Zhang Li-Feng, Wang Li-Yan, Li Ling-Yan, Zeng Xue-Qing, He Ying, Dai Hong-Shuang
Zhongguo Zhong Xi Yi Jie He Za Zhi. 2017 Mar;37(3):314-318.
Objective To observe the effects of scalp electroacupuncture (SEA) combined con- straint-induced movement therapy ( CIMT) on movement function of ischemic stroke patients' upper limbs. Methods Totally 80 stroke patients were assigned to four groups according to random digit table, i.e., the routine rehabilitation group, the SEA group, the CIMT group, and the comprehensive intervention group. Patients in the routine rehabilitation group strengthened the training of upper limbs on the affected side by Bobath dominated technology and Brunnstrom assisted technology. Patients in the SEA group received Jiao's SEA combined EA therapy. Those in the CIMT group restricted the upper limbs of the healthy side and strengthened training of the affected side. Those in the comprehensive intervention group used SEA combined CIMT treatment. Fugl-Meyer assessment scale (FMA) , grading of hand function and range of wrist movement were observed before intervention, at week 4 and 12 after intervention, respectively. Results Compared with before treatment in the same group, FMA scores of upper limbs significantly increased, grading of hand function, and range of wrist movement were obviously improved in the 4 groups after 4-week treatment (P <0. 05, P <0. 01). There was no statistical difference in FMA scores of upper limbs or grading of hand function among the four groups. But dorsal expansion of wrist and radial deviation were more obviously improved in the comprehensive intervention group than in the routine rehabilitation group (P <0. 05). Compared with the routine rehabilitation group, FMA scores of up- per limbs increased, grading of hand function and range of wrist movement were obviously improved in the comprehensive intervention group (P <0. 05). Conclusions Routine rehabilitation, SEA, and CIMT showed better rehabilitation effect on movement function of ischemic stroke patients' upper limbs. But ESA combined CIMT showed most obvious effect with earliest effect shown.
目的 观察头针电刺激（SEA）结合强制性运动疗法（CIMT）对缺血性脑卒中患者上肢运动功能的影响。方法 将80例脑卒中患者按随机数字表法分为四组，即常规康复组、头针电刺激组、强制性运动疗法组和综合干预组。常规康复组患者采用Bobath主导技术和Brunnstrom辅助技术加强患侧上肢训练。头针电刺激组患者接受焦氏头针电刺激结合电针治疗。强制性运动疗法组患者限制健侧上肢活动并加强患侧训练。综合干预组患者采用头针电刺激结合强制性运动疗法治疗。分别于干预前、干预后4周和12周观察Fugl-Meyer评估量表（FMA）、手功能分级及腕关节活动度。结果 与同组治疗前比较，四组患者治疗4周后上肢FMA评分均显著提高，手功能分级及腕关节活动度均明显改善（P<0.05，P<0.01）。四组患者上肢FMA评分及手功能分级比较，差异无统计学意义。但综合干预组腕关节背伸及桡偏改善程度明显优于常规康复组（P<0.05）。与常规康复组比较，综合干预组上肢FMA评分提高，手功能分级及腕关节活动度明显改善（P<0.05）。结论 常规康复、头针电刺激及强制性运动疗法对缺血性脑卒中患者上肢运动功能均有较好的康复效果。但头针电刺激结合强制性运动疗法效果最明显，起效最早。
