摘要
目的:比较"截瘫三联针法"与常规针刺治疗外伤性胸腰段脊髓损伤(SCI)的疗效差异。方法:采用前瞻性随机对照试验设计,将48例外伤性胸腰段SCI患者随机分为观察组和对照组,每组24例。两组均进行常规康复治疗训练,观察组在此基础上采用"截瘫三联针法",即针刺脊髓损伤平面上两节段及下两节段督脉穴、背俞穴,在电刺激引导下针刺双下肢关键肌运动点,并给予脉冲电刺激;对照组采用目前常用体针穴位针刺,穴取环跳、足三里、悬钟、三阴交。两组每日治疗1次,1个月为一疗程,共治疗3个疗程。于治疗前后及治疗结束后1个月随访时采用改良Barthel指数(MBI)、功能综合评定量表(FCA)对患者日常生活活动能力和综合功能进行评定,并以MBI、FCA得分为双反应变量拟合多水平模型,观察两组的MBI、FCA随着时间的变化趋势。结果:随访时两组MBI、FCA评分均较治疗前改善(均P<0.05),两组间MBI和FCA评分在各个时间点的比较,差异均无统计学意义(均P>0.05)。在观察的4个月内,两组MBI和FCA均随着时间的推移有增长的趋势,且趋势大致呈线性,随着时间的推移,观察组的增长幅度更大些,说明两组的近期治疗效果无差别,但是观察组的远期效果更优。结论:"截瘫三联针法"和常规针刺法均能改善外伤性胸腰段SCI患者的日常生活活动能力和综合功能,但从远期效果来看,"截瘫三联针法"结合康复训练疗效更佳,是一种安全有效的治疗方案。
Objective To compare the differences in the efficacy on traumatic spinal cord injury（SCI） in the thoracic and lumbar vertebra between the paraplegia-triple-needling method and the conventional acupuncture the- rapy. Methods The perspectively randomized controlled trial was adopted. Forty-eight cases of traumatic SCI in the thoracic and lumbar vertebra were randomized into an obserwltion group and a control group. 24 cases in each one. The conventional rehabilitation training was applied in both groups. In addition, the paraplegia-triple needling method was used in the observation group. In the treatment, acupuncture was applied to the points of the Gover- nor Vessel and the Back-shu which, located two segments above and below the spinal injury plane separately. Acu puncture with the electric pulsing stimulation was applied to the motor points of the key muscles of the lower ex tremities. In the control group, the conventional acupuncture was applied to Huantiao （GB 30）, Zusanli （ST 36）, Xuanzhong （GB 39） and Sanyinjiao （SP 6）. In each group, the treatment was given once a day, one month treatment made 1 session. Totally, 3 sessions of lreatment were required. Before and after treatment, as well as in lmmnth follow-up visit after treatment, the modified BartheI index （MBI） and the function comprehensive assessment （FCA） were adopted to assess the activities of daily life （ADI） and the comprehensive function of the patients. The score of MBI and FCA were taken as the double response variables to imitate the muhilevel model. The changing tendency of MBI and FCA along with the time was observed in two groups. Results In the follow-up visit, MBI and FCA score were all improved as compared with those before treatment in two groups （all P〈0.05）. There were no statistically significant differences in MBI and FCA score at arly time point between two groups （all P〉0.05）. In 4-month observation, there was a rising tendency with time in MBI and FAC seoe in both groups, which was roughly linear. As time went on, the increasing amplitude in the observation group was much bigger. It was explained that there was no difference in the short-term efficacy between two groups. Howe ver. the long term efficacy in the observation group was much better. Conclusion Both the paraplegia lriple nee dling method and the conventional acupuncture therapy can improve the ADL and the eomprehensive function of the patients with traumatic SCI of the thoracic and lumbar vertebra. Concerning the long term efficacy, the paraplegia triple needling combined with the rehabilitation training achieves better resuh. This therapeutic program is safe and effective.
出处
《中国针灸》
CAS
CSCD
北大核心
2012年第10期877-881,共5页
Chinese Acupuncture & Moxibustion
基金
军队中医药科研专项重点课题项目:10ZYZ 118
全军医学科技"十二五"科研面上项目:CWS 11J284
关键词
脊髓损伤
电针
康复训练
截瘫三联针法
Spinal Injury
Electroacupuncture
Rehabilitation Training
Paraplegia-Triple Needling
