Jia Chengjie, Zhang Hongru, Ni Guangxia, Zhang Yinan, Su Bin, Xu Xinlei
the Second Clinical Medical College Affiliated to Nanjing University of CM, Nanjing 210046, Jiangsu Province, China; Wuxi Tongren International Rehabilitation Hospital Affiliated to Nanjing Medical University, Wuxi 214151, Jiangsu Province.
the Second Clinical Medical College Affiliated to Nanjing University of CM, Nanjing 210046, Jiangsu Province, China.
Zhongguo Zhen Jiu. 2017 Dec 12;37(12):1271-5. doi: 10.13703/j.0255-2930.2017.12.005.
To evaluate the differences in the clinical therapeutic effects on spasmodic hemiplegia after stroke among the alliance therapy of scalp acupuncture, music therapy combined with rehabilitation, the simple rehabilitation therapy and the combination of music therapy and rehabilitation.
A total of 76 patients of post-stroke spasmodic hemiplegia were randomized into a rehabilitation group (25 cases), a combination group with music therapy and rehabilitation (25 cases) and an alliance therapy group with scalp acupuncture, music therapy and rehabilitation (26 cases). In the rehabilitation group, the routine rehabilitation therapy was applied, including the removal of various incentives that cause spasm, the correction of body position and the physical therapy. In the combination group, the music therapy was added on the basis of the treatment as the rehabilitation group. The music physician used the rhythmic auditory stimulation, the patterned sensory enhancement and the therapeutic instrumental music playing to set up the task in the treatment. In the alliance therapy group, scalp acupuncture was added on the basis of the treatment as the combination group. The anterior oblique line of vertex-tempora (MS 6) and the posterior oblique line of vertex-tempora (MS 7) on the contralateral side were selected and stimulated with penetrating needling technique. The needles were retained. During the needling retaining, the needles were rotated once every 10 min, for 2 min each time. The treatment was given one session a day, totally for 5 sessions a week, continuously for 4 weeks. The Fugl-Meyer assessment (FMA), Barthel index (BI) and the modified Ashworth scale (MAS) of the affected elbow and the passive knee movement at static condition were observed in the patients before and after treatment.
The results of FMA, BI and MAS were not different before treatment in the patients among the three groups (all >0.05), indicating the comparability among groups. After treatment, FMA and BI scores were all increased apparently in the three groups as compared with those before treatment (all <0.05). MAS grade was reduced remarkably as compared with that before treatment (all <0.05). After treatment, FMA and BI scores in the alliance therapy group were higher than those in the combination group and the rehabilitation group (all <0.05). FMA and BI scores in the combination group were higher than those in the rehabilitation group (both <0.05). MAS grade in the alliance therapy group was lower than those in the combination group and the rehabilitation group (both <0.05). MAS grade in the combination group was lower than that in the rehabilitation group (<0.05).
The alliance therapy with scalp acupuncture, music therapy and rehabilitation achieve the remarkable clinical therapeutic effects on post-stroke spasmodic hemiplegia as compared with the routine rehabilitation and the combination of music therapy and rehabilitation.
评估头针、音乐疗法联合康复治疗、单纯康复治疗以及音乐疗法与康复治疗相结合对脑卒中后痉挛性偏瘫的临床治疗效果差异。
将76例脑卒中后痉挛性偏瘫患者随机分为康复组（25例）、音乐疗法与康复治疗联合组（25例）和头针、音乐疗法与康复治疗联合组（26例）。康复组采用常规康复治疗，包括去除各种引起痉挛的诱因、体位矫正及物理治疗。联合组在康复组治疗基础上加用音乐疗法，音乐治疗师在治疗中采用节律性听觉刺激、模式化感觉增强及治疗性器乐演奏来设定任务。联合组在联合组治疗基础上加用头针，选取患侧顶颞前斜线（MS6）和顶颞后斜线（MS7），采用透刺法针刺，留针。留针期间，每隔10分钟行针1次，每次2分钟。每天治疗1次，每周共5次，连续治疗4周。观察患者治疗前后的Fugl-Meyer评估（FMA）、Barthel指数（BI）以及患侧肘关节改良Ashworth量表（MAS）和静态下被动膝关节活动情况。
三组患者治疗前FMA、BI和MAS结果差异无统计学意义（均>0.05），表明组间具有可比性。治疗后，三组患者FMA和BI评分均较治疗前明显升高（均<0.05），MAS分级较治疗前明显降低（均<0.05）。治疗后，联合组和康复组FMA和BI评分均高于康复组（均<0.05）。联合组FMA和BI评分高于康复组（均<0.05）。联合组MAS分级低于康复组（<0.05）。联合组MAS分级低于康复组（<0.05）。
与常规康复治疗及音乐疗法与康复治疗相结合相比，头针、音乐疗法与康复治疗联合对脑卒中后痉挛性偏瘫具有显著的临床治疗效果。
