摘要
目的:评价针刺中药康复综合方案治疗中风弛缓性肢体功能障碍的临床价值。方法:采用4中心、单盲、随机、对照研究方法,将240例患者按1∶1比例随机分为综合组、针刺组、康复组、中药组,每组60例。综合组给予针刺、中药、康复综合方案治疗,其中针刺疗法包括取顶中线、顶旁1线、顶旁2线等行单式徐疾补泻法的头针疗法和取患肢拮抗肌群穴行捻转补泻法的体针疗法;中药疗法根据中医辨证属肝肾阴虚、风阳上扰证者服用中风协方Ⅰ号,气虚血瘀、脉络瘀阻证者服用中风协方Ⅱ号,痰瘀互结、阻滞脉络证者服用中风协方Ⅲ号;康复疗法为良肢位摆放加以促通技术为主的康复技术。针刺组、康复组、中药组分别采用综合组中的单纯针刺、单纯康复、单纯中药疗法治疗。以中医证候、肢体运动功能、日常生活能力及晕针反应、过敏反应等为指标评价治疗措施的疗效及安全性。结果:①治疗后4组患者中医证候、肢体运动功能、肢体平衡功能、日常生活能力4项指标均较治疗前得到显著改善(均P<0.01)。②综合组患者上述4项指标的改善程度均较其他3组更显著(P<0.01,P<0.05);针刺组、中药组患者中医证候的改善较康复组显著(均P<0.05);针刺组上肢运动功能的改善较康复组、中药组显著(均P<0.05)。结论:以针刺、中药、康复疗法组成的综合方案治疗中风弛缓性肢体功能障碍安全有效,且较其中任一单一疗法治疗更具疗效优势。
Objective To evaluate the clinical value of the comprehensive therapy of acupuncture,Chinese herbal medicine and rehabilitation in the treatment of post-stroke flaccid limb dysfunction.Methods The four-center,single-blind,randomized and controlled research method was adopted,240 qualified subjects were randomized into a comprehensive therapy group,an acupuncture group,a rehabilitation group and a Chinese herbal medicine group,60 cases in each one,at the ratio of 1∶1.In the comprehensive therapy group,the comprehensive therapy of acupuncture,Chinese herbal medicine and rehabilitation was applied.The acupuncture therapy included the scale acupuncture at middle line of vertex,lateral line 1 of vertex,lateral line 2 of vertex,etc.with the single reinforcing and reducing technique by the speed of needle insertion and withdrawal,and the body acupuncture therapy at the acupoints on the antagonistic muscles with the reinforcing and reducing technique by the needle rotation.The Chinese herbal medicine therapy included No.1 stroke formula for the cases of liver and kidney yin deficiency and the upward disturbance of wind yang,No.2 stroke formula for qi deficiency and blood stagnation,and the stagnation in meridians and No.3 stroke formula for the interaction of phlegm and stasis and blockage of meridians according to the pattern/syndrome differentiation.The rehabilitation therapy focused on the promotion technique by putting the healthy limb.The simple acupuncture,rehabilitation and Chinese herbal medicine therapies as the comprehensive therapy group were applied in the acupuncture group,rehabilitation group and Chinese herbal medicine group separately.The Chinese medicine symptom,the limb motor function,the daily life activity,fainting needle reaction,allergic reaction and the others were taken as indices to evaluate the efficacy and safety of the treatment. Results（1） The results of the four indices named the Chinese medicine symptom,the limb motor function,the limb balance function,the daily life activity were all improved significantly after treatment as compared with those before treat ment in four groups（all P0.01）.（2） Concerning to the improvement degrees,the improvements of the above four indices in the comprehensive therapy group were more significant than those in the other three groups（P0.01,P0.05）.The improvement in Chinese medicine symptom in the acupuncture group and the Chinese herbal medicine group were more significant than that in the rehabilitation group（both P0.05）.The improvement of the upper limb motor function in the acupuncture group was more significant than that in the rehabilitation group and the Chinese herbal medicine group separately（both P0.05）.ConclusionThe comprehensive therapeutic program of acupuncture,Chinese herbal medicine and rehabilitation is safe and effective in the treatment of post-stroke flaccid limb dysfunction.It is more advantageous in efficacy as compared with any simple therapy.
出处
《中国针灸》
CAS
CSCD
北大核心
2012年第12期1057-1062,共6页
Chinese Acupuncture & Moxibustion
基金
四川省科技攻关计划项目:2006z09-004-02
关键词
肢体功能障碍
中风后遗症
针刺疗法
综合疗法
随机对照试验
Dysfunction of Limbs and Trunk
Stroke Sequela
Acupuncture Therapy
Comprehensive Therapy
Randomized Controlled Trial（RCT）
