电针加康复训练对脑卒中偏瘫后踝背屈障碍治疗作用的临床观察

发布时间：2018-07-15 15:59

【摘要】：目的：本研究旨在通过临床试验,观察电针组及电针加康复训练组治疗的有效性,重点观察踝关节背屈的关节活动度、胫前肌肌力、踝关节痉挛程度、平衡以及对Fugl-Meyer下肢功能评分改善情况,寻求一种治疗脑卒中后踝背屈障碍的有效、可行的方案,并求证康复训练在改善踝关节背屈功能中能否起到作用。方法：将75例脑卒中偏瘫后踝背屈障碍患者纳入研究,随机分为电针加康复训练治疗组和电针对照组。两组均在神经科常规及对症治疗基础上进行电针治疗,治疗组在对照组基础上加上康复训练。每周治疗5次,10次一疗程,共两个疗程。然后对两组治疗前后踝关节背屈的关节活动度、胫前肌肌力、踝关节痉挛程度、平衡以及Fugl-Meyer下肢功能评分多方面的改善情况进行疗效评价。结果：两种疗法治疗踝背屈障碍均有疗效,总有效率差异有统计学意义(P0.05),临床有效率治疗组优于对照组(P0.05),治疗10次、治疗20次踝关节关节活动度、胫前肌肌力、平衡及Fugl-Meyer下肢功能评分改善情况治疗组均优于对照组(P0.05),且治疗组较对照组对踝关节痉挛程度的影响更小(P0.05)。结论：电针加康复训练和单纯电针治疗对脑卒中偏瘫后踝背屈障碍均有疗效,但电针加康复训练临床有效率更高,可更好的增加患者踝关节主动背屈的关节活动度、胫前肌肌力,减轻对踝关节痉挛程度的影响,能更好的改善患者平衡和Fugl-Meyer下肢功能评分,具有一定的深入研究及探讨的价值。
[Abstract]:Objective: to observe the effectiveness of electroacupuncture group and electroacupuncture plus rehabilitation training group through clinical trial, and to observe the joint motion, tibialis anterior muscle strength and ankle spasm. The balance and the improvement of Fugl-Meyer 's lower limb function score were investigated to find an effective and feasible scheme for the treatment of malleolus dorsiflexion disorder after stroke, and to verify whether rehabilitation training can play a role in improving ankle dorsiflexion function. Methods: 75 patients with malleolus dorsiflexion disorder after stroke were randomly divided into electroacupuncture plus rehabilitation training treatment group and electroacupuncture control group. Both groups were treated with electroacupuncture on the basis of routine neurology and symptomatic treatment, and rehabilitation training was added to the treatment group on the basis of control group. Five times a week, 10 times a course of treatment, a total of two courses of treatment. Then the improvement of ankle flexion motion, tibialis anterior muscle strength, ankle spasm, balance and Fugl-Meyer lower limb function score before and after treatment were evaluated. Results: the two kinds of therapy were effective in treating ankle dorsiflexion disorder, the total effective rate was significantly different (P0.05). The clinical effective rate in the treatment group was better than that in the control group (P0.05), 10 times of treatment, 20 times of treatment of ankle joint activity, and the muscle strength of tibial anterior muscle, the clinical effective rate of treatment group was better than that of control group (P0.05). The improvement of balance and Fugl-Meyer lower limb function score in the treatment group was better than that in the control group (P0.05), and the effect of the treatment group on ankle spasticity was less than that in the control group (P0.05). Conclusion: electroacupuncture plus rehabilitation training and simple electroacupuncture therapy have curative effect on ankle dorsiflexion disorder after stroke, but the clinical effective rate of electroacupuncture plus rehabilitation training is higher, which can better increase the joint motion of ankle active dorsiflexion. The tibialis anterior muscle strength can reduce the influence of ankle spasticity and can improve the balance of patients and Fugl-Meyer lower limb function score. It has certain value of further study and discussion.
【学位授予单位】：成都中医药大学
【学位级别】：硕士
【学位授予年份】：2013
【分类号】：R246.6

【参考文献】