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林紫嫣, 范升, 刘巨尧, 齐佳, 张又量, 岳增辉, 叶勇.基于“从颈治瘫”理念观察刃针治疗缺血性卒中后上肢痉挛性瘫痪的疗效[J].湖南中医药大学学报英文版,2025,45(2):274-279.[Click to copy
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| 基于“从颈治瘫”理念观察刃针治疗缺血性卒中后上肢痉挛性瘫痪的疗效 |
| 林紫嫣,范升,刘巨尧,齐佳,张又量,岳增辉,叶勇 |
| (湖南中医药大学第一附属医院, 湖南 长沙 410007;湖南中医药大学针灸推拿与康复学院, 湖南 长沙 410208) |
| 摘要: |
| 目的 观察刃针在治疗缺血性卒中后上肢痉挛性瘫痪患者中的临床疗效。方法 将60例缺血性卒中后上肢痉挛性瘫痪患者随机分为颈部联合上肢刃针组（观察组，n=30）和上肢刃针组（对照组，n=30），两组治疗时间均为4周。分别记录患者治疗前后改良Ashworth痉挛量表（MAS）、Fugl-meyer运动功能量表（FMA）、改良Barthel指数评分量表（MBI）及肱二头肌、肱三头肌表面肌电图均方根（RMS）值，以评价两组的上肢痉挛程度、上肢运动功能及生活自理能力。结果 治疗前，两组患者MAS、FMA、MBI和肱二头肌、肱三头肌表面肌电图RMS值比较，差异均无统计学意义（P>0.05）。与治疗前比较，治疗后，两组患者MAS及肱二头肌、肱三头肌的表面肌电图RMS值均下降（P<0.05），FMA、MBI均升高（P<0.05）。与对照组比较，观察组MAS及肱二头肌、肱三头肌表面肌电图RMS值均降低（P<0.05），FMA、MBI均升高（P<0.05）。观察组总有效率为93.33%，高于对照组的80.00%（P<0.05）。结论 颈部联合上肢刃针治疗能够有效改善缺血性卒中后上肢痉挛性瘫痪患者的上肢痉挛程度、上肢运动功能、生活自理能力并调衡患者屈肘肌群表面肌电图以改善上肢张力，且疗效优于对照组。 |
| 关键词: 脑卒中 痉挛性瘫痪 肌张力 刃针 从颈治瘫 表面肌电 |
| DOI：10.3969/j.issn.1674-070X.2025.02.011 |
| Received:August 13, 2024 |
| 基金项目:湖南省“十四五”第一批中医领军人才和学科带头人培养项目（湘中医药〔2022〕4号）。 |
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| Efficacy of blade needle therapy for upper limb spastic paralysis after ischemic stroke based on the concept of“treating paralysis by treating the neck” |
| LIN Ziyan, FAN Sheng, LIU Juyao, QI Jia, ZHANG Youliang, YUE Zenghui, YE Yong |
| (The First Hospital of Hunan University of Chinese Medicine, Changsha, Hunan 410007, China;School of Acupuncture-moxibustion, Tuina and Rehabilitation, Hunan University of Chinese Medicine, Changsha, Hunan 410208, China) |
| Abstract: |
| Objective To observe the clinical efficacy of blade needle therapy in treating upper limb spastic paralysis following ischemic stroke, and to provide new ideas for clinical treatment of this condition. Methods Sixty patients with upper limb spastic paralysis after ischemic stroke were randomly divided into two groups: the group of blade needle therapy in both the neck and upper limb (observation group, n=30) and the group of blade needle therapy in the upper limb alone (control group, n=30). Both groups received corresponding treatment for four weeks. Scores of the modified Ashworth scale (MAS), Fugl-Meyer Assessment (FMA), and modified Barthel Index (MBI), and the root mean square (RMS) values of the surface electromyography (sEMG) of the biceps brachii and triceps brachii were recorded before and after treatment to evaluate the spasticity level, motor function, and activities of daily living (ADLs) of the upper limbs in both groups. Results Before treatment, there were no significant differences between the two groups in terms of the scores of MAS, FMA, and MBI, and sEMG-RMS values of the biceps brachii and triceps brachii (P>0.05). Compared with before treatment, after treatment, the MAS scores and sEMG-RMS values of the biceps brachii and triceps brachii decreased in both groups (P<0.05), while FMA and MBI scores increased (P<0.05). Compared with the control group, the observation group showed lower MAS score and sEMG-RMS values of the biceps brachii and triceps brachii (P<0.05), and higher FMA and MBI scores (P<0.05). The total effective rate in the observation group was 93.33%, higher than the 80.00% in the control group (P<0.05). Conclusion Blade needle therapy in both the neck and upper limb can effectively relieve the upper limb spasticity, improve upper limb motor function and ADLs in patients with upper limb spastic paralysis after ischemic stroke, and help adjust the sEMG of the elbow flexor muscles to reduce the muscle tone of upper limb, with better efficacy than that of the control group. |
| Key words: stroke spastic paralysis muscle tone blade needle treating paralysis by treating the neck surface electromyography |
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