摘要
目的观察电针治疗脑卒中后偏瘫的效果。方法选取浙江省医疗健康集团杭州医院2018年11月至2019年11月收治的脑卒中后偏瘫患者102例为研究对象,按照随机数字表法分为研究组与对照组,各51例。对照组采用常规康复训练,研究组在对照组基础上联合电针治疗。比较治疗前及治疗2周后,两组患者中医症状积分(口眼歪斜、感觉障碍、肢体麻木)、步态时间-空间参数[10 m最快步行速度(10 m MWS)、跨步长、步频]、肢体功能[改良Barthel指数(MBI)、Fugl-Meyer量表(FMA)]、生活质量[脑卒中病人生活质量量表(SS-QOL)]评估变化。结果治疗2周后,两组患者口眼歪斜[(2.15±0.63)分比(1.12±0.71)分、(2.14±0.60)分比(1.65±0.74)分]、感觉障碍[(2.45±0.23)分比(1.32±0.73)分、(2.46±0.25)分比(1.88±0.63)分]、肢体麻木[(1.89±0.73)分比(1.04±0.53)分、(1.88±0.67)分比(1.42±0.48)分]各项中医症状积分均较治疗前显著降低,且研究组明显低于同一时间对照组(t=3.691、4.147、3.795,均P<0.001);两组患者10 m MWS[(0.34±0.15)m/s比(0.53±0.21)m/s、(0.33±0.15)m/s比(0.42±0.16)m/s]、跨步长[(61.54±16.04)cm比(78.93±20.48)cm、(59.80±17.35)cm比(69.68±18.32)cm]、步频[(65.52±10.98)步/min比(78.12±12.04)步/min、(63.10±10.89)步/min比(71.15±9.28)步/min]均较治疗前显著增加,且研究组明显优于同一时间对照组(t=2.976、2.404、3.274,均P=0.001);两组患者MBI[(44.94±3.29)分比(75.27±3.56)分、(43.32±4.51)分比(64.51±3.95)分]、FMA[(52.36±6.89)分比(73.20±5.24)分、(52.35±6.79)分比(61.97±4.88)分]、SS-QOL[(9.42±1.95)分比(15.69±1.78)分、(9.24±2.32)分比(13.65±1.96)分;(8.97±2.58)分比(19.52±1.35)分、(9.48±1.77)分比(16.20±1.72)分;(12.32±2.56)分比(25.26±2.45)分、(12.41±2.50)分比(18.20±2.44)分;(13.03±3.16)分比(20.07±2.67)分、(12.49±2.77)分比(16.60±2.78)分;(5.98±1.23)分比(12.30±1.36)分、(5.99±1.21)分比(8.25±1.37)分]评分均较治疗前显著升高,且研究组明显高于同一时间对照组(t=14.451、11.200、5.502、10.843、14.581、6.429、14.983,均P<0.001)。结论电针治疗脑卒中后偏瘫患者可有效改善其症状及肢体功能,提高患者步态及生活质量水平。
Objective To investigate the effect of electroacupuncture on hemiplegia after stroke.Methods A total of 102 patients with post-stroke hemiplegia who received treatment in Zhejiang Medical and Health Group from November 2018 to November 2019 were included in this study.They were randomly assigned to receive routine rehabilitation training(control group,n=51)or routine rehabilitation training combined with electroacupuncture(study group,n=51)for 2 weeks.Before and after 2 weeks of treatment,traditional Chinese medicine symptom scores(facial paralysis,sensory disturbance,limb numbness)and gait time-space parameters(10-m maximum walking speed,stride length,strides frequency),limb function(modified Barthel index,Fugl-Meyer Assessment score)and quality of life(Stroke Specific Quality of Life Scale)were compared between the control and study groups.Results After treatment,facial paralysis score[(2.15±0.63)points vs.(1.12±0.71)points,(2.14±0.60)points vs.(1.65±0.74)points],sensory disturbance score[(2.45±0.23)points vs.(1.32±0.73)points,(2.46±0.25)points vs.(1.88±0.63)points]and limb numbness score[(1.89±0.73)points vs.(1.04±0.53)points,(1.88±0.67)points vs.(1.42±0.48)points]in the study and control groups were significantly decreased compared with before treatment.These scores after treatment in the study group were significantly lower than those in the control group(t=3.691,4.147,3.795,all P<0.001).After treatment,10-m maximum walking speed[(0.34±0.15)m/s vs.(0.53±0.21)m/s,(0.33±0.15)m/s vs.(0.42±0.16)m/s],stride length[(61.54±16.04)cm vs.(78.93±20.48)cm,(59.80±17.35)cm vs.(69.68±18.32)cm],stride frequency[(65.52±10.98)step/min vs.(78.12±12.04)step/min,(63.10±10.89)step/min vs.(71.15±9.28)step/min]in the study and control groups were significantly increased compared with before treatment.These outcomes after treatment in the study group were superior to those in the control group(t=2.976,2.404,3.274,all P=0.001).After treatment,modified Barthel index[(44.94±3.29)vs.(75.27±3.56),(43.32±4.51)vs.(64.51±3.95)],Fugl-Meyer Assessment score[(52.36±6.89)points vs.(73.20±5.24)points,(52.35±6.79)points vs.(61.97±4.88)points]and Stroke Specific Quality of Life Scale score[(9.42±1.95)points vs.(15.69±1.78)points,(9.24±2.32)points vs.(13.65±1.96)points;(8.97±2.58)points vs.(19.52±1.35)points;(9.48±1.77)points vs.(16.20±1.72)points;(12.32±2.56)points vs.(25.26±2.45)points;(12.41±2.50)points vs.(18.20±2.44)points;(13.03±3.16)points vs.(20.07±2.67)points;(12.49±2.77)points vs.(16.60±2.78)points;(5.98±1.23)points vs.(12.30±1.36)points;(5.99±1.21)points vs.(8.25±1.37)points]in the study and control groups were significantly increased compared with before treatment.After treatment,these scores in the study group were significantly higher than those in the control group(t=14.451,11.200,5.502,10.843,14.581,6.429,14.983,all P<0.001).Conclusion Electroacupuncture can effectively improve the symptoms and limb function of patients with post-stroke hemiplegia,and improve their gait and quality of life.
作者
陈尹剑子
王翠娟
Chen Yinjianzi;Wang Cuijuan(Department of Acupuncture and Moxibustion,Hangzhou Hospital,Zhejiang Medical and Health Group,Hangzhou 310022,Zhejiang Province,China;Department of Rehabilitation,Hangzhou Hospital,Zhejiang Medical and Health Group,Hangzhou 310022,Zhejiang Province,China)
出处
《中国基层医药》
CAS
2021年第3期357-361,共5页
Chinese Journal of Primary Medicine and Pharmacy
关键词
偏瘫
电针
步行速度
跨步长
步频
肢体功能
生活质量
Paralysis
Electroacupuncture
Walking speed
Stride length
Stride frequency
Limb function
Quality of life
