Liu Shu, Chi Xiang-Feng, Kuang Wei-Chuan, Yu Liang-Wen
Graduate School of Guangzhou University of Traditional Chinese Medicine, Guangzhou 510006, China.
Department of Acupuncture-moxibustion and Rehabilitation, Guangdong Second Hospital of Traditional Chinese Medicine, Guangzhou 510095.
Zhen Ci Yan Jiu. 2019 May 25;44(5):367-72. doi: 10.13702/j.1000-0607.180725.
To compare the therapeutic effect of fire-needling plus stuck-needle-stretching and conventional acupuncture for post-stroke foot drop, so as to provide a reference foundation for optimizing clinical treatment regimen.
A total of 60 patients with post-stroke foot drop were equally randomized into a treatment group and a control group. In the treatment group, fire-needling plus stuck-needle-stretching was applied to acupoint pairs Jiexi (ST41)-Taichong (LR3), Xiajuxu (ST39)-ST41, Fenglong (ST40)-ST39, shangjuxu (ST37)-ST40, Zusanli (ST36)-ST37, Dubi (ST35)-ST36, Xuanzhong (GB39)-Qiuxu (GB40) on the affected side, and Chengshan (BL57) and Ashi points were swiftly pricked with red-hot filiform needle without needle retaining. In the conventional acupuncture group, the same acupoints were needled with filiform needles, and the treatment for both groups was given once a day, 6 times a week, for consecutive 4 weeks. The spasm severity of posterior triceps of the lower leg was evaluated using modified Ashworth scale, the tibial anterior muscle strength was measured using Lovett' and Martin's methods, the activities of daily living were assessed using modified Barthel's index, the walking ability was evaluated using Holden walking rating scale and the lower limb motor function assessed using Fugl-Meyer assessment scale, and the severity of foot drop was assessed in reference to Garceau criteria.
After the treatment, the score of the modified Ashworth scale was significantly reduced (<0.01), and those of Lovett muscle strength scale, Barthel index, Holden walking rating scale and Fugl-Meyer lower limb motor function scale were considerably increased in both groups versus their own pre-treatment (<0.01). The therapeutic effect of the treatment group was significantly superior to that of the control group in reducing Ashworth scale score and in increasing the scores of Lovett muscle strength test, Barthel index, Holden walking function scale and Fugl-Meyer lower limb motor function scale (<0.01). Of the two 30 cases in the control and treatment groups, 10(33.33%)and 14(46.67%) experienced a remarkable improvement, 10(33.33%)and 12(40.00%)were improved, 7(23.33%)and 3(10.00%)had a mild progress, 3(10.00%) and 1(3.33%) failed, with the excellent plus good effective rates being 66.67% and 86.67%, respectively, but without significant difference between the two groups (>0.05).
Both fire-needling plus stuck-needle-stretching and conventional acupuncture are effective in the treatment of post-stroke foot drop, but the former is relatively better.
比较火针结合滞针拉伸与传统针刺治疗中风后足下垂的疗效，为优化临床治疗方案提供参考依据。
将60例中风后足下垂患者随机分为治疗组和对照组，每组各30例。治疗组采用火针结合滞针拉伸法，针刺患侧解溪（ST41）-太冲（LR3）、下巨虚（ST39）-解溪（ST41）、丰隆（ST40）-下巨虚（ST39）、上巨虚（ST37）-丰隆（ST40）、足三里（ST36）-上巨虚（ST37）、犊鼻（ST35）-足三里（ST36）、悬钟（GB39）-丘墟（GB40）穴位对，并用烧红的毫针快速针刺承山（BL57）及阿是穴，不留针。传统针刺组采用毫针针刺上述相同穴位，两组均每日治疗1次，每周6次，连续治疗4周。采用改良Ashworth量表评估小腿三头肌痉挛程度，采用Lovett和Martin方法测量胫前肌肌力，采用改良Barthel指数评估日常生活活动能力，采用Holden步行评定量表评估步行能力，采用Fugl-Meyer评估量表评估下肢运动功能，并参照Garceau标准评估足下垂严重程度。
治疗后，两组改良Ashworth量表评分均显著降低（<0.01），Lovett肌力量表、Barthel指数、Holden步行评定量表及Fugl-Meyer下肢运动功能量表评分均较治疗前显著提高（<0.01）。治疗组在降低Ashworth量表评分及提高Lovett肌力测试、Barthel指数、Holden步行功能量表及Fugl-Meyer下肢运动功能量表评分方面，疗效显著优于对照组（<0.01）。对照组30例中，显效10例（33.33%），有效10例（33.33%），进步7例（23.33%），无效3例（10.00%）；治疗组30例中，显效14例（46.67%），有效12例（40.00%），进步3例（10.00%），无效1例（3.33%），两组优良率分别为66.67%和86.67%，但差异无统计学意义（>0.05）。
火针结合滞针拉伸与传统针刺治疗中风后足下垂均有效，但前者疗效相对更佳。
