全经针刺法配合刺络拔罐治疗脑卒中恢复期上肢痉挛的临床观察

发布时间：2018-03-10 06:06

本文选题：脑卒中　切入点：上肢痉挛　出处：《湖南中医药大学》2016年硕士论文　论文类型：学位论文

【摘要】：目的:观察全经针刺法配合刺络拔罐治疗脑卒中恢复期上肢痉挛的疗效,以期为“邪气恶血住留”是脑卒中后肢体痉挛的关键病因病机假说的科学性提供临床依据。方法:将符合脑卒中恢复期上肢痉挛诊断和纳入标准的60例患者,按照就诊及纳入顺序编号随机分配至全经针刺法配合刺络拔罐组(治疗组)30例、全经针刺法组(对照组)30例,分别接受全经针刺法配合刺络拔罐、全经针刺法治疗,两组予以相应的基础治疗和康复训练。治疗前、治疗1个疗程后、治疗2个疗程后分别记录患者上肢痉挛分级评分、上肢被动牵拉力评定、上肢运动功能评分的数据并予以统计学处理分析。结果:1.在治疗1个疗程后,两组患者组内的上肢痉挛评分、上肢被动牵拉力评定、上肢运动功能评分较治疗前均明显改善,差异有显著统计学意义(P0.01)。两组患者组间的上肢痉挛评分、上肢运动功能评分的差异无统计学意义,两组患者组间的上肢被动牵拉力评定差异有统计学意义(P0.05)。2.在治疗2个疗程后,两组患者组内的上肢痉挛评分、上肢被动牵拉力评定、上肢运动功能评分较治疗前及治疗1个疗程后均明显改善,差异有显著统计学意义(P0.01)。两组患者组间的上肢痉挛评分、上肢被动牵拉力评定、上肢运动功能评分差异有统计学意义(上肢痉挛评分P0.05,上肢被动牵拉力评定P0.01,上肢运动功能评分P0.05)。结论:1.全经针刺法配合刺络拔罐、全经针刺法均可改善脑卒中恢复期上肢痉挛患者的上肢痉挛程度、上肢被动牵拉力、上肢运动功能情况,但全经针刺法配合刺络拔罐疗法的上述指标改善程度优于单纯全经针刺法。2.全经针刺法配合刺络拔罐、全经针刺法治疗脑卒中恢复期上肢痉挛均有效,全经针刺法配合刺络拔罐组的总有效率优于单纯全经针刺法,前者总体疗效更好,为“邪气恶血住留”是脑卒中后肢体痉挛关键病因病机假说的科学性提供了一定的临床依据。
[Abstract]:Objective: to observe the curative effect of acupuncture combined with acupuncture and cupping on upper limb spasm in convalescent stage of stroke. The aim of this study was to provide a clinical basis for the scientific nature of the hypothesis of the key etiology and pathogenesis of limb spasm after stroke. Methods: 60 patients who met the criteria of diagnosis and inclusion of upper limb spasm in convalescent stage of stroke were included in the study. The patients were randomly assigned to the treatment group with acupuncture combined with acupuncture and cupping (30 cases in the treatment group and 30 cases in the control group) according to the order of visit and inclusion. The two groups were given corresponding basic treatment and rehabilitation training. Before and after one course of treatment, the patients' upper limb spasm grading and upper limb passive traction were recorded respectively after two courses of treatment. Results 1. After one course of treatment, the scores of upper limb spasm, upper limb passive traction, upper limb motor function and upper limb motor function were significantly improved in both groups. The difference was statistically significant (P 0.01). There was no significant difference in upper limb spasm score and upper limb motor function score between the two groups, but there was significant difference in upper limb passive traction assessment between the two groups. After two courses of treatment, there was no significant difference between the two groups. The scores of upper limb spasm, upper limb passive traction and upper limb motor function in the two groups were significantly improved compared with those before treatment and after one course of treatment, and the difference was statistically significant (P 0.01), and the score of upper limb spasm between the two groups was significantly higher than that before treatment and after one course of treatment. There were significant differences in upper limb motor function score (upper limb spasm score P0.05, upper limb passive traction rating P0.01, upper limb motor function score P0.05.Conclusion: 1. The total acupuncture can improve the degree of upper limb spasm, the passive traction of upper limb, the motor function of upper limb in convalescent stage of stroke. However, the improvement degree of the above indexes of total acupuncture combined with acupuncture and cupping therapy was better than that of pure acupuncture therapy. 2. The total acupuncture method combined with acupuncture and cupping therapy was effective in the treatment of upper limb spasm in the convalescent stage of cerebral apoplexy. The total effective rate of total acupuncture combined with acupuncture and cupping was better than that of pure acupuncture, which provided a certain clinical basis for the hypothesis that "evil qi and bad blood stay" is the key etiology and pathogenesis hypothesis of limb spasm after stroke.
【学位授予单位】：湖南中医药大学
【学位级别】：硕士
【学位授予年份】：2016
【分类号】：R246.6

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