摘要
目的:比较不同针刺刺激量治疗中风软瘫期肢体功能障碍的临床疗效。方法:选取2022年2月—2024年3月安徽中医药大学第二附属医院中风软瘫期80例患者,随机分为对照组、小刺激量组、中刺激量组、大刺激量组,每组20例。所有患者均行内科基础治疗,对照组行普通针刺治疗,上肢取穴肩髃、曲池、手三里、合谷、外关、极泉,下肢取穴委中、足三里、阳陵泉、阴陵泉、三阴交、太溪,普通针刺得气后不行手法操作;小刺激量、中刺激量及大刺激量组均行手法操作,针刺穴位得气后分别采用小刺激量、中刺激量及大刺激量操作20 s,针刺15 min后再次采取对应的手法刺激量操作20 s,留针30 min,每日针刺1次,所有患者连续针刺6次后休息1 d,2周为1个疗程,连续治疗2个疗程,比较各组患者治疗前、治疗1个疗程后及治疗2个疗程后的中医证候评分、Fugl-Meyer运动功能评分、日常生活活动能力评分(ADL评分),评估各组的临床疗效及安全性。结果:治疗1个疗程、2个疗程后,4组患者的中医证候评分、Fugl-Meyer运动功能评分、ADL评分均随时间推移明显改善(P<0.05);治疗1个疗程后,4组患者的中医证候评分、Fugl-Meyer运动功能评分、ADL评分整体比较存在明显差异(P<0.05),组间两两比较,大刺激量组与其他3组比较存在明显差异性(P<0.05),其余各组不存在差异性(P>0.05);治疗2个疗程后,4组患者中医证候评分、Fugl-Meyer运动功能评分、ADL评分整体比较存在明显差异(P<0.05),组间两两比较,大刺激量组与其他3组比较存在明显差异性(P<0.05),其余各组无显著差异(P>0.05)。整体疗效比较,大剂量组与其他3组比较存在明显差异性(P<0.05),其余各组比较不存在差异性(P>0.05)。结论:大刺激量针刺治疗中风后软瘫期肢体功能障碍患者疗效更加确切,能更好地改善患者神经功能缺损症状。
Objective:To compare the clinical efficacy of different levels of acupuncture stimulation in treating limb dysfunction during the flaccid paralysis stage after stroke.Methods:A total of 80 patients in the flaccid paralysis stage post-stroke from February 2022 to March 2024 were selected at the Second Affiliated Hospital of Anhui University of Chinese Medicine and randomly divided into four groups:control,low-stimulation,moderate-stimulation,and high-stimulation groups,with 20 patients in each group.All patients received basic internal medicine treatment.The control group underwent usual acupuncture treatment at the following points:Jianyu(LI15),Quchi(LI11),Shousanli(LI10),Hegu(LI4),Waiguan(SJ5),and Jiquan(HT1)on the upper limbs;Weizhong(L40),Zusanli(ST36),Yanglingquan(GB34),Yinlingquan(SP9),Sanyinjiao(SP6),Taixi(KI3)on the lower limbs.Usual acupuncture treatment had no manual manipulation after“Deqi”sensation.The low,moderate,and high-stimulation groups received manual manipulation,with low,moderate,and high levels of stimulation for 20 seconds after achieving“Deqi,”and this procedure was repeated after 15 minutes needle retention.Then,the needles were retained for 30 minutes.The acupuncture was performed once daily,with a rest day after every six sessions.Each treatment course lasted two weeks,with a total of two courses.The TCM syndrome scores,Fugl-Meyer motor function scores,and Activities of daily living(ADL)scores of patients in each group before treatment,after one course of treatment,and after two courses of treatment were compared to evaluate the clinical efficacy and safety of each group.Pre-treatment,after one treatment course,and after two treatment courses,Clinical efficacy and safety were evaluated via TCM syndrome scores,Fugl-Meyer motor function scores,and Activities of Daily Living(ADL)scores.Results:TCM syndrome scores,Fugl-Meyer,and ADL scores showed significant improvement over time(P<0.05)across all groups after one and two treatment courses.Following the first treatment course,significant differences were observed between groups in TCM syndrome scores,Fugl-Meyer,and ADL scores(P<0.05),with notable differences between the high-stimulation group and other groups(P<0.05),while no differences were observed between the other groups(P>0.05).After two courses,TCM syndrome scores,Fugl-Meyer,and ADL scores exhibited similar group differences,with the high-stimulation group showing significantly better outcomes(P<0.05),and no differences observed between the other groups(P>0.05).Overall,the high-stimulation group demonstrated significantly better efficacy(P<0.05),with no significant differences among the other groups(P>0.05).Conclusion:High-stimulation acupuncture treatment for limb dysfunction in the flaccid paralysis stage after stroke is more effective,significantly improving neurological deficit symptoms.
作者
郑之俊
梁发俊
章显宝
张静波
浦延鹏
王震
ZHENG Zhijun;LIANG Fajun;ZHANG Xianbao;ZHANG Jingbo;PU Yanpeng;WANG Zhen(The 6th Department of Brain Disease,Second Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230061,China)
出处
《中医药学报》
2025年第5期40-46,共7页
Acta Chinese Medicine and Pharmacology
基金
安徽省自然科学基金项目(RZ2300001602)
安徽省高校自然科学研究重点项目(2023AH050769)
安徽中医药大学临床科研项目(2021efylc16)
安徽中医药大学第二附属医院人才支持项目。
关键词
中风软瘫期
肢体功能障碍
不同刺激量
针刺
Flaccid paralysis stage after stroke
Limb dysfunction
Different stimulation levels
Acupuncture
