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[针刺拔罐结合康复训练对脑卒中后上肢肘关节屈曲痉挛及其表面肌电图值的影响]

[Effects of pricking and cupping combined with rehabilitation training on elbow flexion spasticity of upper limb after stroke and its IEMG value].

作者信息

Huang Zhiqiang, Zhao Ning, Su Zhaoyuan, Su Jiafu, Wu Qiang

机构信息

Fujian University of TCM, Fuzhou 350122, China; Department of Acupuncture and Rehabilitation, Quanzhou Hospital of TCM Affiliated to Fujian University of TCM, Quanzhou 362000.

Department of Rehabilitation, Nanshan District People's Hospital of Shenzhen, Guangdong Province.

出版信息

Zhongguo Zhen Jiu. 2018 Feb 12;38(2):119-25. doi: 10.13703/j.0255-2930.2018.02.002.

Abstract

OBJECTIVE

Based on rehabilitation training, to observe the clinical effect difference between pricking combined with cupping and western medication for elbow flexion spasticity of upper limb of stroke patients.

METHODS

Sixty patients were randomly assigned by SPSS software random number generator into a comprehension group and a western medication group, 30 cases in each one. Rehabilitation was used in the two groups. Pricking and cupping were applied at the affected abdominal center of biceps brachii muscle on Tuesday and Friday continuously for 4 weeks in the comprehensive group. Baclofen was prescribed orally continuously for 4 weeks, once 10 mg and 3 times a day in the western medication group. The indexes were observed before and after 4-week treatment as well as at immediate treatment, immediately after the first treatment in the comprehension group and 24 h after treatment in the western medication group, including the affected elbow joint activity, modified Ashworth scale (MAS), simple Fugl-Meyer assessment (FMA), integrated electromyogram (IEMG) of the affected biceps brachii and triceps brachii. The clinical effects were evaluated.

RESULTS

After treatment, the elbow joint activity in the two groups was improved compared with that before treatment (both <0.05), with better result in the comprehension group (<0.05). There was no statistical significance for MAS and FMA scores at immediate treatment between the two groups (both >0.05). After treatment, the MAS score decreased and the FMA score increased in the two groups (both <0.05), with better results in the comprehension group (both <0.05). At immediate treatment and after treatment, biceps brachii IEMG decreased in the two groups (all <0.05). The biceps brachii IEMG in the comprehension group at the immediate treatment was higher and that after treatment was lower compared with those in the western medication group (both <0.05). The triceps brachii IEMG at immediate treatment was not statistically different from that before treatment in the comprehension group (>0.05) and that in the western medication group decreased (<0.05). After treatment, the triceps brachii IEMG increased in the two groups (both <0.05), with higher IEMG in the comprehension group (<0.05). The total effective rate was 83.3% (25/30) in the comprehensive group, which was higher than 60.0% (18/30) in the western medication group (<0.05). .

CONCLUSION

Pricking and cupping combined with rehabilitation training can reduce the IEMG of the biceps brachii muscle in patients with stroke, and improve the spasticity and motor function.

摘要

目的

基于康复训练,观察针刺联合拔罐与西药治疗脑卒中患者上肢肘屈曲痉挛的临床疗效差异。

方法

采用SPSS软件随机数字生成器将60例患者随机分为综合组和西药组,每组30例。两组均采用康复治疗。综合组于每周二、周五在患侧肱二头肌腹中央进行针刺拔罐,连续治疗4周。西药组口服巴氯芬连续4周,每次10mg,每日3次。观察两组治疗4周前后及即刻治疗时(综合组首次治疗后即刻、西药组治疗后24小时)的指标,包括患侧肘关节活动度、改良Ashworth量表(MAS)、简易Fugl-Meyer评估法(FMA)、患侧肱二头肌和肱三头肌的表面肌电图(IEMG)。评价临床疗效。

结果

治疗后,两组肘关节活动度均较治疗前改善(均P<0.05),综合组改善更明显(P<0.05)。两组即刻治疗时MAS和FMA评分比较,差异无统计学意义(均P>0.05)。治疗后,两组MAS评分降低,FMA评分升高(均P<0.05),综合组改善更明显(均P<0.05)。即刻治疗及治疗后,两组肱二头肌IEMG均降低(均P<0.05)。综合组即刻治疗时肱二头肌IEMG高于西药组,治疗后低于西药组(均P<0.05)。综合组即刻治疗时肱三头肌IEMG与治疗前比较,差异无统计学意义(P>0.05),西药组降低(P<0.05)。治疗后,两组肱三头肌IEMG升高(均P<0.05),综合组IEMG更高(P<0.05)。综合组总有效率为83.3%(25/30),高于西药组的60.0%(18/30)(P<0.05)。

结论

针刺拔罐联合康复训练可降低脑卒中患者肱二头肌IEMG,改善痉挛及运动功能。

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