| 朱宗俊,饶美林,刘华胜,等.关刺治疗卒中后上肢痉挛的疗效观察[J].中国临床保健杂志,2024,27(6):749-753. |
| 关刺治疗卒中后上肢痉挛的疗效观察 |
| Observation on the therapeutic effect of articular needling for upper limb spasm after stroke |
| 投稿时间：2024-03-09 |
| DOI：10.3969/J.issn.1672-6790.2024.06.007 |
| 中文关键词: 卒中 痉挛 上肢 关刺 经颅磁刺激 日常生活活动 |
| 英文关键词: Stroke Spasm Upper extremity Joint needling Transcranial magnetic stimulation Activities of daily living 〖FL |
| 基金项目:安徽省卫生健康委科研项目(AHWJ2023A30123)；安徽省临床医学研究转化专项(202304295107020101)；安徽省高等学校科学研究项目(2023AH050824) |
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| 中文摘要: |
| 目的 观察关刺对卒中后上肢痉挛的临床疗效。方法 前瞻性选取2022年7月至2023年8月安徽中医药大学第一附属医院收治的60例脑卒中上肢痉挛患者,运用随机数字表法分为对照组与观察组,各30例。2组均予以常规内科治疗及常规康复训练,对照组同时进行经颅磁刺激(TMS)治疗,观察组在对照组的基础上联合关刺治疗。治疗前和治疗3周后,分别评定2组患者改良Ashworth量表(MAS)、Fugl-Meyer运动功能评分上肢部分(FMA-UE)、改良Barthel指数(MBI),并运用超声评估偏瘫侧肱二头肌、肱肌、肱桡肌的肌肉厚度(MT),最后进行临床疗效评定。结果 2组均无脱落病例；观察组总有效率(83.33%),高于对照组总有效率(46.67%),差异有统计学意义(χ2=8.864,P=0.003)；与治疗前比较,2组患者MAS评分、MT值(肱二头肌、肱肌、肱桡肌)均下降(P<0.05),FMA-UE评分、MBI评分均升高(P<0.05),且观察组优于对照组(P<0.05)；2组患者在治疗期间均未发生不良反应。结论 关刺治疗能够改善卒中后上肢痉挛状态,提高上肢运动功能与日常生活活动能力,利于卒中后上肢痉挛的恢复。 |
| 英文摘要: |
| Objective To observe the therapeutic effect of articular needling combined with transcranial magnetic stimulation(TMS) on upper limb spasms after stroke.Methods Sixty stroke patients with upper limb spasticity admitted to the First Affiliated Hospital of Anhui University of Traditional Chinese Medicine from July 2022 to August 2023 were randomly divided into a control group and an observation group,with 30 cases in each group,using a random number table method.Two groups were given routine medical therapy and conventional rehabilitation training.The control group was treated with TMS,and the observation group was combined with articular needling on the basis of the control group.The modified ashworth scale(MAS),Fugl-Meyer assessment upper extremity(FMA-UE),modified bathel index(MBI) were used to evaluate patients before treatment and after 3 weeks of treatment,and muscle thickness(MT) of the biceps brachii,brachialis muscle,and brachioradialis muscle of the hemiplegic side were evaluated by ultrasound.finally,clinical efficacy evaluation will be evaluated.Results There were no cases of detachment in both groups.The total effective rate of the observation group (83.33%) was higher than that of the control group (46.67%),and the difference was statistically significant (χ2=8.864,P=0.003).Compared with before treatment,both groups of patients showed a decrease in MAS score and MT value (biceps brachii,brachialis muscle,brachioradialis muscle) (P<0.05),while FMA-UE score and MBI score increased (P<0.05),and the observation group was superior to the control group(P<0.05).Patients of both groups did not experience any adverse reactions during the treatment period.Conclusions Articular needling combined with TMS treatment can reduce the upper limb spasms after stroke,improve the upper limb motor function and activities of daily living ability,and facilitate the recovery of upper limb spasticity after stroke. |
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