摘要
目的探讨镜像疗法联合头部电针透穴疗法治疗缺血性脑卒中偏瘫的效果。方法选取2023年5月—2024年5月河北省沧州中西医结合医院收治的缺血性脑卒中偏瘫患者120例作为研究对象,采用随机数字表法将患者分为对照组(n=60)和治疗组(n=60)。对照组患者采用镜像疗法,治疗组患者采用镜像疗法联合头部电针透穴疗法,两组均连续治疗2个月。比较两组治疗前、治疗2个月后偏瘫侧脑血流灌注参数[脑血流量(CBF)、脑血容量(CBV)、对比剂峰值时间(TTP)、对比剂平均通过时间(MTT)及相对脑血流量(rCBF)、相对脑血容量(rCBV)、相对对比剂峰值时间(rTTP)、相对对比剂平均通过时间(rMTT)],偏瘫侧胫骨前肌、股四头肌、腓肠肌表面肌电信号(sEMG)、均方根振幅(RMS),神经功能指标[血清S100β、神经元特异性烯醇化酶(NSE)、脑源性神经营养因子(BDNF)],简化Fugl-Meyer运动功能评估量表(FMA)、Berg平衡量表(BBS)、改良巴氏指数(MBI)、脑卒中专用生活质量量表(SS-QOL)、改良Ashworth量表(MAS)评分。结果治疗2个月后,治疗组偏瘫侧CBF、CBV高于对照组,偏瘫侧TTP、MTT短于对照组,偏瘫侧rCBF、rCBV、rTTP、rMTT低于对照组(P<0.05)。治疗2个月后,治疗组偏瘫侧胫骨前肌、股四头肌、腓肠肌sEMG、RMS低于对照组(P<0.05)。治疗2个月后,治疗组血清S100β、NSE水平低于对照组,血清BDNF水平高于对照组(P<0.05)。治疗2个月后,治疗组FMA、BBS、MBI、SS-QOL评分高于对照组,MAS评分低于对照组(P<0.05)。结论镜像疗法联合头部电针透穴疗法可有效改善缺血性脑卒中偏瘫患者的脑血流灌注及神经功能,提高肌肉收缩力、肢体运动功能和平衡能力,降低肌张力,继而提高患者的日常生活活动能力及生活质量。
Objective To explore the effect of mirror therapy combined with head point-through-point electric acupuncture therapy for hemiplegia after ischemic stroke.Methods From May 2023 to May 2024,120 patients with hemiplegia after ischemic stroke were selected in Cangzhou Hospital of Integrated TCM-WM·Hebei as the research subjects,and they were divided into control group(n=60)and treatment group(n=60)by random number table method.Patients in control group received mirror therapy,while patients in treatment group received mirror therapy combined with head point-through-point electric acupuncture therapy,both groups were treated continuously for 2 months.The cerebral blood perfusion parameters of hemiplegic side[cerebral blood flow(CBF),cerebral blood volume(CBV),time to peak(TTP),mean transit time(MTT)and relative cerebral blood flow(rCBF),relative cerebral blood volume(rCBV),relative time to peak(rTTP),relative mean transit time(rMTT)],surface electromyography(sEMG),root mean square(RMS)of tibialis anterior,quadriceps femoris and gastrocnemius on the hemiplegic side,neurofunctional indicators[serum S100β,neuron specific enolase(NSE),brain derived neurotrophic factor(BDNF)]and scores of Fugl-Meyer Motor Assessment(FMA),Berg Balance Scale(BBS),Modified Barthel Index(MBI),Stroke-Specific Quality of Life Scale(SS-QOT),Modified Ashworth Scale(MAS)were compared between the two groups before treatment and after 2 months of treatment.Results After 2 months of treatment,CBF and CBV of hemiplegic side in treatment group were higher than those in control group,TTP,MTT of hemiplegic side were shorter than those in control group,rCBF,rCBV,rTTP and rMTT of hemiplegic side were lower than those in control group(P<0.05).After 2 months of treatment,sEMG and RMS of tibialis anterior,quadriceps femoris and gastrocnemius of hemiplegic side in treatment group were lower than those in control group(P<0.05).After 2 months of treatment,serum levels of S100βand NSE in treatment group were lower than those in control group,and serum level of BDNF was higher than that in control group(P<0.05).After 2 months of treatment,scores of FMA,BBS,MBI and SS-QOL in treatment group were higher than those in control group,MAS score was lower than that in control group(P<0.05).Conclusion Mirror therapy combined with head point-through-point electric acupuncture therapy can effectively improve the cerebral blood perfusion and neurological function of patients with hemiplegia after ischemic stroke,enhance muscle contractility,motor function and balance ability,reduce muscle tone,and then promote daily activity ability and quality of life.
作者
路凯
张桂成
刘鑫
吴悦
胡方梅
崔友祥
孙云川
马宇
LU Kai;ZHANG Guicheng;LIU Xin;WU Yue;HU Fangmei;CUI Youxiang;SUN Yunchuan;MA Yu(Imaging Center,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,China;Department of Traditional Chinese Medicine Acupuncture and Moxibustion,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,China;Department of Neurology,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,China;Radiotherapy Center,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061001,China)
出处
《实用心脑肺血管病杂志》
2025年第8期104-109,共6页
Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease
基金
河北省2025年度中医药类科学研究课题计划项目(2025156)。
关键词
缺血性卒中
偏瘫
镜像疗法
电针透穴疗法
Ischemic stroke
Hemiplegia
Mirror therapy
Point-through-point electric acupuncture therapy
