Liu Sen-Yung, Hsieh Ching-Liang, Wei Ta-Sen, Liu Peng-Ta, Chang Yu-Jun, Li Tsai-Chung
Department of Physical Medicine and Rehabilitation, Changhua Christian Hospital, Changhua, Taiwan.
Am J Chin Med. 2009;37(3):483-94. doi: 10.1142/S0192415X09006990.
The disturbance of balance function is one of main etiology resulting in falling down in stroke patients. A number of studies report that acupuncture may improve the motor function of stroke patients. Therefore, the aim of the present study was to investigate the effect of acupuncture on balance function. We designed a single-blinded, controlled, randomized study. A total of 30 stroke patients were randomized into experimental and control groups. Experimental groups received acupuncture treatment accompanied by the manual twisting of needles and obtaining of qi (the subjects experienced sensations of soreness, numbness, swelling and heaviness, while the acupuncturist experienced a sensation of needle resistance), whereas the control group did not receive manual twisting of needles and without obtaining of qi. All of the subjects were first-time stroke patients; infarction location was limited to either the left or right hemisphere, and all subjects were able to walk for at least 6 meters. Acupuncture stimulation (AS) was applied to Baihui (GV 20) acupoint as well as to 4 spirit acupoints (1.5 cun anterior, posterior, left and right laterals from Baihui acupoint, respectively) for 20 min. Balance function outcome measures were: (1) the displacement area of the patient's center of gravity; (2) the time taken for a patient to stand vertically from a seated position; (3) the time taken for a patient to walk a distance of 6 meters; (4) muscle strength of both lower extremities. Results indicated that the displacement area from the center of gravity decreased in the experimental group, but not in the control group. There was greater reduction in the displacement area in the experimental group than in the control group. Following AS, the time taken to reach a standing position from a seated position, as well as the time taken to walk 6 meters was decreased equally in both the experimental and control groups. The muscle strength of the hip flexor and knee extensor were increased in the paralyzed and non-paralyzed sides of patients in the experimental group, but not in the control group. The results of the present study suggest that acupuncture stimulation may induce an immediate effect that improves balance function in stroke patients.
平衡功能障碍是导致中风患者跌倒的主要病因之一。多项研究报告称，针灸可能改善中风患者的运动功能。因此，本研究的目的是探讨针灸对平衡功能的影响。我们设计了一项单盲、对照、随机研究。总共30例中风患者被随机分为实验组和对照组。实验组接受针灸治疗，同时进行捻转提插手法得气（受试者会有酸、麻、胀、重的感觉，而针灸师会有针下阻力感），而对照组不进行捻转提插手法且不得气。所有受试者均为首次中风患者；梗死部位仅限于左半球或右半球，且所有受试者至少能行走6米。针刺刺激（AS）应用于百会穴（GV 20）以及4个精神穴位（分别在百会穴前、后、左、右旁开1.5寸），持续20分钟。平衡功能结局指标为：（1）患者重心位移面积；（2）患者从坐位垂直站立所需时间；（3）患者行走6米所需时间；（4）双下肢肌力。结果表明，实验组重心位移面积减小，而对照组未减小。实验组重心位移面积的减小幅度大于对照组。针刺刺激后，实验组和对照组从坐位达到站立位所需时间以及行走6米所需时间均同等减少。实验组患者瘫痪侧和非瘫痪侧的髋屈肌和膝伸肌肌力增加，而对照组未增加。本研究结果表明，针刺刺激可能立即产生改善中风患者平衡功能的效果。
