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[梅花针叩刺关键点结合Bobath疗法治疗偏瘫痉挛的疗效:一项随机对照试验]

[Efficacy on hemiplegic spasticity treated with plum blossom needle tapping therapy at the key points and Bobath therapy: a randomized controlled trial].

作者信息

Wang Fei, Zhang Lijuan, Wang Jianhua, Shi Yan, Zheng Liya

出版信息

Zhongguo Zhen Jiu. 2015 Aug;35(8):781-4.

Abstract

OBJECTIVE

To evaluate the efficacy on hemiplegic spasticity after cerebral infarction treated with plum blossom needle tapping therapy at the key points and Bobath therapy.

METHODS

Eighty patients were collected, in compliance with the inclusive criteria of hemiplegic spasticity after cerebral infarction, and randomized into an observation group and a control group, 40 cases in each one. In the control group, Bobath manipulation therapy was adopted to relieve spasticity and the treatment of 8 weeks was required. In the observation group, on the basis of the treatment as the control group, the tapping therapy with plum blossom needle was applied to the key points, named Jianyu (LI 15), Jianliao (LI 14), Jianzhen (SI 9), Hegu (LI 4), Chengfu (BL 36), Zusanli (ST 36), Xiyangguan (GB 33), etc. The treatment was given for 15 min each time, once a day. Before treatment, after 4 and 8 weeks of treatment, the Fugl-Meyer assessment (FMA) and Barthel index (BI) were adopted to evaluate the motor function of the extremity and the activity of daily life in the patients of the two groups separately. The modified Ashworth scale was used to evaluate the effect of anti-spasticity.

RESULTS

In 4 and 8 weeks of treatment, FMA: scores and BI scores were all significantly increased as compared with those before treatment in the two groups: (both P<0. 05). The results in 8 weeks of treatment in the observation group were significantly better than those in the control group (all P<0. 05). In 4 and 8 weeks of treatment, the scores of spasticity state were improved as compared with those before treatment in the patients of the two groups (all P<0. 05). The result in 8 weeks of treatment in the observation group was significantly better than that in the control group (P<0. 05). In 8 weeks of treatment, the total effective rate of anti-spasticity was 90. 0% (36/40) in the observation group, better than 75. 0% (30/40) in the control group (P<0. 05).

CONCLUSION

The tapping therapy with plum blossom needle at the key points combined with Bobath therapy effectively relieves hemiplegic spasticity in the patients of cerebral infarction and improves the motor function of extremity and the activity of daily life.

摘要

目的

评估醒脑开窍针法结合Bobath疗法对脑梗死偏瘫痉挛状态的疗效。

方法

选取符合脑梗死偏瘫痉挛状态纳入标准的患者80例,随机分为观察组和对照组,每组40例。对照组采用Bobath手法治疗以缓解痉挛,疗程8周。观察组在对照组治疗基础上,采用醒脑开窍针法针刺患侧肩髃(LI 15)、肩髎(LI 14)、肩贞(SI 9)、合谷(LI 4)、承扶(BL 36)、足三里(ST 36)、膝阳关(GB 33)等穴位,每次留针15分钟,每日1次。分别于治疗前、治疗4周、治疗8周采用Fugl-Meyer评估量表(FMA)、Barthel指数(BI)对两组患者肢体运动功能和日常生活活动能力进行评定,采用改良Ashworth量表评定抗痉挛效果。

结果

治疗4周、8周时,两组患者FMA评分、BI评分均较治疗前显著提高(均P<0.05),且观察组治疗8周时各项评分均显著高于对照组(均P<0.05)。治疗4周、8周时,两组患者痉挛状态评分均较治疗前改善(均P<0.05),且观察组治疗8周时改善程度显著优于对照组(P<0.05)。治疗8周时,观察组抗痉挛总有效率为90.0%(36/40),优于对照组的75.0%(30/40)(P<0.05)。

结论

醒脑开窍针法结合Bobath疗法能有效缓解脑梗死偏瘫患者的痉挛状态,提高肢体运动功能和日常生活活动能力。

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