Wang Haiqiao, Bao Chunling, Li He, Qi Hong, Jiao Zhihua, Dong Guirong
Zhongguo Zhen Jiu. 2015 Jun;35(6):534-8.
To explore the impacts on the fine movement of upper extremity with flaccid paralysis in stroke treated with acupuncture and motor imagery.
Sixty-two cases of flaccid paralysis of upper extremity in stroke were randomized into an observation group (30 cases) and a control group (32 cases). In the control group, the conventional western medication and the passive movement of the extremity were applied. Additionally, the penetrating needling technique was used at the head points [penetrating needling from Baihui (GV 20) to Taiyang (EX-HN 5)] and the local affected extremity [penetrating needling from Jianyu (LI 15) to Binao (LI1 14), from Quchi (LI 11) to Shaohai (HT 3), from Waiguan (TE 5) to Neiguan (PC 6), etc]. The needles were retained for 30 min. In the observation group, on the basic treatment as the control group, during the needle retaining, the motor imagery therapy was supplemented. The treatment was given once a day, 5 treatments a week, for 4 weeks totally in the either group. The scores in the action research arm test (ARAT) and the modified Fugl-Meyer assessment (FMA) were recorded at the moment of enrollment, in 2 and 4 weeks of treatment, in the 6th and 8th weeks, as well as after 90 days separately.
(1) ARAT score: since the 2nd week, ARAT scores in the observation group were all improved significantly as compared with those in the control group at the each time points (all P<0. 05). In the observation group, the scores were improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, the score in the 2nd week was not different significantly as compared with that before treatment (P>0. 05), but the scores at the rest time points were improved significantly in the pair comparison (all P<0. 05); (2) FMA score: in the 2nd week and on the 90th day, FMA score in the observation group was higher significantly than those in the control group (both P < 0. 05). In the observation group, the scores were all improved significantly in the pair comparison at the time points (all P<0. 05). In the control group, except that in comparison between the 90th day and the 8th week (P>0. 05), the results were all P<0. 05 at the rest time points.
The early intervention of the combined therapy of acupuncture and motor imagery effectively promotes the recovery of the coordination function and the fine movement of upper extremity, especially the improvements of the fine movement in stroke at flaccid paralysis stage. The efficacy is better than the single acupuncture treatment.
探讨针刺联合运动想象疗法对脑卒中上肢弛缓性瘫痪精细运动的影响。
将62例脑卒中上肢弛缓性瘫痪患者随机分为观察组(30例)和对照组(32例)。对照组采用传统西药及肢体被动运动治疗。此外,在头部穴位[从百会(GV 20)透刺至太阳(EX-HN 5)]及患侧肢体局部[从肩髃(LI 15)透刺至臂臑(LI1 14),从曲池(LI 11)透刺至少海(HT 3),从外关(TE 5)透刺至内关(PC 6)等]采用透刺针法。留针30分钟。观察组在对照组基础治疗的基础上,留针期间补充运动想象疗法。两组均每日治疗1次,每周治疗5次,共治疗4周。分别在入组时、治疗2周和4周、6周和8周以及90天后记录动作研究臂测试(ARAT)和改良Fugl-Meyer评估(FMA)评分。
(1)ARAT评分:自第2周起,观察组各时间点ARAT评分均较对照组显著提高(均P<0.05)。观察组各时间点组内比较评分均显著提高(均P<0.05)。对照组第2周评分与治疗前比较差异无统计学意义(P>0.05),但其余时间点组内比较评分均显著提高(均P<0.05);(2)FMA评分:第2周和90天时,观察组FMA评分显著高于对照组(均P<0.05)。观察组各时间点组内比较评分均显著提高(均P<0.05)。对照组除90天与8周比较(P>0.05)外,其余时间点结果均P<0.05。
针刺联合运动想象疗法的早期干预能有效促进上肢协调功能及精细运动的恢复,尤其对脑卒中弛缓性瘫痪期精细运动的改善作用明显。其疗效优于单纯针刺治疗。