电针结合屈伸肌交替刺激法对中风偏瘫患者步行能力影响的临床观察

发布时间：2018-05-16 15:13

本文选题：中风 + 屈伸肌交替刺激法　；参考：《黑龙江中医药大学》2017年硕士论文

【摘要】：目的:观察电针结合屈伸肌交替低频穴位电刺激治疗和电针治疗对中风后下肢功能障碍患者步行能力的影响,优化临床治疗方案,提高临床疗效。方法:将60例符合中风偏瘫下肢功能障碍纳入标准的患者随机分为对照组与试验组,每组30例。两组患者均接受针灸科常规治疗。对照组接受常规电针治疗,选取患侧阳陵泉、足三里、悬钟与丘墟,采用频率为2Hz的连续波,每日治疗2次,每次30分钟,治疗6天,休息1天,共治疗4周;试验组在电针治疗基础上接受屈伸肌交替低频穴位电刺激治疗,选取患侧阳陵泉、悬钟;承山、昆仑,采用断续波,断续比(1:1),频率为50Hz,每次治疗20分钟。每日1次,治疗6天,休息1天,共治疗4周。采用RM Gait步态.分析系统(步长、步速、步频及患侧单支撑相),运动功能评定表(Fugl-Meyer量表),日常生活活动表Barthel指数,Tinnetti平衡步态评分进行疗效判定。利用SPSS 20.0统计软件对数据进行处理与分析。结果:1.治疗后对照组与试验组患者患侧步长、步速、步频与患侧单支撑相占整个步态周期百分比较疗前明显增加,两组患者疗后疗前组内差异具有统计学意义(P0.01),试验组患者患侧步长、步速、步频与患侧单支撑相占整个步态周期百分比较对照组显著增加,两组患者疗后组间差异具有统计学意义(P0.05),电针结合屈伸肌交替低频电刺激治疗优于电针治疗。2.治疗后对照组与试验组患者的下肢Fulg-Meyer评分较治疗前均增加,两组患者疗后疗前组内差异具有统计学意义(P0.01),治疗后试验组患者下肢Fulg-Meyer评分较对照组显著增高,两组患者疗后组间差异具有统计学意义(P0.05),电针结合屈伸肌交替低频电刺激治疗优于电针治疗。3.治疗后对照组与试验组患者的Barthel指数、Tinnetti平衡步态评分较治疗前均增加,两组患者疗后疗前组内差异具有统计学意义(P0.01),试验组患者Barthel指数、Tinnetti平衡步态评分较对照组显著增高,两组患者疗后组间差异具有统计学意义(P0.05),电针结合屈伸肌交替低频电刺激治疗优于电针治疗。结论:1.电针结合屈伸肌交替低频穴位电刺激治疗与电针治疗均能改善中风偏瘫患者下肢功能障碍,提高中风偏瘫患者步行能力。2.电针结合屈伸肌交替低频穴位电刺激对改善中风后下肢功能障碍疗效优于常规电针治疗。
[Abstract]:Objective: to observe the effect of electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle and electroacupuncture on walking ability of patients with lower limb dysfunction after apoplexy. Methods: 60 patients with stroke hemiplegic lower limb dysfunction were randomly divided into control group and experimental group with 30 cases in each group. Both groups received routine acupuncture therapy. The control group was treated with conventional electroacupuncture. Yanglingquan, Zusanli, suspension bell and Qiu market of the affected side were treated with continuous wave with frequency of 2Hz twice a day for 30 minutes for 6 days, rest for 1 day, for a total of 4 weeks. On the basis of electroacupuncture treatment, the experimental group was treated with alternating low frequency acupoint electric stimulation of flexion and extensor muscle, selected Yanglingquan, suspension bell, Chengshan, Kunlun, using intermittent wave, intermittent ratio of 1: 1 to 1: 1, frequency of 50 Hz, for 20 minutes each time. Once a day, 6 days, rest 1 day, a total of 4 weeks. RM Gait gait was used. The analysis system (step size, step speed, gait frequency and single support phase of the affected side), motor function evaluation table (Fugl-Meyer scale), daily life activity scale (Barthel index) and Tinnetti balance gait score (TINETI) were used to evaluate the curative effect. The data are processed and analyzed by SPSS 20.0 software. The result is 1: 1. After treatment, the step length, step speed, gait frequency and the percentage of the whole gait cycle of the patients in the control group and the experimental group were significantly increased compared with those in the control group and the experimental group. The difference between the two groups before and after treatment was statistically significant (P 0.01), and the step length of the affected side in the test group was significantly higher than that in the control group. The percentage of walking speed, gait frequency and single support of the affected side in the whole gait cycle was significantly higher than that in the control group. The difference between the two groups after treatment was statistically significant (P 0.05). Electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle was superior to electroacupuncture treatment. After treatment, the lower limb Fulg-Meyer scores of the patients in the control group and the experimental group were increased compared with those before treatment. The difference between the two groups before and after treatment was statistically significant (P 0.01). After treatment, the Fulg-Meyer score of the lower limbs in the test group was significantly higher than that in the control group. The difference between the two groups after treatment was statistically significant (P 0.05). Electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle was superior to electroacupuncture treatment. After treatment, the Barthel index and Tinnetti balance gait score of the patients in the control group and the experimental group were increased compared with those before treatment. The difference between the two groups before and after treatment was statistically significant (P 0.01). The Barthel index and the balance gait score of the patients in the test group were significantly higher than those in the control group. The difference between the two groups after treatment was statistically significant (P 0.05). Electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor muscle was superior to electroacupuncture. Conclusion 1. Electroacupuncture combined with alternating low frequency electric stimulation of flexion and extensor muscle and electroacupuncture treatment can improve lower limb dysfunction and improve walking ability of stroke hemiplegic patients. The effect of electroacupuncture combined with alternative low frequency electric stimulation of flexion and extensor on improving lower limb dysfunction after stroke was better than that of conventional electroacupuncture.
【学位授予单位】：黑龙江中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R743.3

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