| 引用本文: |
孟灵,杨松,钟青华,王瑞安,林伟弟,尹刚刚,常小荣,蒋学余.康复机器人手套结合电针治疗痰瘀阻络型脑卒中手功能障碍患者的临床研究[J].湖南中医药大学学报,2022,42(3):387-392[点击复制] |
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| 康复机器人手套结合电针治疗痰瘀阻络型脑卒中手功能障碍患者的临床研究 |
| 孟灵,杨松,钟青华,王瑞安,林伟弟,尹刚刚,常小荣,蒋学余 |
| (湖南中医药大学, 湖南 长沙 410208;上海司羿智能科技有限公司, 上海 201318;湖南中医药大学附属岳阳医院, 湖南 岳阳 414000) |
| 摘要: |
| 目的 观察康复机器人手套结合电针治疗痰瘀阻络型脑卒中手功能障碍的有效性、安全性。方法 纳入2019年1月至2020年12月湖南中医药大学附属岳阳医院收治的痰瘀阻络型脑卒中手功能障碍患者200例，完全随机分成手套联合电针组、手套组、电针组、康复组，每组50例。手套联合电针组采用常规康复、康复机器人手套及电针“中风十四穴”治疗，手套组采用常规康复配合康复机器人手套治疗，电针组采用常规康复配合电针“中风十四穴”治疗，康复组采用常规康复治疗。4组均连续治疗20 d。比较4组治疗前后患侧手最大握力、患侧腕关节活动度、上肢功能研究量表（action research arm test, ARAT）评分及脑血流量（cerebral blood flow, CBF），并评价其疗效。结果 手套联合电针组、电针组、手套组、康复组总有效率分别为88%、77.6%、76%、70.8%，手套联合电针组总有效率优于其他3组（P<0.05）。与治疗前比较，4组患者治疗后患侧手最大握力、患侧腕关节背伸活动度、ARAT评分、小脑皮层CBF、额叶CBF、顶叶CBF和枕叶CBF均有改善（P<0.05）；手套联合电针组患者疗后患侧腕关节掌屈活动度较治疗前改善（P<0.05），其余3组患者治疗后患侧腕关节掌屈活动度与治疗前差异无统计学意义（P>0.05）。治疗后各组间比较，手套联合电针组治疗后患侧手最大握力、患侧腕关节背伸和掌屈活动度、ARAT评分、小脑皮层CBF、额叶CBF、顶叶CBF、枕叶CBF改善程度均优于其他3组（P<0.05）。结论 康复机器人手套结合电针可提高痰瘀阻络型脑卒中手功能障碍患者患侧手最大握力，增大腕关节背伸、掌屈活动度，改善脑血流量，提高手部运动功能。 |
| 关键词: 脑卒中 康复机器人手套 手功能障碍 电针 痰瘀阻络 最大握力 腕关节活动度 上肢功能 脑血流量 |
| DOI：10.3969/j.issn.1674-070X.2022.03.007 |
| 投稿时间：2021-09-14 |
| 基金项目:科技部研发计划重点专项课题项目（2018YFC1707806）；湖南省自然科学基金面上项目（2019JJ40217）。 |
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| Clinical study of rehabilitation robot gloves combined with electroacupuncture to treat patients with phlegm-stasis blocking collaterals stroke hand dysfunction |
| MENG Ling,YANG Song,ZHONG Qinghua,WANG Ruian,LIN Weidi,YIN Ganggang,CHANG Xiaorong,JIANG Xueyu |
| (Hunan University of Chinese Medicine, Changsha, Hunan 410208, China;Shanghai Siyi Intelligent Technology, Shanghai 201318, China;Yueyang Hospital Affilitated to Hunan University of Chinese Medicine, Yueyang, Hunan 414000, China) |
| Abstract: |
| Objective To observe the efficacy and safety of rehabilitation robot gloves combined with electroacupuncture in the treatment of hand dysfunction in stroke with phlegm-stasis blocking collaterals. Methods 200 patients with hand dysfunction caused by phlegm-stasis blocking collaterals stroke treated in Yueyang Hospital Affiliated to Hunan University of Chinese Medicine from January 2019 to December 2020 were randomly divided into gloves combined electroacupuncture group, gloves group, electroacupuncture group and rehabilitation group, with 50 patients in each group. The gloves combined with electroacupuncture group was treated with routine rehabilitation, rehabilitation robot gloves and electroacupuncture at "apoplexy fourteen acupoint", the gloves group was treated with routine rehabilitation combined with rehabilitation robot gloves, and the electroacupuncture group was treated with routine rehabilitation combined with electroacupuncture at "apoplexy fourteen acupoint", the rehabilitation group was treated with routine rehabilitation. All the four groups were treated continuously for 20 d. The maximum grip strength and wrist range of motion on affected side, action research arm test (ARAT) score and cerebral blood flow (CBF) were compared in the four groups before and after treatment, and the curative effect was evaluated. Results The total effective rate of gloves combined with electroacupuncture group, electroacupuncture group, gloves group and rehabilitation group were 88%, 77.6%, 76% and 70.8%, respectively. The total effective rate of gloves combined electroacupuncture group was better than that of the other three groups (P<0.05). Compared with those before treatment, the maximum grip strength and dorsal extension range of wrist on affected side, ARAT score, cerebellar cortex CBF, frontal lobe CBF, parietal lobe CBF and occipital lobe CBF were improved in the four groups after treatment (P<0.05), and the metacarpal flexion range of wrist on affected side in the gloves combined with electroacupuncture group was improved after treatment (P<0.05), but there was no significant difference in the other three groups after treatment (P>0.05). After treatment, the maximum grip strength, wrist dorsal extension and metacarpal flexion on affected side, ARAT score, cerebellar cortex CBF, frontal lobe CBF, parietal lobe CBF and occipital lobe CBF in the gloves combined with electroacupuncture group were better than those in the other three groups (P<0.05). Conclusion Rehabilitation robot gloves combined with electroacupuncture can improve the maximum grip strength on affected side, increase the range of wrist extension and metacarpal flexion, improve cerebral blood flow and hand motor function in stroke patients with hand dysfunction caused by phlegm-stasis blocking collaterals. |
| Key words: stroke rehabilitation robot gloves hand dysfunction electroacupuncture phlegm-stasis blocking collaterals the maximum grip strength wrist range of motion upper limb function cerebral blood flow |
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