摘要
目的:比较辰时腹部艾灸联合康复训练与单纯康复训练治疗中风后下肢痉挛的疗效。方法:将100例中风后下肢痉挛患者随机分为观察组(50例,脱落3例)和对照组(50例,脱落4例)。对照组予内科基础治疗及肢体康复训练;观察组在对照组的基础上于辰时(7:00-9:00)采用八卦灸盒行腹部艾灸(中央灸盒对准神阙穴),持续2 h,隔日1次,两组均治疗6周。分别于治疗前后评定两组患者患侧Fugl-Meyer下肢运动功能评分及踝关节改良Ashworth痉挛量表评级,采用肌骨超声检测两组患者患侧胫骨前肌第一层厚度、羽状角度数及腓肠肌内侧头的肌纤维长度,并于治疗后评定两组疗效。结果:治疗后两组患者患侧Fugl-Meyer下肢运动功能评分、患侧踝关节改良Ashworth痉挛量表评级均较治疗前改善(P<0.01,P<0.05),且观察组Fugl-Meyer下肢运动功能评分改善程度及改良Ashworth痉挛量表评级优于对照组(P<0.01,P<0.05)。治疗后两组患者胫骨前肌第一层厚度、羽状角度数及腓肠肌内侧头的肌纤维长度均较治疗前增加(P<0.01),且观察组增加幅度大于对照组(P<0.01)。观察组临床总有效率为93.6%(44/47),高于对照组的80.4%(37/46,P<0.05)。结论:辰时腹部艾灸联合康复训练能有效改善中风后下肢痉挛程度,改善肢体功能与肌肉结构,总体疗效优于单纯康复训练。
Objective To compare the therapeutic effect on post-stroke lower limb spasticity between the combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training and the simple rehabilitation training.Methods A total of 100 patients with post-stroke lower limb spasticity were randomized into an observation group(50 cases,3 cases dropped off)and a control group(50 cases,4 cases dropped off).In the control group,the basic treatment of internal medicine and rehabilitation training of the limbs were adopted.In the observation group,on the basis of the treatment in the control group,at the time zone from 7 am to 9 am,moxibustion on the abdomen with"eight-trigram"moxa box[the central moxa box accurately facing Shenque(CV 8)]was given,lasting for 2 h,once every two days.Both groups were treated for 6 weeks.Separately,before and after treatment,the score of Fugl-Meyer assessment of the lower extremity(FMA-LE)and the grade of modified Ashworth scale(MAS)of ankle joint were evaluated on the affected side in patients of the two groups.Muscle skeleton ultrasound(MSUS)was adopted to determine the first layer muscle thickness(MT)anterior to the tibia,the number of pennation angle(PA)and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side.Besides,after treatment,the therapeutic effect was evaluated in the two groups.Results After treatment,the score of FMA-LE and the grade of MAS of ankle joint on the affected side were both improved as compared with those before treatment in patients of the two groups(P<0.01,P<0.05).The improvements in the observation group were better than those in the control group(P<0.01,P<0.05).After treatment,MT anterior to the tibia,the number of PA and the length of muscle fibers in the medial head of gastrocnemius muscle on the affected side were all increased as compared with before treatment in patients of the two groups(P<0.01).The increase degree in the observation group was larger than that in the control group(P<0.01).The total effective rate was 93.6%(44/47)in the observation group,better than 80.4%(37/46)in the control group(P<0.05).Conclusion The combined treatment of abdominal moxibustion from 7 am to 9 am and rehabilitation training effectively relieves post-stroke lower limb spasticity and improves the limb functions and muscle structure.The total effective rate of this combined treatment is better than that of simple rehabilitation training.
作者
林子涵
阮传亮
周文强
曾丽蓉
陈春燕
曾萍萍
LIN Zi-han;RUAN Chuan-liang;ZHOU Wen-qiang;ZENG Li-rong;CHEN Chun-yan;ZENG Ping-ping(Department of Acupuncture-Moxibustion and Rehabilitation,Quanzhou Hospital of TCM Affiliated to Fujian University of TCM,Quanzhou 362000,China)
出处
《中国针灸》
CAS
CSCD
北大核心
2020年第10期1042-1046,共5页
Chinese Acupuncture & Moxibustion
基金
泉州市科技计划项目:2018N100S。
关键词
中风
下肢痉挛
辰时
艾灸
康复训练
肌骨超声
随机对照试验
stroke
lower limb spasticity
a period of the day from 7 am to 9 am
moxibustion
rehabilitation training
muscle skeleton ultrasound
randomized controlled trial(RCT)
作者简介
第一作者:林子涵,主治中医师。E-mail:icerain126@126.com。
