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1.西安市中医医院针灸推拿康复科,陕西西安710021
2.宁波市海曙区第二医院针灸推拿科,浙江宁波315153
3.陕西中医药大学针灸推拿学院
毛浩亮,主治医师。E-mail:534796805@qq.com
收稿:2023-01-31,
网络首发:2023-07-21,
纸质出版:2023-10-12
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刘艳芳,毛浩亮,李彦娇等.互动式头针治疗缺血性脑卒中偏瘫上肢功能障碍:随机对照试验[J].中国针灸,2023,43(10):1109-1113.
LIU Yan-fang,MAO Hao-liang,LI Yan-jiao,et al.Interactive scalp acupuncture for hemiplegic upper extremity motor dysfunction in patients with ischemic stroke: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(10):1109-1113.
刘艳芳,毛浩亮,李彦娇等.互动式头针治疗缺血性脑卒中偏瘫上肢功能障碍:随机对照试验[J].中国针灸,2023,43(10):1109-1113. DOI: 10.13703/j.0255-2930.20230131-0002.
LIU Yan-fang,MAO Hao-liang,LI Yan-jiao,et al.Interactive scalp acupuncture for hemiplegic upper extremity motor dysfunction in patients with ischemic stroke: a randomized controlled trial[J].Chinese Acupuncture & Moxibustion,2023,43(10):1109-1113. DOI: 10.13703/j.0255-2930.20230131-0002.
目的
2
比较互动式头针与传统头针治疗缺血性脑卒中偏瘫上肢功能障碍的疗效。
方法
2
将70例缺血性脑卒中偏瘫上肢功能障碍患者随机分为互动头针组(35例,中止1例)和传统头针组(35例,脱落1例)。两组患者均予脑梗死二级预防药物及常规康复治疗。互动头针组在头针留针期间同时进行上肢作业疗法,传统头针组在头针结束后进行上肢作业疗法。两组取穴相同,均取伏象头部、伏象上肢肩点、伏象上肢肘点、伏象上肢腕点等,采用飞针直刺法进针,轻捻重压震颤三联法行针,留针30 min;根据患者上肢运动功能障碍程度的不同,制定个体化的上肢作业疗法方案,每次30 min。两组均每日1次,每周治疗5次,治疗4周。观察两组治疗前后Fugl-Meyer上肢运动功能评定量表(FMA-UE)、Wolf运动功能测试量表(WMFT)、改良 Barthel 指数(MBI)评分及改良 Ashworth 量表(MAS)分级。
结果
2
治疗后,两组患者FMA-UE评分、WMFT评分、 MBI评分均高于治疗前(
P
<
0.01),MAS分级较治疗前改善(
P
<
0.05);互动头针组FMA-UE 评分、WMFT评分和 MBI 评分均高于传统头针组(
P
<
0.01,
P
<
0.05),但两组MAS分级比较差异无统计学意义(
P
>
0.05)。
结论
2
互动式头针可有效改善缺血性脑卒中偏瘫患者上肢运动功能,提高其日常生活活动能力,疗效优于传统头针,但在改善痉挛方面两者疗效相当。
Objective
2
To compare the curative effect between interactive scalp acupuncture and traditional scalp acupuncture on hemiplegic upper extremity motor dysfunction in the patients with ischemic stroke.
Methods
2
Seventy cases of hemiplegic upper extremity motor dysfunction of ischemic stroke were randomly divided into an interactive scalp acupuncture group (35 cases
1 case breaked off) and a traditional scalp acupuncture group (35 cases
1 case dropped off). The patients of the two groups received the secondary prevention medication and routine rehabilitation therapy. Besides
in the interactive scalp acupuncture group
the upper extremity occupational therapy was operated during the needle retaining of scalp acupuncture; and in the traditional scalp acupuncture group
the upper extremity occupational therapy was delivered after the completion of scalp acupuncture. The same points were selected in the two groups such as
Fuxiang
head area
Fuxiang
upper-limb-shoulder point
Fuxiang
upper-limb-elbow point and
Fuxiang
upper-limb-wrist point. The needles were inserted perpendicularly by flying-needle technique and manipulated by triple technique of gentle twisting
heavy pressure and vibrating. The needles were retained for 30 min. Based on the degree of the upper extremity motor impairment
the regimen of the upper extremity occupational therapy was formulated individually and one treatment took 30 min. In the two groups
the therapies were delivered once daily
5 times a week
lasting 4 weeks. Before and after treatment
the scores of Fugl-Meyer assessment of upper extremity (FMA-UE)
Wolf motor function test (WMFT)
the modified Barthel index (MBI) and the modified Ashworth scale (MAS) grade in the two groups were observed before and after treatment.
Results
2
After treatment
the scores of FMA-UE
WMFT and MBI were higher than those before treatment (
P
<
0.01)
and MAS grade was improved (
P
<
0.05) in the two groups. The scores of FMA-UE
WMFT and MBI in the interactive scalp acupuncture group were higher than those in the traditional scalp acupuncture group (
P
<
0.01
P
<
0.05)
and there was no statistical significance in the difference of MAS grade between the two groups (
P
>
0.05).
Conclusion
2
The interactive scalp acupuncture can effectively improve the motor function of the hemiplegic upper extremities and the activities of daily living in the patients with ischemic stroke and its efficacy is better than traditional scalp acupuncture. But these two types of scalp acupuncture obtain the similar effect on spasticity.
王陇德 , 彭斌 , 张鸿祺 , 等 . 《中国脑卒中防治报告2020》概要 [J ] . 中国脑血管病杂志 , 2022 , 19 ( 2 ): 136 - 144 .
潘俊晓 , 陈艳萍 , 位娜娜 . 平衡针结合运动再学习疗法对脑卒中患者上肢功能恢复的影响 [J ] . 针刺研究 , 2018 , 43 ( 2 ): 123 - 126 .
汪军 , 裴建 , 崔晓 , 等 . 互动式头针结合作业疗法治疗脑卒中上肢运动功能障碍:随机对照研究 [J ] . 中国针灸 , 2015 , 35 ( 10 ): 983 - 989 .
Xu Y , Lin SF , Jiang C , et al . Synergistic effect of acupuncture and mirror therapy on post-stroke upper limb dysfunction:a study protocol for a randomized controlled trial [J ] . Trials , 2018 , 19 ( 1 ): 303 .
中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学组 . 中国急性缺血性脑卒中诊治指南2018 [J ] . 中华神经科杂志 , 2018 , 51 ( 9 ): 666 - 682 .
唐强 . 临床康复学 [M ] . 北京 : 中国中医药出版社 , 2017 : 21 .
中华医学会神经病学分会 , 中华医学会神经病学分会脑血管病学组 , 彭斌 , 等 . 中国缺血性卒中和短暂性脑缺血发作二级预防指南2022 [J ] . 中华神经科杂志 , 2022 , 55 ( 10 ): 1071 - 1110 .
周琳 , 刘征 , 曹中伟 . 脑卒中后患者康复研究现状与中医药康复治疗研究进展 [J ] . 上海中医药杂志 , 2023 , 57 ( 5 ): 96 - 100 .
方本正 . 头皮针: 方氏针灸创新之一 [M ] . 西安 : 陕西科学技术出版社 , 1994 : 52 - 99 .
刘艳芳 , 安军明 , 刘益华 . 黄琳娜教授运用方氏头针治疗抽动秽语综合征经验总结 [J ] . 中国针灸 , 2019 , 39 ( 7 ): 765 - 770 .
纪树荣 . 运动疗法技术学 [M ] . 北京 : 华夏出版社 , 2004 : 342 .
卞立 , 董万利 , 张丽 , 等 . Orem部分补偿的团体作业治疗在脑卒中上肢运动障碍患者中的应用 [J ] . 中国康复 , 2022 , 37 ( 3 ): 136 - 139 .
Amano S , Umeji A , Takebayashi T , et al . Clinimetric properties of the shortened Fugl-Meyer assessment for the assessment of arm motor function in hemiparetic patients after stroke [J ] . Top Stroke Rehabil , 2020 , 27 ( 4 ): 290 - 295 .
Kim TL , Hwang SH , Lee WJ , et al . The Korean version of the fugl-meyer assessment:reliability and validity evaluation [J ] . Ann Rehabil Med , 2021 , 45 ( 2 ): 83 - 98 .
吴娱倩 , 张玉梅 , 孟霞 , 等 . Wolf运动功能测试量表评定卒中患者偏瘫侧上肢功能的效度和信度研究 [J ] . 中国卒中杂志 , 2022 , 17 ( 3 ): 244 - 250 .
王赛华 , 施加加 , 孙莹 , 等 . 简体版改良Barthel指数在脑卒中恢复期中的信度与效度研究 [J ] . 中国康复 , 2020 , 35 ( 4 ): 179 - 182 .
郭铁成 , 卫小梅 , 陈小红 . 改良Ashworth量表用于痉挛评定的信度研究 [J ] . 中国康复医学杂志 , 2008 , 23 ( 10 ): 906 - 909 .
王玉龙 . 康复功能评定学 [M ] . 3版 . 北京 : 人民卫生出版社 , 2018 .
祁丽丽 , 韩振翔 , 周一心 , 等 . 互动式头针结合PNF技术对缺血性卒中痉挛性偏瘫上肢功能的影响 [J ] . 中国针灸 , 2018 , 38 ( 3 ): 234 - 238 .
章春霞 , 张绍华 , 王玉龙 , 等 . 互动式头针治疗脑卒中后认知功能障碍:随机对照研究 [J ] . 中国针灸 , 2021 , 41 ( 3 ): 252 - 256 .
尹正录 , 孟兆祥 , 葛晟 , 等 . 互动式头针结合任务导向性镜像疗法治疗缺血性脑卒中偏瘫上肢功能障碍临床观察 [J ] . 中国针灸 , 2020 , 40 ( 9 ): 918 - 922 .
沈家兴 . 方氏头皮针结合体针治疗心肾不交型失眠的临床疗效观察 [D ] . 广州 : 广州中医药大学 , 2016 .
宋玉娟 . 头穴丛刺为主针刺联合康复训练对脑梗死(恢复期)患者神经功能恢复的影响 [J ] . 针灸临床杂志 , 2014 , 30 ( 7 ): 52 - 54 .
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