个性化头针治疗脑卒中运动功能障碍:随机对照研究

发布时间：2018-01-20 15:52

本文关键词： 脑卒中运动功能障碍个性化头针传统头针随机对照试验　出处：《中国针灸》2017年09期 　论文类型：期刊论文

【摘要】：目的:评价基于脑功能定位的个性化头针治疗对脑卒中运动功能障碍的临床疗效。方法:将180例脑卒中运动功能障碍患者随机分为个性化头针组、传统头针组和康复组,每组60例。个性化头针组选取四神聪、运动区、平衡区为基本头针刺激区,并根据伴随功能障碍情况,伴肌张力高者配运动前区,伴不随意运动配运用区、颞三针,伴运动协调性差配运用区,伴认知障碍配额五针,伴感觉障碍配感觉区,患者在头针治疗过程中进行康复训练;传统头针组选取病灶同侧顶颞前斜线、顶颞后斜线和枕下旁线为头针刺激区,同样在头针治疗过程中进行康复训练;康复组仅接受康复治疗。均周一至周五每天治疗1次,周六、日休息,共治疗4周(20次),治疗结束后随访8周。采用Fugl-Meyer运动功能评定量表(FMA)、改良Barthel指数量表(MBI)评价临床疗效。结果:治疗4周后与随访时,3组患者FMA运动功能评分、MBI评分均高于治疗前(均P0.01);治疗4周后、随访时3组患者组间FMA运动功能评分、MBI评分比较差异均有统计学意义(均P0.000 1);其中,治疗4周时和随访时,个性化头针组FMA运动功能评分、MBI评分均高于传统头针组和康复组(P0.05,P0.01);治疗4周时和随访时,传统头针组FMA运动功能评分、MBI评分均高于康复组(均P0.05)。结论:个性化头针治疗可以有效改善脑卒中患者运动功能障碍、提高日常生活自理能力。
[Abstract]:Objective: to evaluate the clinical effect of individualized scalp acupuncture therapy on motor dysfunction of stroke. Methods: 180 patients with motor dysfunction of stroke were randomly divided into individualized scalp acupuncture group. In the traditional scalp acupuncture group and rehabilitation group, 60 cases in each group. The individualized scalp acupuncture group selected Sishen Cong, motor area and balance area as the basic acupuncture stimulation area. According to the condition of accompanying dysfunction, the patients with high muscle tension were assigned the pre-exercise area. The patients were given rehabilitation training during scalp acupuncture treatment, accompanied by involuntary exercise use area, temporal three needles, poor coordination of motor use area, with cognitive impairment quota of five needles, and with sensory disorder. In the traditional scalp acupuncture group, the ipsilateral anterior parietal oblique, posterior parietal oblique and suboccipital parietal line were selected as the stimulating area of scalp acupuncture, and rehabilitation training was also carried out in the course of scalp acupuncture treatment. The rehabilitation group received rehabilitation treatment only once a day from Monday to Friday, and took a rest on Saturdays and Sundays for a total of 4 weeks and 20 times). The patients were followed up for 8 weeks after treatment. Fugl-Meyer motor function scale was used. The clinical efficacy was evaluated by modified Barthel Index scale (MBI). Results: the FMA motor function score was evaluated in 3 groups after 4 weeks of treatment and at follow-up. MBI scores were higher than those before treatment (P 0.01). After 4 weeks of treatment, there were significant differences in FMA motor function score and MBI score between the three groups at follow-up (P < 0. 000 1). The FMA motor function score in the individualized scalp acupuncture group was higher than that in the traditional scalp acupuncture group and rehabilitation group at 4 weeks and follow-up. After 4 weeks of treatment and follow-up, the traditional scalp acupuncture group had FMA motor function score. MBI scores were higher in rehabilitation group than in rehabilitation group (P 0.05). Conclusion: individualized scalp acupuncture therapy can effectively improve motor dysfunction and self-care ability of daily life in stroke patients.
【作者单位】：上海中医药大学附属龙华医院针灸科;上海市长宁区天山中医医院康复科;上海交通大学附属儿童医学中心中医科;江苏省盐城市第三人民医院康复科;陕西省西安市兵器工业卫生研究所神经内科;
【基金】：上海市卫计委中医药科研基金项目:2014 LQ 021 A;上海市卫计委“杏林新星”人才培养项目:ZY 3-RCPY-2-2048;上海市卫计委科研基金项目:ZJ 2016001;上海市卫计委海派中医流派“陆氏针灸”传承研究项目:ZY 3-CCCX-1-1007 上海市科委重要疾病临床研究项目:1640197030;上海市教委博士点基金项目(2015)
【分类号】：R246.6
【正文快照】： 脑卒中后约60%~80%患者遗留不同程度的功1临床资料能障碍,而运动功能障碍是其最显著的症状[1]。由于1.1一般资料运动功能障碍使其独立生活能力及社会参与能力受选择2014年10月至2016年9月上海市长宁区限,直接影响其生活质量和回归社会,给家庭和社会天山中医医院康复科、江苏省

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