased (P<0.05),and the scores of MBI indexes were gradually increased (P<0.05);the NFD score in the observation group was lower than that in the control group 1 and that in the control group 2 at the same period (P<0.05),and the MBI score was higher than those in the control group 1 and the control group 2 at the same period (P<0.05). After 1 month and 3 months of treatment,the FMA scores of upper and lower limbs in the three groups were gradually increased (P<0.05), and the FMA scores of upper and lower limbs in the observation group were higher than those in the control group 1 and the control group 2 at the same period (P<0.05). After 1 month and 3 months of treatment,the BBS scores in the three groups were gradually increased (P<0.05),and the BBS score in the observation group was higher than those in the control group 1 and the control group 2 (P<0.05). After 1 month and 3 months of treatment,the N20 latency of median nerve in the three groups were gradually shortened (P<0.05),and the N20 latency in the observation group was shorter than those in the control group 1 and the control group 2 (P<0.05);the peak amplitude of N20-P25 in median nerve in the three groups was gradually increased (P<0.05),and the peak amplitude in the observation group was larger than those in the control group 1 and the control group 2 (P<0.05). After 1 month and 3 months of treatment, SS- QOL scores in the three groups were gradually increased (P<0.05),and the score in the observation group was higher than those in the control group 1 and the control group 2 at the same period (P<0.05). Conclusion: Scalp- body acupuncture and contralateral meridian needling method combined with PNF technique has a definite curative effect in the treatment of hemiplegia after stroke, which can improve the nerve function and balance ability of patients, reduce the degree of limb disorder, promote the recovery of somatosensory evoked potential of median nerve,and enhance the ability of daily life and the quality of life of patients.

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常士峰,杨保元,狄心灵.头体针巨刺法联合本体感觉神经肌肉促进技术治疗脑卒中后偏瘫临床研究[J].新中医,2024,56(3):125-131

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  • 在线发布日期: 2024-02-23
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