[应用Fugl-Meyer量表评估靳氏“三针”疗法联合康复训练对脑卒中偏瘫患者的疗效]

[Evaluation on efficacy of Jin's "Sanzhen" therapy combined with rehabilitation training for hemiplegia of stroke patients by Fugl-Meyer scale].

作者信息

Han De-Xiong, Zhuang Li-Xing, Zhang Ying

机构信息

The Third Hospital Affiliated to Zhejiang University of Chinese Medicine, Hangzhou 310005, China.

出版信息

Zhen Ci Yan Jiu. 2011 Jun;36(3):209-14.

PMID:21793387

Abstract

OBJECTIVE

To assess the therapeutic effect of Jin's "Sanzhen" therapy combined with rehabilitation training on limb-motor function of stroke patients by using Fugl-Meyer scale.

METHODS

A total of 254 hemiplegic stroke outpatients and inpatients from 7 hospitals were randomly divided into Jin's "Sanzhen" (JSZ) group (n = 83), rehabilitation group (n = 84) and combination group (n = 87). Acupuncture was applied to acupoints of Jin's "Sanzhen" including Quchi (LI 11), Waiguan (SJ 5) and Hegu (LI 4); Futu (ST 32). Zusanli (ST 36) and Sanyinjiao (SP 6); etc. The acupuncture needles were retained for 30 min after "Deqi". Rehabilitation training included passive joint movement, standing-sitting training, tapping-pressing stimulation, walking training, etc. The treatment was conducted once daily, 5 sessions a week and for 4 weeks. Fugl-Meyer scale composed of 100-point motor domain of the upper- and lower-extremity sections was used to assess the patients' motor function.

RESULTS

On day 28 after the treatment, of the 83.84 and 87 hemiplegic stroke patients in the JSZ, rehabilitation and combination groups, 48 (57.8%), 31 (36.9%) and 50 (57.5%) experienced marked improvement in their clinical symptoms and signs, 26 (31.3%), 44 (52.4%) and 31(35.6%) had an improvement, and 9 (10.8%), 9 (10.7%) and 6 (6.9%) failed in the treatment, with the total effective rates being 89.2%, 89.3% and 93.1%, respectively. The neurological deficit score (NDS) of the combination group was significantly lower than that of the rehabilitation group (P < 0.05). The Fugl-Meyer assessment score (FMAS) for extremity motor function of the combination group was apparently higher than those of the JSZ and rehabilitation groups (P < 0.05). No significant differences were found between the JSZ and rehabilitation groups in both NDS and FMAS (P > 0.05).

CONCLUSION

Jin's "Sanzhen" therapy combined with rehabilitation training can significantly improve the limb motor function of hemiplegic stroke patients, and has a good synergistic effect.

摘要

目的

采用Fugl-Meyer量表评估靳氏“三针”疗法联合康复训练对脑卒中患者肢体运动功能的治疗效果。

方法

将7家医院的254例偏瘫脑卒中门诊及住院患者随机分为靳氏“三针”组（n = 83）、康复组（n = 84）和联合组（n = 87）。针刺靳氏“三针”穴位，包括曲池（LI 11）、外关（SJ 5）和合谷（LI 4）；伏兔（ST 32）、足三里（ST 36）和三阴交（SP 6）等。得气后留针30分钟。康复训练包括关节被动活动、坐立训练、拍打按压刺激、步行训练等。治疗每日1次，每周5次，共4周。采用由上下肢100分运动域组成的Fugl-Meyer量表评估患者的运动功能。

结果

治疗28天后，靳氏“三针”组、康复组和联合组的83例、84例和87例偏瘫脑卒中患者中，48例（57.8%）、31例（36.9%）和50例（57.5%）临床症状和体征显著改善，26例（31.3%）、44例（52.4%）和31例（35.6%）有所改善，9例（10.8%）、9例（10.7%）和6例（6.9%）治疗无效，总有效率分别为89.2%、89.3%和93.1%。联合组的神经功能缺损评分（NDS）显著低于康复组（P < 0.05）。联合组的肢体运动功能Fugl-Meyer评估评分（FMAS）明显高于靳氏“三针”组和康复组（P < 0.05）。靳氏“三针”组和康复组在NDS和FMAS方面均无显著差异（P > 0.05）。