分级电针治疗中风后腕手痉挛的临床观察

发布时间：2018-03-03 00:00

本文选题：中风　切入点：腕手　出处：《时珍国医国药》2017年09期 　论文类型：期刊论文

【摘要】：目的比较中风后腕手痉挛的分级电针治疗与常规电针治疗的疗效差异,为临床治疗提供新的思路。方法随机将患者分为治疗组及对照组。二组患者均在常规康复治疗的基础上,对照组给予常规电针治疗,针刺曲池、手三里、外关、合谷,选择2Hz连续波,刺激强度以患者耐受为宜,每次30min,每日1次,连续治疗28天;治疗组于疗前根据肌张力高低进行分级分组,给予个体化电针治疗,选穴手三里、外关、内关、郄门,选择50 Hz、续断比为1∶1的断续波,刺激强度以患者出现抬腕和屈腕动作为度,每次15min,每日1次,分别于治疗第7天、第14天、第21天再次进行评定,根据新的分级给予新的治疗方案,连续治疗28天。分别于疗前、疗后应用改良Ashworth痉挛量表、ROM测量、Fugl-Meyer评定法、Barthel ADL指数评价、神经功能缺损评分法CSS进行评定。应用SPSS13.0统计软件统计分析,计量资料用t检验、等级资料用Ridit分析。结果 Ashworth痉挛量表经Ridit分析,治疗组R的均值为0.599166,可信区间不重叠;ROM测量、FuglMeyer量表、Barthel ADL指数评分、CSS量表均显示治疗组差值高于对照组,治疗组总有效率高于对照组,组间比较均有显著性差异(P0.05)。结论分级电针治疗可以较快的缓解中风后腕手痉挛,且根据痉挛程度不同给予个体化治疗,使治疗更具有针对性,疗效优于常规电针治疗。
[Abstract]:Objective to compare the curative effect of graded electroacupuncture on wrist and hand spasm after stroke and to provide a new idea for clinical treatment. Methods the patients were randomly divided into treatment group and control group. The control group was treated with conventional electroacupuncture, acupuncture of Quchi, three li of the hand, Waiguan, Hegu, select 2Hz continuous wave, the stimulation intensity was suitable for patient tolerance, 30 mins every time, once a day for 28 days; The treatment group was divided into groups according to muscle tension before treatment, and was given individualized electroacupuncture therapy. The treatment group selected points for hand three li, Waiguan, Neiguan, Ximen, selected 50 Hz, dipsacus ratio 1: 1 intermittent wave, The intensity of stimulation was measured by wrist lift and wrist flexion, 15 mins, once a day, respectively, on the 7th, 14th and 21st day after treatment, and the new treatment was given according to the new classification. Before and after the treatment, the modified Ashworth spasticity scale was used to evaluate the Barthel ADL index, and the nerve function defect score (CSS) was used to evaluate Barthel ADL index. SPSS13.0 statistical software was used to analyze the statistical data and t test was used to measure the data. Results by Ridit analysis, the mean value of R in the treatment group was 0.599166, and the confidence interval was not overlapped with ROM. The scores of Barthel ADL index in the treatment group were higher than those in the control group. The total effective rate of the treatment group was higher than that of the control group, and there were significant differences between the two groups. Conclusion the treatment of graded electroacupuncture can relieve wrist-hand spasm after stroke more quickly, and give individualized treatment according to the degree of spasm, which makes the treatment more targeted. The curative effect is superior to that of conventional electroacupuncture.
【作者单位】：黑龙江中医药大学附属第二医院;黑龙江中医药大学;黑龙江省中医药科学院;
【基金】：国家自然科学基金面上项目(No.81473763) 黑龙江中医药大学科研基金面上项目(No.201203)
【分类号】：R246.6

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