头穴丛刺结合神经肌肉电刺激治疗脑卒中后中枢性面瘫的临床观察

发布时间：2018-03-07 16:00

  本文选题：头穴丛刺　切入点：神经肌肉电刺激　出处：《黑龙江中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的：评价头穴丛刺结合神经肌肉电刺激治疗脑卒中后中枢性面瘫的临床疗效。方法：按照随机数字表法,将符合纳入标准40例脑卒中后中枢性面瘫患者随机分为治疗组和对照组,每组20例患者均给予相同的基础治疗,对照组给予神经肌肉电刺激治疗；治疗组采用头穴丛刺结合神经肌肉电刺激治疗,治疗4周。治疗前、后采用表面肌电分析及House-Brackmann(H-B)量表评价两种治疗方案的临床疗效。结果：1.sEMG分析：两组治疗前鼻肌、口轮匝肌、颊部肌群均方根(RMS)平均值比值,差异无统计学意义(P0.05)；两组治疗后鼻肌、口轮匝肌、颊部肌群RMS平均值比值较治疗前提高,均有统计学意义(P0.01)；与对照组比较,治疗组鼻肌、口轮匝肌、颊部肌群RMS平均值比值的差值较高,有统计学差异(P0.05)。治疗组三组肌肉RMS平均值比值差值比较,差异无统计学意义(P0.05)；对照组鼻肌与口轮匝肌和颊部肌群RMS平均值比值差值比较差异有统计学意义(P0.05),口轮匝肌和颊部肌群,差异无统计学意义(P0.05)；2.H-B量表评定：两组患者H-B面神经功能分级,差异无统计学意义(P0.05)；两组治疗后H-B面神经功能分级较治疗前提高,差异均有统计学意义(P0.05)。治疗后治疗组H-B面神经功能分级较对照组提高,差异有统计学意义(P0.05)。两组患者治疗前H-B计分,差异无统计学意义(P0.05)：两组治疗后H-B计分较治疗前降低,差异均有统计学意义(P0.01)。治疗后治疗组H-B计分较对照组更低,差异有统计学差异(P0.05),治疗组总有效率95%。结论：1.头穴丛刺结合神经肌肉电刺激疗法与神经肌肉电刺激疗法均可以调节鼻肌、口轮匝肌、颊部肌群的神经肌肉电活动,且头穴丛刺结合神经肌肉电刺激疗法优于神经肌肉电刺激疗法。2.头穴丛刺结合神经肌肉电刺激疗法与神经肌肉电刺激疗法均可以改善脑卒中后中枢性面瘫的面神经功能,且头穴丛刺结合神经肌肉电刺激疗法的有效率优于神经肌肉电刺激疗法。
[Abstract]:Objective: To evaluate the scalp acupuncture combined with neuromuscular electrical stimulation treatment clinical curative effect of facial paralysis after stroke. Methods: according to the random number table method, will meet the inclusion criteria of 40 cases of central post-stroke paralysis were randomly divided into treatment group and control group, 20 patients in each group were given the same basic treatment. The control group received neuromuscular electrical stimulation therapy; treatment group was treated by scalp acupuncture combined with neuromuscular electrical stimulation therapy, treatment for 4 weeks. Before treatment, after using surface electromyography (H-B) and House-Brackmann scale evaluation of clinical curative effect of two treatment regimens. Results: 1.sEMG analysis: the two groups before treatment of nasal muscle, muscle the orbicularis oris muscle, buccal root mean square (RMS) the average value of the ratio, the difference was not statistically significant (P0.05); the two groups after treatment of nasal muscle, orbicularis muscle, cheek muscle group average RMS ratio increased compared with before treatment, were statistically significant (P0.01) ; compared with the control group, the treatment group of nasal muscle, orbicularis muscle, buccal muscle RMS average difference between high ratio, there were significant differences (P0.05). The treatment group of three groups of muscle RMS ratio of the average difference comparison, the difference was not statistically significant (P0.05); group of nasal muscle and orbicularis oris muscle and cheek the average RMS value of muscle group was statistically significant difference between the control ratio (P0.05), orbicularis muscle and cheek muscles, there was no statistically significant difference (P0.05); 2.H-B scale: two groups of patients with H-B facial nerve function classification, the difference was not statistically significant (P0.05); to improve the H-B of two groups after treatment of facial nerve the function of classification than before treatment, the differences were statistically significant (P0.05). After treatment, the H-B classification of facial nerve function than the control group increased, the difference was statistically significant (P0.05). The H-B score of treatment group two patients, there was no statistically significant difference (P0.05): the two groups after treatment H-B score was 娌荤枟鍓嶉檷浣，

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