舌针治疗脑卒中后感觉障碍的临床研究

发布时间：2018-06-12 15:23

  本文选题：脑卒中后感觉障碍 + 舌针　； 参考：《广州中医药大学》2017年硕士论文

【摘要】：目的:研究舌针治疗脑卒中后感觉障碍的临床疗效,以评价舌针治疗脑卒中后感觉障碍的优效性,为舌针治疗脑卒中后感觉障碍提供临床依据。方法:将70例脑卒中后感觉障碍的合格受试者随机分为治疗组(舌针+常规针刺组)和对照组(常规针刺组)2组,每组35例。常规针刺组采用徐恒泽主编的《针灸学》中"中风病"的取穴方案:肩毭、曲池、手三里、合谷、外关、环跳、足三里、阳陵泉、昆仑、解溪。治疗组在常规针刺治疗的基础上,应用孙介光的《实用舌针学》中"脑血管意外"治疗方案:主穴:襞中穴、脑灵穴、脑中穴、脑源穴、颈穴、心穴。配穴:舌下襞肿胀区域、舌下节结处、颜色形态异常反应点。两组均为每天治疗1次,6天为1个疗程,疗程间休息1天,共2个疗程。分别在治疗前、治疗中(治疗6次后)、治疗结束时(治疗12次后)进行疗效评价。疗效评价:感觉障碍评定采用感觉障碍评定积分表(改进Fugl—Meyer及Lind-mark评价法)、运动功能评定采用Fugl-me yer运动量表、日常生活能力评定采用改良Barthel指数评定量表(MBI)。结果:(一)两组患者的一般情况,如性别、年龄、病程、治疗前感觉障碍评定积分表(改进Fugl—Meyer及Lindmark评价法)、Fugl-meyer运动量表、改良Barthel指数评定量表(MBI)评分情况比较,差异均无统计学意义(P0.05),具有可比性。(二)疗效分析:1.组内比较:两组的感觉障碍评定积分表、Fugl-meyer运动量表、MBI量表在治疗前、第6次治疗后、第12次治疗后组内比较,第6次治疗后优于治疗前(P0.001),第12次治疗后优于第6次治疗后(P0.001),第12次治疗后优于治疗前(P0.001),提示两种针刺疗法均能改善患者感觉、运动功能及提高日常生活能力。2.组间比较:感觉障碍评定积分表第6次治疗后、第12次治疗后组间比较,治疗组优于对照组(P0.001);Fugl-meyer运动量表第6次治疗后、第12次治疗后组间比较,治疗组优于对照组(P0.001);MBI量表第6次治疗后、第12次治疗后组间比较,治疗组优于对照组(P0.001)。提示舌针结合常规针刺组(治疗组)在改善患者感觉、运动功能及日常生活能力方面均优于常规针刺组(对照组),舌针在改善感觉、运动功能及日常生活能力方面疗效确切。结论:舌针与常规体针均可改善脑卒中后感觉障碍患者的感觉、运动功能及日常生活能力,且舌针结合常规体针在改善感觉、运动功能及日常生活能力方面较常规针刺效果显著。
[Abstract]:Objective: to study the clinical effect of tongue acupuncture on sensory disorders after stroke, to evaluate the efficacy of tongue acupuncture in treating poststroke sensory disorders, and to provide clinical basis for tongue acupuncture treatment of poststroke sensory disorders. Methods: 70 eligible subjects with sensory disorders after stroke were randomly divided into treatment group (tongue acupuncture group) and control group (conventional acupuncture group 2), with 35 cases in each group. In the routine acupuncture group, the acupoints of apoplexy in Xu Hengze's Science of Acupuncture and moxibustion were selected as follows: shoulder, Quchi, hand, Hegu, Waiguan, Ring-Jump, Zusanli, Yanglingquan, Kunlun, and Jiexi. On the basis of routine acupuncture therapy, the treatment group was treated with "cerebrovascular accident" in Sun Jie-guang 's "practical tongue Acupuncture": main points: central point in the fold, point in the brain, point in the source of the brain, point in the neck and the point in the heart. Matching points: sublingual plica swelling area, sublingual ganglion node, color shape abnormal reaction point. The two groups were treated once a day for 6 days as a course of treatment, and between courses of treatment for 1 day, a total of 2 courses of treatment. The therapeutic effect was evaluated before and after treatment (6 times after treatment and 12 times after treatment). The sensory disorders were evaluated with the sensory dysfunction scale (improved Fugl-Meyer and Lind-mark method), the motor function was evaluated by Fugl-me yer exercise volume table, and the ability of daily living was evaluated by modified Barthel Index. Results the general situation of the two groups, such as gender, age, course of disease, scores of sensory disorders before treatment (improved Fugl-Meyer and Lindmark evaluation method) and modified Barthel Index scale (MBI), were compared between the two groups. The differences were not statistically significant (P 0.05) and were comparable. (2) Therapeutic Analysis: 1. Intra-group comparison: the two groups were compared with the Fugl-meyer exercise volume scale before treatment, after the sixth treatment, and after the 12th time of treatment with the Fugl-meyer exercise Meter scale MBI before and after the treatment. After the sixth treatment, it was better than that before treatment (P 0.001), after the twelfth treatment (P 0.001) and after the 12th treatment (P 0.001), it was better than that before treatment (P 0.001). It was suggested that the two kinds of acupuncture therapy could improve the feeling, motor function and daily life ability of the patients. Comparison between groups: after the sixth treatment and the 12th time treatment, the comparison between the treatment group and the control group was better than that in the control group after the sixth treatment and the 12th time treatment. The treatment group was better than the control group (P 0.001) after the sixth treatment and the 12th time treatment. The treatment group was superior to the control group (P 0.001). The results suggest that the tongue acupuncture combined with conventional acupuncture group (treatment group) is more effective than the conventional acupuncture group in improving the feeling, motor function and daily living ability of the patients (control group, tongue acupuncture is effective in improving sensation, motor function and daily living ability). Conclusion: tongue acupuncture and routine body acupuncture can improve sensation, motor function and daily living ability of patients with sensory disorders after stroke, and tongue acupuncture combined with conventional body acupuncture can improve feeling. The effect of motor function and daily life ability was more remarkable than that of routine acupuncture.
【学位授予单位】：广州中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R246.6
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本文编号：2010128