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针刺联合康复治疗对脑缺血性卒中偏瘫患者肢体运动功能及血清环磷酸腺苷和环磷酸鸟苷的影响

[Influence of acupuncture combined with rehabilitation therapy on limb motor function and serum cAMP and cGMP in patients with hemiplegia of cerebral ischemic stroke].

作者信息

Jing Fu-Quan, Qin Hu, Liu Huan, Wang Zeng-Liang

机构信息

Department of Acupuncture-Moxibustion and Tuina.

Department of Neurosurgery, First Affiliated Hospital of Xinjiang Medical University, Urumqi 830011, China.

出版信息

Zhongguo Zhen Jiu. 2020 Jun 12;40(6):581-5. doi: 10.13703/j.0255-2930.20190613-k0001.

Abstract

OBJECTIVE

To evaluate the therapeutic effect of the combined treatment with balance acupuncture therapy and exercise re-learning rehabilitation therapy and the impact on serum cAMP and cGMP in the patients with hemiplegia of cerebral ischemic stroke.

METHODS

A total of 90 patients of hemiplegia of cerebral ischemic stroke were randomized into an observation group and a control group, 45 cases in each one. All of the patients in the two groups received health education, diet guidance, routine symptomatic treatment as well as exercise re-learning rehabilitation therapy. Additionally, in the observation group, balance acupuncture therapy was applied, in which, the acupoints on the aspect of the human body, on the governor vessel and bladder meridian were adopted in the morning and those on the aspect of the human body, on the conception vessel and kidney meridian were stimulated in the afternoon. In the control group, the regular acupuncture was given. In the two groups, both acupuncture and rehabilitation therapies were given 5 days a week, 2 week-treatment as one course and totally 2 courses were required. Separately, before and after treatment, the score of Fugl-Meyer assessment (FMA) and the score of Chinese stroke scale (CSS) were recorded, the levels of cyclic adenosine monophosphate (cAMP) and cyclic guanosine monophosphate (cGMP) detected in serum and the clinical therapeutic effect were evaluated in the two groups.

RESULTS

After treatment, FMA score was increased in the patients of either of the groups as compared with that before treatment (<0.01) and CSS score decreased as compared with that before treatment (<0.01). After treatment, FMA score in the observation group was higher than that in the control group (<0.01) and CSS score was lower than the control group (<0.01). After treatment, the level of serum cAMP of the patients in either of the groups was increased as compared with that before treatment (<0.01) and that of cGMP decreased as compared with that before treatment (<0.01). After treatment, the level of cAMP in the observation group was higher than that in the control group (<0.01) and that of cGMP was lower than the control group (<0.01). The total effective rate was 93.3% (42/45) in the observation group, better than 73.3% (33/45) in the control group (<0.01).

CONCLUSION

The balance acupuncture therapy combined with exercise re-learning rehabilitation effectively improves the motor function of the affected limb, relieves injury and regulate the levels of serum cAMP and cGMP in the patients with hemiplegia of ischemic stroke.

摘要

目的

评价平衡针灸疗法与运动再学习康复疗法联合治疗对脑缺血性卒中偏瘫患者的治疗效果及对血清环磷腺苷(cAMP)和环磷鸟苷(cGMP)的影响。

方法

将90例脑缺血性卒中偏瘫患者随机分为观察组和对照组,每组45例。两组患者均接受健康教育、饮食指导、常规对症治疗以及运动再学习康复疗法。此外,观察组采用平衡针灸疗法,上午选取人体侧面、督脉和膀胱经上的穴位,下午刺激人体侧面、任脉和肾经上的穴位。对照组采用常规针刺。两组针刺和康复治疗均每周5天,2周为1个疗程,共需2个疗程。分别记录两组治疗前后的Fugl-Meyer评估(FMA)评分和中国脑卒中量表(CSS)评分,检测血清中环磷腺苷(cAMP)和环磷鸟苷(cGMP)水平,并评价两组的临床治疗效果。

结果

治疗后,两组患者的FMA评分均较治疗前升高(<0.01),CSS评分较治疗前降低(<0.01)。治疗后,观察组FMA评分高于对照组(<0.01),CSS评分低于对照组(<0.01)。治疗后,两组患者血清cAMP水平均较治疗前升高(<0.01),cGMP水平较治疗前降低(<0.01)。治疗后,观察组cAMP水平高于对照组(<0.01),cGMP水平低于对照组(<0.01)。观察组总有效率为93.3%(42/45),优于对照组的73.3%(33/45)(<0.01)。

结论

平衡针灸疗法联合运动再学习康复疗法能有效改善缺血性卒中偏瘫患者患侧肢体运动功能,减轻损伤,并调节血清cAMP和cGMP水平。

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