Xu Lei, Li Lin, Du Jun-Tao, Tong Xin, Lu Yan, Li Fei
Department of Rehabilitation Medicine, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233004, Anhui Province, China.
The Second Department of Rehabilitation, The Second Affiliated Hospital of Anhui University of Chinese Medicine, Hefei 230061.
Zhen Ci Yan Jiu. 2022 Feb 25;47(2):154-9. doi: 10.13702/j.1000-0607.20210487.
To observe the effect of acupuncture at Huatuo Jiaji (EX-B2) combined with core muscle training on motor function of lower limbs, balance function and core muscle in patients with hemiplegia after stroke.
A total of ninety-six patients with hemiplegia after stroke were randomly and equally divided into acupuncture, training and combination groups (=32 cases in each). Patients of the acupuncture group were given acupuncture at the 5, 7, 9 and 11 chest vertebrae, and the 1 to 5 lumbar vertebrae of EX-B2. Patients in the training group received core muscle training. In the combination group, both acupuncture treatment and core muscle training were given to the patients. The treatment was conducted once daily, 5 times a week for 4 weeks. The Fugl-Meyer lower limb motor function score (FMA), Berg balance function scale (BBS), Barthel index (BI) and surface electromyography (sEMG) of the erector spinae and rectus abdominis were evaluated before and after treatment and during the follow-up period.
Compared with the scores before the treatment, the FMA, BBS and BI scores were obviously increased after the treatment and during the follow-up period in the three groups respectively (<0.05). After treatment and during the follow-up period, the root mean square (RMS) of erector spinae and rectus abdominis in the sitting position flexed 45° and extended 30° on the healthy and affected side were higher than those of the same side before treatment in the three groups (<0.05). The therapeutic effect of combination of acupuncture at EX-B2 and core muscle training was obviously superior to that of single acupuncture or single training (<0.05). Before the treatment, the RMS of erector spinae and rectus abdominis in the sitting position flexed 45° and extended 30° on the affected side were lower than those of the healthy side in the three groups (<0.05), while there was no significant difference between the RMS of the erector spinae and rectus abdominis of the affected side and the healthy side in the comprehensive group after treatment and during the follow-up period (P＞0.05).
Acupuncture at EX-B2 combined with core muscle training can significantly improve the balance function and lower limb motor function of patients with hemiplegia after stroke.
观察针刺华佗夹脊穴（EX - B2）结合核心肌群训练对脑卒中偏瘫患者下肢运动功能、平衡功能及核心肌群的影响。
将96例脑卒中偏瘫患者随机等分为针刺组、训练组和联合组（每组32例）。针刺组患者取EX - B2的胸5、7、9、11椎及腰1至腰5椎进行针刺。训练组患者接受核心肌群训练。联合组患者同时给予针刺治疗和核心肌群训练。治疗每日1次，每周5次，共4周。治疗前后及随访期间评估Fugl - Meyer下肢运动功能评分（FMA）、Berg平衡功能量表（BBS）、Barthel指数（BI）以及竖脊肌和腹直肌的表面肌电图（sEMG）。
与治疗前相比，三组治疗后及随访期间FMA、BBS和BI评分均明显升高（P＜0.05）。治疗后及随访期间，三组患者健侧和患侧坐位屈曲45°和伸展30°时竖脊肌和腹直肌的均方根（RMS）均高于治疗前同组同侧水平（P＜0.05）。EX - B2针刺结合核心肌群训练的治疗效果明显优于单纯针刺或单纯训练（P＜0.05）。治疗前，三组患者患侧坐位屈曲45°和伸展30°时竖脊肌和腹直肌的RMS低于健侧（P＜0.05），而联合组治疗后及随访期间患侧竖脊肌和腹直肌的RMS与健侧相比差异无统计学意义（P＞0.05）。
针刺EX - B2结合核心肌群训练可显著改善脑卒中偏瘫患者的平衡功能和下肢运动功能。
