摘要
[目的]观察针刺联合推拿治疗脑卒中后肌张力增高(气滞血瘀、肝肾阴虚)疗效。[方法]使用随机平行对照方法,将140例住院患者按病案号抽签随机分两组。对照组70例康复训练,早期牵拉上下肢使其充分放松,后期指导患者对患肢先水平方向移动,以患者肘、膝关节为中心,固定患者肘、膝关节,对患肢被动训练;牵手、拧绳、握拳训练,从充分放松局部关节后,仰卧位,双臂上举过头,下肢充分伸展,直至患者感到舒适后放松;坐位,曲臂上举,嘱患者髋关节不动,以髋关节为中心,上身躯体分别向左、右转动45~90°,左右旋转5次为1组,做3组。治疗组70例,针刺:合谷、三阴交、内庭、足三里等,照海、大陵、内关为配穴;留针30min,每15min行针一次,5次/周;拿法按摩患侧,配合患肢外展、内收等动作,充分松弛肌肉群,手法轻柔、有力,30min/次,1次/d;点揉尺泽、肩井、曲池及膝眼、承山、委中、解溪等;康复训练同对照组。连续治疗7d为1疗程。观测临床症状、日常生活活动能力(ADL)、改良Ashworth量表(MAS)、不良反应。连续治疗3疗程,判定疗效。[结果]治疗组显效56例,有效12例,无效2例,总有效率97.10%;对照组显效39例,有效22例,无效9例,总有效率88.60%;治疗组疗效优于对照组(P<0.01)。日常生活活动能力(BADL)、改良Ashworth量表(MAS)两组均有改善(P<0.01),治疗组改善优于对照组(P<0.01)。[结论]针刺联合推拿治疗脑卒中后肌张力增高(气滞血瘀、肝肾阴虚),疗效满意,无严重不良反应,值得推广。
[Objective] To observe the effect of acupuncture combined with massage on hypertonicity （Qi stagnation, blood stasis, and liver-kidney yin deficiency） after stroke. [Method] Randomized parallel control method was used to randomly divide 140 inpatients into two groups according to the disease records. In the control group, 70 patients were rehabilitated. The upper and lower limbs were pulled to make them fully relaxed. Later, the patient was instructed to move horizontally on the affected limbs. The elbow and knee joints were the center of the patient＇s elbows and knee joints. The patient＇s elbows and knee joints were fixed and the affected limbs were passively trained. Holding hands, twisting ropes, and making fist-training exercises, after fully relaxing the local joints, supine position, raising arms over their heads, fully stretching the lower limbs until the patient feels comfortable and relaxing, sitting position, lifting arms, and holding the patient＇s hip joint motionless The hip joint is centered, and the upper body is rotated 45° to 90° to the left and right, and the left and right sides are rotated 5 times to form a group of 3 groups. In the treatment group 70 cases, acupuncture： Hegu, Sanyinjiao, Inner Court, Zusanli, etc., according to the sea, Daling, Neiguan as acupuncture points; retention needle 30min, once every 15min needle, 5 times/week; holding the massage affected side, With the limbs abduction, adduction and other movements, fully relax muscle groups, gentle and powerful techniques, 30 min/time, 1 time/d; point rub rub feet, shoulder well, Quchi and knee eyes,Chengshan, Venezuela, Xie Xi et al.; rehabilitation training with the control group. Continuous treatment 7d is a course of treatment. Observed clinical symptoms, activities of daily living （ADL）, modified Ashworth scale （MAS）, and adverse reactions. Continuous treatment of 3 courses to determine efficacy. [Results] In the treatment group, 56 cases were markedly effective, 12 cases were effective, 2 cases were ineffective, and the total effective rate was 97.10%. In the control group, 39 cases were markedly effective, 22 cases were effective, 9 cases were ineffective, and the total effective rate was 88.60%. The curative effect of the treatment group was better than that of the control group. （P〈0.01）. Both activities of daily living （BADL） and modified Ashworth （MAS） improved in both groups （P〈0.01）, and the treatment group improved better than the control group （P〈0.01）. [Conclusion] Acupuncture and massage combined with treatment of post-stroke muscle hypertonia （Qi stagnation, blood stasis, liver-kidney yin deficiency） have satisfactory curative effect and no serious adverse reactions. It is worth promoting.
作者
周越
ZHOU Yne(Rehabilitation Department of the Second People＇s Hospital,Panzhihua 617000,Sichuan,China)
出处
《实用中医内科杂志》
2018年第7期69-71,77,共4页
Journal of Practical Traditional Chinese Internal Medicine
关键词
肌张力增高
脑卒中
气滞血瘀
肝肾阴虚
针刺
推拿
康复训练
日常生活活动能力(ADL)
改良Ashworth量表(MAS)
中医药治疗
随机平行对照研究
hypertonia
stroke
Qi stagnation and blood stasis（气滞血瘀）
liver and kidney Yin deficiency（肝肾阴虚）
acupuncture
massage
rehabilitation training
activities of daily living （ADL）
modified ashworth scale （MAS）
Chinese medicine treatment
random parallel control the study
