摘要
目的：探讨针刺结合康复训练与单纯康复训练治疗脑卒中后足下垂患者的临床疗效差异性。方法：选取2013年5月—2015年5月于本中心就诊的脑卒中后足下垂患者92例,随机分为联合组和常规组各46例,常规组给予常规康复训练而联合组在常规训练基础上加用针刺特定穴位治疗,比较两组治疗前后胫前肌及腓肠肌表面肌电值（i MEG）及两肌肉在踝背屈状态下的协同收缩率（CR）,比较治疗前后患肢H反射中Hmax/Mmax;比较两组治疗前后患肢FuglMeyer下肢运动功能评分（FMA）,并对胫前肌肌力进行MMT分级Kendall百分比法评价,选用Ashworth量表对小腿三头肌肌张力进行评价;比较两组治疗前后步行能力（FAC）及踝关节活动度。结果：治疗后联合组在FMA、胫前肌肌力、FAC和踝关节活动度上较常规组更高,小腿三头肌肌张力则明显较常规组低,差异均有统计学意义（P〈0.05）;治疗后联合组在Hmax/Mmax、腓肠肌i MEG及CR上较常规组下降更低,胫前肌i MEG则明显较常规组上升更高,差异均有统计学意义（P〈0.05）。结论：常规康复训练加上取穴主用阳明经穴位,辅以针刺拮抗肌穴位的方法,能够从多途径治疗脑卒中后足下垂畸形,且效果良好,值进临床推广。
Objective： To compare the clinical efficacy difference between acupuncture combined with rehabilitation and simple rehabilitation for foot drop after stroke. Methods： Ninety-two patients were randomly divided into combination group and routine group（ both n = 46）. The routine group got the routine rehabilitation while the combination group got acupuncture and rehabilitation. The i MEG and CR of the musculi hippicus and gastrocnemius,the Hmax/Mmax,the FMA,the animal force of the musculi hippicus and the muscular tension of the gastrocnemius,the FAC and the Ankle motion were compared between the 2 groups before and after treatment. Results： The combination group owned a higher FMA,the animal force of the musculi hippicus,FAC and Ankle motion and owned a lower muscular tension of the gastrocnemius（ P〈0. 05）. The ombination group owned a lower Hmax/Mmax,i MEG of the gastrocnemius and CR,but a higher i MEG of the musculi hippicus than the routine group＇s（ P〈0. 05）. Conclusion： Acupuncture combined with rehabilitation for foot drop after stroke was safe and reliable,owning a significant effect,worthy of clinical appliation.
作者
王争
陈钢
WANG Zheng,CHEN Gang(Department of Rehabilitation Medicine, PU Ai Hospital Affiliated to Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430035, Hubei, Chin)
出处
《辽宁中医杂志》
CAS
2018年第3期610-613,共4页
Liaoning Journal of Traditional Chinese Medicine
关键词
针刺
康复训练
脑卒中
足下垂
acupuncture
rehabilitation
stroke
foot drop
