摘要
目的 评价针刺疗法联合常规西医疗法作为脑血管病后偏瘫患者综合治疗方案的临床疗效及安全性。方法 采用随机对照实验设计,纳入80例脑血管病后偏瘫患者,随机分为观察组与对照组各40例。对照组采用常规西医疗法,包括抗血小板、神经保护及对症治疗;观察组在此基础上加用针刺治疗,以上肢手阳明大肠经为主,下肢涉及足阳明胃经、足太阴脾经及足少阳胆经。观察两组的治疗前、治疗4周后的运动功能(FMA)、生活能力(BI)、神经缺损(NIHSS)、肌张力(MAS)、不良反应发生率等情况。结果 治疗4周后,观察组的FMA总分、BI指数显著高于对照组,NIHSS评分显著低于对照组(P<0.05);观察组的MAS评级改善比对照组更显著(P<0.01)。两组不良反应发生率相比较差异无统计学意义(P>0.05)。结论 针刺联合常规西医可有效改善脑血管病后偏瘫患者的运动功能、生活能力及神经功能缺损,且安全性良好,其机制可能与促进神经可塑性及抑制痉挛相关。
Objective To evaluate the clinical efficacy and safety of acupuncture therapy combined with conventional Western medicine as a comprehensive treatment regimen for patients with post-stroke hemiplegia.Methods A prospective RCT assessed integrated acupuncture-Western medicine therapy versus conventional treatment alone in 80 hemiplegic stroke survivors,with random assignment to experimental(acupuncture+routine drug therapy,n=40)or control(pharmacological treatment alone,n=40)arms.Conventional treatment included antiplatelet therapy,neuroprotective agents,and symptomatic management.The observation group received additional acupuncture targeting the Hand Yangming Large Intestine Meridian for upper limbs and the Foot Yangming Stomach Meridian,Foot Taiyin Spleen Meridian,and Foot Shaoyang Gallbladder Meridian for lower limbs,administered five times per week for four weeks.Efficacy was assessed using the Fugl-Meyer Assessment(FMA)for motor function,Barthel Index(BI)for daily living ability,National Institutes of Health Stroke Scale(NIHSS)for neurological deficits,and Modified Ashworth Scale(MAS)for spasticity.Results After 4 weeks of treatment,the observation group showed significantly higher FMA total scores and BI scores,as well as significantly lower NIHSS scores,compared to the control group(P<0.05).MAS improvement was more pronounced in the observation group(P<0.01).No statistically significant difference in adverse event incidence was observed between groups(P>0.05).Conclusion Acupuncture combined with conventional Western medicine effectively improves motor function,daily living ability,and neurological deficits in post-stroke hemiplegia patients with ensured safety.The mechanism may involve enhanced neuroplasticity and suppression of spasticity.
作者
柴萌萌
孙阳
Chai Mengmeng;Sun Yang(Department of Rehabilitation Medicine,The Fourth People's Hospital of Shangqiu,Shangqiu 476000,Henan,China)
