Zhang Jian-Bo, Wei Rui-Peng, Yang Hong, Han Bing
Department of Rehabilitation Medicine, Ninth People's Hospital of Shenzhen, Shenzhen 518116, Guangdong Province, China.
Zhongguo Zhen Jiu. 2022 Apr 12;42(4):381-4. doi: 10.13703/j.0255-2930.20210406-k0001.
To compare the improvement effect between simultaneous electroacupuncture at antagonistic muscle and agonistic muscle and simple electroacupuncture at antagonistic muscle on spasticity degree, upper-extremity motor function and activity of daily living in patients with upper-extremity spasticity after stroke.
A total of 60 patients with upper-extremity spasticity after stroke were randomized into a comprehensive group (30 cases, 1 case dropped off) and an antagonistic muscle group (30 cases, 2 cases dropped off). In the antagonistic muscle group, acupuncture was applied at Jianyu (LI 15), Binao (LI 14), Zhouliao (LI 12), Shousanli (LI 10), Waiguan (TE 5) and Houxi (SI 3), electric stimulation was attached to Jianyu (LI 15)-Binao (LI 14), Zhouliao (LI 12)-Shousanli (LI 10) and Waiguan (TE 5)-Houxi (SI 3), with discontinuous wave, 15 Hz in frequency. On the basis of the treatment in the antagonistic muscle group, acupuncture was applied at Tianquan (PC 2), Chize (LU 5), Jianshi (PC 5) and Daling (PC 7) in the comprehensive group, electric stimulation was attached to Tianquan (PC 2)-Chize (LU 5) and Jianshi (PC 5)-Daling (PC 7), with continuous wave, 5 Hz in frequency. The treatment was given once a day, 6 days a week for 4 weeks in the two groups. Before and after treatment, the scores of modified Ashworth scale (MAS), Fugl-Meyer assessment upper extremity scale (FMA-UE) and modified Barthel index (MBI) scale were observed in the two groups.
Compared before treatment, the MAS scores of elbow flexors and wrist flexors after treatment were decreased (<0.05), the scores of FMA-UE and MBI scale after treatment were increased in the two groups (<0.05). The scores of FMA-UE and MBI scale after treatment in the comprehensive group were higher than those in the antagonistic muscle group (<0.05).
Simultaneous electroacupuncture at antagonistic muscle and agonistic muscle and simple electroacupuncture at antagonistic muscle can both improve the spasticity degree in patients with upper-extremity spasticity after stroke, however, the former can better restore motor function and improve activity of daily living.
比较拮抗肌与主动肌同步电针和单纯拮抗肌电针改善脑卒中后上肢痉挛患者痉挛程度、上肢运动功能及日常生活活动能力的效果。
将60例脑卒中后上肢痉挛患者随机分为综合组（30例，脱落1例）和拮抗肌群（30例，脱落2例）。拮抗肌群针刺肩髃（LI 15）、臂臑（LI 14）、肘髎（LI 12）、手三里（LI 10）、外关（TE 5）、后溪（SI 3），在肩髃（LI 15）-臂臑（LI 14）、肘髎（LI 12）-手三里（LI 10）、外关（TE 5）-后溪（SI 3）连接电刺激，采用断续波，频率15Hz。综合组在拮抗肌群治疗基础上，针刺天泉（PC 2）、尺泽（LU 5）、间使（PC 5）、大陵（PC 7），在天泉（PC 2）-尺泽（LU 5）、间使（PC 5）-大陵（PC 7）连接电刺激，采用连续波，频率5Hz。两组均每日治疗1次，每周6天，共4周。观察两组治疗前后改良Ashworth量表（MAS）、Fugl-Meyer上肢评定量表（FMA-UE）及改良Barthel指数（MBI）量表评分。
与治疗前比较，两组治疗后肘屈肌和腕屈肌MAS评分降低（<0.05），FMA-UE及MBI量表评分升高（<0.05）。综合组治疗后FMA-UE及MBI量表评分高于拮抗肌群（<0.05）。
拮抗肌与主动肌同步电针和单纯拮抗肌电针均可改善脑卒中后上肢痉挛患者的痉挛程度，但前者能更好地恢复运动功能，提高日常生活活动能力。
