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针刺治疗中风后上肢功能障碍的疗效:一项采用表面肌电图评估的随机对照试验方案

Efficacy of acupuncture on upper limb dysfunction after stroke: a randomized controlled trial protocol with surface electromyography evaluation.

作者信息

Wang Liying, Guo Zining, Zhang Jiewen, Lin Run, Tang Xiaorong, Gao Cui, Cui Shaoyang, Xu Nenggui

机构信息

Shenzhen Hospital (Fu Tian) of Guangzhou University of Chinese Medicine, Shenzhen, China.

South China Research Center for Acupuncture and Moxibustion, Medical College of Acu-Moxi and Rehabilitation, Guangzhou University of Chinese Medicine, Guangzhou, China.

出版信息

Front Med (Lausanne). 2025 Jul 10;12:1615762. doi: 10.3389/fmed.2025.1615762. eCollection 2025.

Abstract

BACKGROUND

Upper extremity functional reconstruction remains a major clinical challenge in post-stroke neurorehabilitation. Acupuncture has unique advantages as a complementary alternative therapy. Thus, in this study, we aim to compare sham acupuncture to reveal the efficacy and safety of acupuncture in the treatment of upper limb dysfunction post-stroke with surface electromyography (sEMG), a validated objective assessment tool, and a subjective index.

METHODS

In this prospective, principal-investigator-blinded randomized controlled trial, 74 patients who meet the inclusion criteria are randomly assigned to the acupuncture and sham acupuncture groups in a 1:1 ratio using a central randomization system. The patients receive the same routine basic treatment. The core acupoints selected in the acupuncture group are GV20 (Bai hui), DU14 (Da zhui), and LI11 (Qu chi). Six non-meridian acupuncture points are selected for the sham acupuncture group. The treatment cycle lasts for 4 weeks, five times per week, for 20 treatments. The Fugl-Meyer Upper Limb Assessment scale score is used as the main outcome. Secondary outcomes include the Motor Status Scale, Action Research Arm Test, Motor Assessment Scale, Self-rating Anxiety Scale, and Self-rating Depression Scale scores. Simultaneously using sEMG as an auxiliary efficacy indicator.

CONCLUSION

This study assesses the effectiveness and safety of acupuncture for post-stroke upper limb impairment in multiple aspects and elucidates the underlying neuromuscular effect mechanism of acupuncture to provide clinical evidence.

REGISTRATION

International Traditional Medicine Clinical Trials Registry. Registration No. ITMCTR2025000228. November 27, 2024. The study was approved by the Ethics Committee of Guangzhou University of Traditional Chinese Medicine, Shenzhen Hospital (Futian), Ethics. No. GZYLL (KY)-2024-045-01. November 13, 2024.

摘要

背景

上肢功能重建仍是中风后神经康复中的一项重大临床挑战。针灸作为一种补充替代疗法具有独特优势。因此,在本研究中,我们旨在通过表面肌电图(sEMG,一种经过验证的客观评估工具)和主观指标,比较假针灸以揭示针灸治疗中风后上肢功能障碍的疗效和安全性。

方法

在这项前瞻性、研究者设盲的随机对照试验中,74名符合纳入标准的患者使用中央随机系统以1:1的比例随机分配到针灸组和假针灸组。患者接受相同的常规基础治疗。针灸组选取的核心穴位为GV20(百会)、DU14(大椎)和LI11(曲池)。假针灸组选取六个非经穴。治疗周期持续4周,每周五次,共20次治疗。采用Fugl-Meyer上肢评估量表评分作为主要结局指标。次要结局指标包括运动状态量表、动作研究臂试验、运动评估量表、自评焦虑量表和自评抑郁量表评分。同时使用sEMG作为辅助疗效指标。

结论

本研究从多个方面评估针灸治疗中风后上肢功能障碍的有效性和安全性,并阐明针灸潜在的神经肌肉作用机制,以提供临床证据。

注册信息

国际传统医学临床试验注册库。注册号:ITMCTR2025000228。2024年11月27日。本研究已获得广州中医药大学深圳医院(福田)伦理委员会批准,伦理号:GZYLL(KY)-2024-045-01。2024年11月13日。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2f5b/12287058/d10bdf48e3db/fmed-12-1615762-g001.jpg

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