Wei Yan-Xia, Zhao Xia, Zhang Bao-Chao
Department of Rehabilitation, the Affiliated Hospital of Zhengzhou University, Nanyang 473009, China.
Department of ENT, the Affiliated Hospital of Zhengzhou University, Nanyang 473009, China.
Complement Ther Med. 2016 Jun;26:55-60. doi: 10.1016/j.ctim.2016.02.014. Epub 2016 Feb 22.
To evaluate the therapeutic benefit of combining moxibustion and rehabilitation training for functional recovery in post-stroke spastic hemiplegic patients.
We randomly divided 84 cases subjecting to inclusion criteria into moxibustion plus rehabilitation training group (MRT group, n=44) and rehabilitation training group (RT group, n=40). Evaluation of therapeutic effect was observed before treatment, 2 weeks during treatment and 6 months after treatment. Spasticity was evaluated using modified Ashworth scale (MAS) and Clinical Spasticity Index (CSI), recovery of motor function was assessed by Brunnstrom recovery stages and Simplified Fugl-Meyer Motor Scale, and performance of activities of daily living (ADL) was measured, and the quality of life was assessed by Patient Reported Outcomes (PRO).
Evaluation of upper limbs, hands and lower limbs based on CSI and MAS revealed significant improvements in patients treated with MRT, compared to RT alone, both during and after therapy. CSI and MAS also showed significant improvement in patients at each time point in the MRT group, compared to RT group. Marked improvement in Fugl-Meyer Motor Scale was also observed in MRT group at each time point. Based on Brunnstrom grades of upper limbs, hands and lower limbs, significant differences between the two groups were recorded at all time points during and after therapy. Barthel index (BI) and PRO also confirmed the dramatic differences between the two therapy groups.
Our results demonstrate that combination therapy with moxibustion and rehabilitation training offers greater clinical benefits in relieving spasticity, promoting function recovery of motion, improving the performance of ADL, and increasing quality of life in post-stroke spastic hemiplegic patients, compared to RT alone.
评估艾灸与康复训练相结合对脑卒中后痉挛性偏瘫患者功能恢复的治疗效果。
我们将84例符合纳入标准的患者随机分为艾灸加康复训练组（MRT组，n = 44）和康复训练组（RT组，n = 40）。在治疗前、治疗期间2周和治疗后6个月观察治疗效果评估。使用改良Ashworth量表（MAS）和临床痉挛指数（CSI）评估痉挛程度，通过Brunnstrom恢复阶段和简化Fugl-Meyer运动量表评估运动功能恢复情况，测量日常生活活动（ADL）表现，并通过患者报告结局（PRO）评估生活质量。
基于CSI和MAS对上肢、手部和下肢的评估显示，与单独进行康复训练相比，MRT组患者在治疗期间和治疗后痉挛程度均有显著改善。与RT组相比，MRT组患者在每个时间点的CSI和MAS也有显著改善。MRT组在每个时间点的Fugl-Meyer运动量表也有明显改善。基于上肢、手部和下肢的Brunnstrom分级，两组在治疗期间和治疗后的所有时间点均存在显著差异。Barthel指数（BI）和PRO也证实了两组治疗方法之间的显著差异。
我们的结果表明，与单独进行康复训练相比，艾灸与康复训练相结合的联合治疗在缓解痉挛、促进运动功能恢复、改善ADL表现以及提高脑卒中后痉挛性偏瘫患者的生活质量方面具有更大的临床益处。
