醒脑开窍针刺法联合电子生物反馈治疗脑卒中后上肢功能障碍临床研究
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R255.2;R743.3

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河南省中医药科研专项(2025ZY3128)


Clinical Study on Xingnao Kaiqiao Acupuncture Combined with Electronic Biofeedback for Post-Stroke Upper Limb Dysfunction
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    摘要:

    目的:观察醒脑开窍针刺法联合电子生物反馈治疗脑卒中后上肢功能障碍的临床疗效。方法:选 取2024年9月—2025年8月濮阳市中医医院康复科收治的脑卒中后偏瘫患者100例,按随机数字表法分为对照 组、观察组各50例。2组均给予基础治疗,对照组给予电子生物反馈治疗方法,观察组在对照组基础上给予醒 脑开窍针刺治疗。比较2组临床疗效,治疗前后上肢Brunnstrom分期情况,腕关节背伸和肩关节前屈主动关节 活动度(AROM), 上肢功能测试评分(UEFT), 上肢运动功能量表评分(FMA-UE), 改良巴氏指数评 分(MBI),前臂伸肌群、肱三头肌、三角肌表面肌电均方根值(RMS),血清中枢神经特异性蛋白β(S100β)、 神经元特异性烯醇化酶(NSE)、神经生长因子(NGF)、脑源性神经营养因子(BDNF) 水平。结果:观察组 总有效率为96.00%(48/50),对照组为84.00%(42/50),组间比较,差异有统计学意义(P<0.05)。治疗后, 2组Brunstrom分期较治疗前改善(P<0.05),且观察组Brunstrom分期优于对照组(P<0.05)。治疗后,2组腕 关节背伸和肩关节前屈AROM均较治疗前提高(P<0.05),且观察组腕关节背伸和肩关节前屈AROM均高于对 照组(P<0.05)。治疗后,2组MBI、FMA-UE、UEFT评分均较治疗前升高(P<0.05),且观察组3项评分均 高于对照组(P<0.05)。治疗后,2组前臂伸肌群、肱三头肌、三角肌RMS均较治疗前均升高(P<0.05),且 观察组3项指标值均大于对照组(P<0.05)。治疗后,2组血清S100β、NSE水平均较治疗前降低(P<0.05), 且观察组2项指标水平均低于对照组(P<0.05);2组血清NGF、BDNF水平均较治疗前升高(P<0.05),且观 察组2项指标水平均高于对照组(P<0.05)。结论:醒脑开窍针刺法联合电子生物反馈可改善脑卒中后上肢功 能障碍患者炎症因子和神经营养因子水平,提高肢体运动功能和日常生活自理能力,从而提高临床疗效。

    Abstract:

    Abstract:Objective:To observe the clinical efficacy of Xingnao Kaiqiao acupuncture combined with electronic biofeedback in the treatment of post-stroke upper limb dysfunction. Methods: A total of 100 post-stroke hemiplegia patients admitted to the Rehabilitation Department of Chinese Medicine Hospital of Puyang from September 2024 to August 2025 were selected and randomly divided into the control group and the observation group using the random number table method, with 50 cases in each group. Both groups received basic treatment. The control group received electronic biofeedback therapy,while the observation group received additional Xingnao Kaiqiao acupuncture based on the control group's treatment. Clinical efficacy was compared between the two groups. The following were compared before and after treatment between the two groups: Brunnstrom stages of the upper limb, active range of motion (AROM) for wrist dorsiflexion and shoulder flexion, Upper Extremity Function Test(UEFT) score, Fugl- Meyer Assessment for Upper Extremity(FMA-UE) score, Modified Barthel Index(MBI) score, root mean square (RMS) value of surface electromyography for the forearm extensor muscles, triceps brachii, and deltoid muscles, as well as serum levels of central nervous system-specific protein β(S100β) , neuron-specific enolase (NSE), nerve growth factor (NGF), and brain-derived neurotrophic factor (BDNF). Results: The total effective rate was 96.00% (48/50) in the observation group and 84.00% (42/50) in the control group, with a statistically significant difference between the two groups (P<0.05). After treatment, Brunnstrom stages improved in both groups compared to before treatment (P<0.05),and the observation group showed superior Brunnstrom stages to the control group (P<0.05). After treatment, AROM for wrist dorsiflexion and shoulder flexion increased in both groups compared to before treatment (P<0.05), and the AROM for wrist dorsiflexion and shoulder flexion in the observation group was greater than that in the control group (P<0.05). After treatment,MBI,FMA-UE,and UEFT scores increased in both groups compared to before treatment (P<0.05),and MBI,FMA-UE,and UEFT scores in the observation group were higher than those in the control group (P<0.05). After treatment, the RMS values of the forearm extensor muscles, triceps brachii, and deltoid muscle increased in both groups compared to before treatment (P<0.05),and all three values were greater in the observation group than in the control group (P<0.05). After treatment, serum levels of S100β and NSE decreased in both groups compared to before treatment (P<0.05), and the leveles of both indicators in the observation group were lower than those in the control group (P<0.05). Serum levels of NGF and BDNF increased in both groups compared to before treatment (P<0.05), and the levels of both indicators in the observation group were higher than those in the control group(P<0.05). Conclusion: Xingnao Kaiqiao acupuncture combined with electronic biofeedback can regulate levels of inflammatory factors and neurotrophic factors,enhance limb motor function and daily living ability,thereby improving clinical efficacy in patients with poststroke upper limb dysfunction.

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徐振华,郑为娜.醒脑开窍针刺法联合电子生物反馈治疗脑卒中后上肢功能障碍临床研究[J].新中医,2026,58(6):150-156

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  • 在线发布日期: 2026-03-31
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