摘要
目的:采用表面肌电图观察腹部透灸法对中风患者腹横肌、多裂肌肌肉电生理的影响,并采用相关量表评价其对患者姿势控制和下肢运动功能的影响。方法:将58例脑卒中患者随机分为透灸组和对照组,每组29例。两组均予以常规针刺、内科基础治疗和康复训练,透灸组在此基础上加用腹部透灸法,以神阙穴为中心放置,每次治疗约50min。两组共治疗4周,每周5天,于治疗前、治疗4周后检测双侧腹横肌、多裂肌的均方根值(RMS)变化,并于治疗前,治疗2周后、治疗4周后,对脑卒中患者进行姿势控制量表(PASS)、下肢Fugl-Meyer运动功能评定量表(FMA)评分。结果:治疗后,透灸组患者双侧RMS值均较治疗前升高(患侧P<0.01,健侧P<0.05),对照组患者双侧RMS值亦较治疗前上升(均P<0.05);治疗后透灸组患者患侧RMS值高于对照组(P<0.05),健侧RMS值与对照组比较差异无统计学意义(P>0.05)。健患侧比较,从坐到站,治疗前两组患者健侧RMS值均高于患侧(均P<0.05),治疗后透灸组患者双侧RMS值比较差异无统计学意义(P>0.05),而对照组患者健侧RMS值高于患侧(P<0.05);健侧迈步,治疗前两组患者健侧RMS值均高于患侧(均P<0.05),治疗后两组双侧RMS值差异均无统计学意义(均P>0.05);患侧迈步,治疗前两组健侧RMS值均明显高于患侧(均P<0.01),治疗后透灸组健侧RMS值高于患侧(P<0.05),而对照组健侧RMS值明显高于患侧(P<0.01)。治疗4周后,两组患者PASS、下肢FMA评分较治疗前均有改善(P<0.01)。治疗4周后,透灸组患者两项量表评分均优于对照组(P<0.01)。结论:腹部透灸法可以有效改善脑卒中患者腹横肌和多裂肌的肌力,并改善姿势控制和下肢运动功能。
Objective:To observe the electrophysiological changes of abdominal transverse muscle and multifidus muscles of stroke patients by using surface electromyography,and to evaluate their effects on posture control and lower limb motor function using related scales.Methods:58 patients with stroke were randomly divided into penetrating moxibustion group(n=29)and control group(n=29).Both groups were given routine acupuncture,basic medical treatment and rehabilitation training.On this basis,the penetrating moxibustion group was treated with abdominal penetrating moxibustion,with Shenque acupoint as the center,about 50 min each treatment.The two groups were treated for 4 weeks,5 days a week.The changes of root mean square(RMS)of bilateral transverse abdominis muscle and multifida muscle were detected before and 4 weeks after treatment.The stroke patients’postural control scale(PASS)and lower limb Fugl-Meyer motor function scale(FMA)were evaluated before treatment,2 weeks after treatment and 4 weeks after treatment.Results:After treatment,the RMS values of both sides in the penetrating moxibustion group were higher than those before treatment(affected side P<0.01,healthy side P<0.05),and the RMS values of both sides in the control group were also higher than those before treatment(all P<0.05);The RMS value of the affected side in the penetrating moxibustion group was higher than that in the control group(P<0.05),but there was no significant difference between the healthy side and the control group(P>0.05).Comparison of the healthy side and the affected side,from sitting to standing,the healthy side of the two groups was higher than that of the affected side before treatment(all P<0.05),there was no significant difference between the two sides in the penetrating moxibustion group after treatment(P>0.05),the healthy side was higher than the affected side in the control group(P<0.05);When the healthy side took a step,the healthy side of the two groups were higher than the affected side before treatment(all P<0.05),and the differences between the affected side and the healthy side of the two groups were not significant after treatment(all P>0.05).When the affected side took a step,the healthy side of the two groups were significantly higher than the affected side before treatment(all P<0.01).After treatment,the healthy side of the penetrating moxibustion group was higher than the affected side(P<0.05),while the healthy side of the control group was significantly higher than the affected side(P<0.01).After 4 weeks of treatment,the scores of PASS and FMA of lower extremities in both groups were improved(P<0.01).After 4 weeks of treatment,the scores of the two scales in the penetrating moxibustion group were better than those in the control group(P<0.01).Conclusion:Abdominal penetrating moxibustion can effectively improve the muscle strength of transverse abdominis and multifidus muscles,and improve posture control and lower limb motor function in patients with stroke.
作者
潘顺丹
阮传亮
陈桂芬
Pan Shundan;Ruan Chuanliang;Chen Guifen(College of Acupuncture,Fujian University of Traditional Chinese Medicine,Fuzhou 350108,China;Quanzhou Traditional Chinese Medical Hospital,Quanzhou 362000,China)
出处
《亚太传统医药》
2020年第11期111-115,共5页
Asia-Pacific Traditional Medicine
基金
福建省泉州市科技计划项目(2019N058S)
关键词
中风
表面肌电图
透灸法
Stroke
Surface Electromyography
Penetrating Moxibustion
作者简介
潘顺丹(1994-),女,福建中医药大学硕士研究生,研究方向为针灸、康复治疗脑血管疾病;通讯作者:阮传亮(1973-),男,博士,福建中医药大学附属泉州市中医院副主任医师,硕士生导师,研究方向为针灸、康复治疗脑血管疾病。E-mail:rclcat@21cn.com
