扶正补土针灸联合经颅磁刺激治疗脑卒中后手功能障碍临床研究
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R743.3

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2023年度河南省医学科技攻关计划联合共建项目(LHGJ20230922)


Clinical Study on Acupuncture and Moxibustion of Reinforcing Healthy Qi and Nourishing Earth Combined with Transcranial Magnetic Stimulation in Treating Post- Stroke Hand Dysfunction
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    摘要:

    目的:观察扶正补土针灸联合经颅磁刺激治疗脑卒中后手功能障碍的临床疗效。方法:选取 2022年6月—2023年7月濮阳市中医医院收治的82例脑卒中后手功能障碍患者,根据治疗方式不同分为研究组 和对照组,各41例。对照组采用经颅磁刺激治疗,研究组在对照组基础上采用扶正补土针灸治疗。2组均治疗 4周。比较2组中医证候评分、Fugl-Meyer量表评分、手指总主动活动度、腕背伸肌群及腕掌屈肌群积分肌电 值、临床疗效及不良反应。结果:治疗后,研究组总有效率为95.12% (39/41),对照组为80.94% (33/41), 2组比较,差异有统计学意义(P<0.05)。治疗后,2组肢体困重、五心烦热、纳差、腹胀、倦乏等中医证候 评分均较治疗前下降(P<0.05),且研究组各项评分均低于对照组(P<0.05)。治疗后,2组Fugl-Meyer、手 指总主动活动度评分均较治疗前升高(P<0.05),且研究组Fugl-Meyer、手指总主动活动度评分均高于对照 组(P<0.05)。治疗后,2组腕背伸肌群及腕掌屈肌群积分肌电值均较治疗前升高(P<0.05),且研究组上述 2项指标均高于对照组(P<0.05)。研究组不良反应发生率为9.76%(4/41),对照组为12.20%(5/41),2组比 较,差异无统计学意义(P>0.05)。结论:扶正补土针灸联合经颅磁刺激治疗脑卒中后手功能障碍,可提高治 疗效率,有效缓解患者临床症状,改善手指功能,提升腕背伸肌群、腕掌屈肌群力量,且不良反应相对较少。

    Abstract:

    Abstract:Objective:To observe the clinical effect of acupuncture and moxibustion of reinforcing healthy qi and nourishing earth combined with transcranial magnetic stimulation in treating post-stroke hand dysfunction. Methods:A total of 82 patients with post-stroke hand dysfunction admitted to Chinese Medicine Hospital of Puyang from June 2022 to July 2023 were selected and divided into the study group and the control group based on different treatment methods,with 41 cases in each group. The control group was treated with transcranial magnetic stimulation,and the study group was treated with acupuncture and moxibustion of reinforcing healthy qi and nourishing earth on the basis of the control group. Both groups were treated for four weeks. Compared the traditional Chinese medicine (TCM) syndrome scores, Fugl-Meyer scale scores, total finger active range of motion, integrated electromyographic values of wrist extensor and wrist flexor muscle groups, clinical efficacy, and adverse reactions between the two groups. Results: After treatment, the total effective rate was 95.12%(39/41) in the study group, and 80.94%(33/41) in the control group,the difference being significant (P<0.05). After treatment,the scores of TCM symptoms such as heaviness of the limb, vexing heat in the five centers, poor appetite, abdominal distension, and fatigue in both groups were decreased when compared with those before treatment (P<0.05), and the scores in the study group were lower than those in the control group (P<0.05). After treatment,both groups showed an increase in Fugl-Meyer and total finger active range of motion scores compared to those before treatment (P<0.05),and the Fugl-Meyer and total finger active range of motion scores in the study group were higher than those in the control group (P<0.05). After treatment,the integrated electromyographic range of motion of the wrist extensor and wrist flexor-muscle groups in both groups were increased when compared with those before treatment (P<0.05),and both indicators in the study group were higher than those in the control group( P<0.05). The incidence of adverse reactions was 9.76%(4/41) in the study group,and 12.20%(5/41) in the control group, there being no significance in the difference (P>0.05). Conclusion: Acupuncture and moxibustion of reinforcing healthy qi and nourishing earth combined with transcranial magnetic stimulation for post-stroke hand dysfunction can improve the treatment efficiency, effectively alleviate the clinical symptoms of patients,improve the finger function,and enhance the strength of wrist extensor muscles and wrist flexor muscles groups after stroke,with relatively few adverse reactions.

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霍尚飞,葛青叶,罗贺艳,刘敏.扶正补土针灸联合经颅磁刺激治疗脑卒中后手功能障碍临床研究[J].新中医,2025,57(2):118-122

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  • 在线发布日期: 2025-02-05
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